Preterm: Born before end of 37 weeks regardless of wt.

Full term: Born between 38-42 weeks regardless of wt.

Post term: Born after 42 weeks regardless of wt.

Low birth wt: Born less than 5.5lbs or 2,500gm

IUGR(intrauterine growth retardation): growth restriction can be caused by HTN or placenta causes. Failure of fetus to grow as expected during gestation.

SGA(small for gestational age): 10th and lower percentile of all babies.

LGA(large for gestational age): 90th and above percentile of all babies.

Immediate assessment of cardiac and respiratory.

Done at 1, 5, and 10 minutes.

10 total points possible.

Asssesed on 5 categories: HR, respiratory effort, muscle tone, reflex irratability, color.

A healthy baby will be 7 or greater.

An assessment is done q5m until a score of 7 is reached.

Is a 9 at the first minute and 9 at 5 minutes.

It's because of color.

They're circulation isn't getting to the extremities because it's focusing on the vital organs.

This is normal.

Ability of the newborn infant to produce and maintain a normal body temperature on their own.

Maintaing newborn temperature is one of your main tasks.

Large body surface area relative to weight.

Thin skin

Little subcutaneous Fat

Head is 40% of total weight and most heat is lost through the head.

They have an inability to shiver.

Evaporation: When skin is wet and moisture evaporates through air.

Conduction: Heat is lost to cooler suface by direct contact.

Convection: heat is lost by cold air current/draft.

Dry immediately (helps them cry as well)

Hat

Pre-warmed blankies

Skin to skin contact

Protect from drafts

Warm all surfaces before they contact neonate (hands & stethoscope)

Only bathe when temp above 97.7

Do not submerge in water. Not until umbilical cord falls off.

Body temp less than 97.6

Can be harmful or fatal.

Oxygenation is compromised. Oxygen requirements go up. Can send them into respiratory distress.

Whole body is working over time causes them to become hypoglycemia because they're burning off the sugar.

Jitteriness & irritability

Poor Feeding

Listlessness & Lethargy

Apnea & respiratory distress

High pitched cry

Large babies

Gestational or type 1/2 diabetes

Because baby is used to living with high blood sugar and pancreas is secreting high amounts of insulin.

After you cut the cord pancreas still secretes the high amounts of insulin and the blood sugar drops.

Erythromycin eye ointment ASAP following delivery

Proper umbilical cord care

Watch for S/SX of infection. Clean the base of the cord with alcohol. Clean and dry it.

Babies are born with immature clotting mechanisms.

Vitamin K is produced in the gut and babies gut is immature at birth.

They need a Vitamin K/aquamephyton shot at birth to help prevent hemorrhage.

Identification Bands!

You must identify a baby every time the baby goes to the mother or guardian.

NO EXCEPTIONS!!!

When umbilical cord is severed at delivery, closure of fetal circulatory structures begin. Umbilical vein and arteries contract and eventually become ligaments.

Ductus Arteriosis: Shunt between the pulmonary artery and the aorta. As the pulmonary arterioles dilate in response to increased O2, the ductus arteriosis constracts and closes 15-24 hours after birth.

If oxygenation decreases, ductus arteriosis may reopen during first few weeks resulting in R sided heart failure and pulmonary congestion, which means it's a patent ductus arteriosis PDA.

Resolving Fetal Adaptation Structures

Cont'd

Ductus Venosus: Allows oxygenated blood from the mother to mostly bypass the liver and enter the inferior vena cava. 

Clamping the umbilical cord causes the blood flow through the ductus venosus to stop and it constricts and becomes a ligament.

PKU: Metabolic screening for the genetic disease phenylketouria which causes build up of metabolic byproducts which affect the brain causing mental retardation. Also tests for 7 other inborn diseases of metabolism. Need to ingest protein before test. Heel stick test. TX: Diet low in phenylalanine.

Hearing Screen: Hooked up to electrodes and look at brain waves.

Hypoglycemia: If at risk of symptomatic, heel stick is done. 40-80 is normal range.

Caput Succedaneum: Crosses the suture line

Cephalohematoma: Doesn't cross the suture line