NSG 3500
EXAM 4 STUDY GUIDE
Unit 9 & 10 Study Guide
Nursing Practice – Maternal Health
Galen College of Nursing
, MATERNITY – EXAM 4
NEWBORN ASSESSMENT CH 17, 18, 19
Babies come out covered in secretions
o !!!!Always wear gloves (family members should wear gloves as well)
o Typically, don’t bathe babies for 24 hours
Physiological transition of the newborn:
Initiation of Respirations
Airway is always FIRST!!
Normal to hear fluid in lungs until it’s absorbed
Should see equal rise/fall of chest
Should see
!!!!Surfactant: lipid-based substance in lungs. Alveoli needs to stay open for there to be gas exchange.
Surfactant is made from 34 weeks on, it prevents molecules from sticking to each other. Very important
to understand that premature babies DO NOT have surfactant…younger than 34 weeks won’t have it.
Must GIVE premature babies Surfactant. (Give mom tocolytic and Betamethasone to promote lung
development)
Cardiovascular Adaptations
Good circulation is very important
Very different circulation in utero and outside mom
!!!! Look for signs of good perfusion: do they have
Cyanosis or not?
mucous membranes to get an idea
athrocyanosis is NORMAL (can last roughly 24 hrs)
cap refill should be less than
HR should be 110-160 (<100 need intervention)
Normal to hear murmurs in the first 24 hours of birth.
More concerned to hear heart murmurs after 24 hours, they should be closing
Thermogenic Adaptations
Must keep them warm!
!!!!Brown fat: specifically used to burn for ENERGY
Premature babies can’t keep themselves warm! Will have trouble with temperatures
Heat loss
Fluid on baby that is evaporated by the air takes heat off, dry them off quickly (Evaporation)
Weigh them: if you do skin on scale, baby will LOSE heat (Conduction – touching)
Environment itself is cooler, dropping baby’s temp (Radiation)
take baby’s crib and put it under the air vent cooling baby (Convection)
Babies do not have the ability to shiver! They can only get heat through their brown fat (if they shiver
it’s NOT from being cold)
Best way to get baby warm: skin to skin (preferred), radiant warmers
First 24 hours keep in 2 blankets and a hat
After that, whatever mom is comfortable in + one layer
EXAM 4 STUDY GUIDE
Unit 9 & 10 Study Guide
Nursing Practice – Maternal Health
Galen College of Nursing
, MATERNITY – EXAM 4
NEWBORN ASSESSMENT CH 17, 18, 19
Babies come out covered in secretions
o !!!!Always wear gloves (family members should wear gloves as well)
o Typically, don’t bathe babies for 24 hours
Physiological transition of the newborn:
Initiation of Respirations
Airway is always FIRST!!
Normal to hear fluid in lungs until it’s absorbed
Should see equal rise/fall of chest
Should see
!!!!Surfactant: lipid-based substance in lungs. Alveoli needs to stay open for there to be gas exchange.
Surfactant is made from 34 weeks on, it prevents molecules from sticking to each other. Very important
to understand that premature babies DO NOT have surfactant…younger than 34 weeks won’t have it.
Must GIVE premature babies Surfactant. (Give mom tocolytic and Betamethasone to promote lung
development)
Cardiovascular Adaptations
Good circulation is very important
Very different circulation in utero and outside mom
!!!! Look for signs of good perfusion: do they have
Cyanosis or not?
mucous membranes to get an idea
athrocyanosis is NORMAL (can last roughly 24 hrs)
cap refill should be less than
HR should be 110-160 (<100 need intervention)
Normal to hear murmurs in the first 24 hours of birth.
More concerned to hear heart murmurs after 24 hours, they should be closing
Thermogenic Adaptations
Must keep them warm!
!!!!Brown fat: specifically used to burn for ENERGY
Premature babies can’t keep themselves warm! Will have trouble with temperatures
Heat loss
Fluid on baby that is evaporated by the air takes heat off, dry them off quickly (Evaporation)
Weigh them: if you do skin on scale, baby will LOSE heat (Conduction – touching)
Environment itself is cooler, dropping baby’s temp (Radiation)
take baby’s crib and put it under the air vent cooling baby (Convection)
Babies do not have the ability to shiver! They can only get heat through their brown fat (if they shiver
it’s NOT from being cold)
Best way to get baby warm: skin to skin (preferred), radiant warmers
First 24 hours keep in 2 blankets and a hat
After that, whatever mom is comfortable in + one layer
