3500 Exam 4 Box Review
April said in Class
April said in Review
Normal Newborn Vital Signs:
● HR: 110-160
● RR: 40-60 rpm
○ Tachypnea: more than 60 rpm
● BP: <2000g=50/35mmHg 2000g -3000g=60/35mmHg >3000g=51/40mmHg
● Temp: 97 and up
● Normal Newborn Blood Sugar → 40-60 mg/dL
Mila (Milk Spots) Vernix Lanugo
Small white papules or sebaceous cysts White naturally occurring biofilm that Fine, downy hair noted on infant’s
on infant’s face that resembles pimples covers skin of newborn back, shoulders, head (large =
● Can be present in axillary & preterm)
genital areas (large = preterm)
Mongolian Spots → Are Benign
● Areas that appear gray, dark, blue or purple
● Commonly located on back/buttocks can also be found on shoulders, wrists, forearms, & ankles
● Mostly in infants ethnic background: Mediterranean, Latin America, Asia or Africa
● Will fade/disappear usually as infant gets older
● b/c can be mistaken for bruises, important to document on infant’s chart
Telangiectatic Nevus AKA Stork Bite:
● Red birthmark often seen at nape of neck & commonly referred to as a “stork bite” or “angel kiss”
● Can occur on face b/w the eyebrows or on eyelids, nose, or upper lip
Epstein Pearls - whitish hardened nodules on gums or roof of mouth, may be visualized or palpated
Red Reflex:
● Tested by viewing pupil through an ophthalmoscope from a distance of 10 inches
● If pupil appears red, the finding is normal
● A white retinal reflex may indicate cataracts, retinoblastoma or chorioretinitis
1
,Normal Newborn Assessment:
● Hands = clenched = normal finding
○ If the baby is clenched w/ the thumb is tucked inside their fist = abnormal
● Skin:
○ POSTTERM → normal for fingernails to be long & skin is cracked & peely
■ Cracked & peely not normal finding in a TERM baby!
● Baby’s suture lines are together:
○ Is it normal for a diamond shape where it all comes together: yes normal in a term newborn
● Preterm:
○ Ears push down/ slow recoil
○ Large amount of vernix or lanugo
○ Skin is thin & translucent
○ Males → both testicles have not distended
○ Females → labia mejora (fatty tissue) would be flat
● Term Baby female could have vagina discharge from mom’s hormones
Newborn Reflexes:
● Sucking - place finger or object in mouth and baby will suck
● Rooting - stroke baby cheek will turn head to suck
● Palmar - infant curls fingers around object in hand
● Moro - extension of both arms along with flexion of legs when baby is startled
● Plantar - infant curls toes around an object at sole of foot
● Babinski - stroke sole of foot from heel to toes, toes should fan out
APGAR → know categories
● A score lower than 7 → LOW
● Assigned at:
○ 1 min
○ 5 min
○ 10 min → don’t usually do if baby is
doing great, but can do
● 5 minute APGAR score of 7-10 is NORMAL
● If baby gets a low APGAR @ 1 min & 5 min
○ Doing resuscitation → bagging baby &
call NICU (brings their equipment)
● When baby is crying vigorously →
acrocyanosis can go away & baby can get an
APGAR score of 10
Acrocyanosis: Most newborns exhibit cyanosis of extremities at 1-min APGAR check, and this normal finding is
termed acrocyanosis
2
, Heat:
● Babies are not swaddled in nursery warmer beds b/c they can get too hot!
● Do not put several layers on just one onesie!
Newborn Medications:
● Eye Prophylaxis:
○ Has to be done within first hour of birth
○ Place ointment at inner canthus → outer canthus
○ It prevents eye infection
○ One time dose
● Vitamin K → p. 313
○ Given within (1hr) 2 hr after birth
○ Injected in Vastus Lateralis → CAN MASSAGE IN to promote absorption & decrease discomfort
○ Med!! Not vaccine
○ Given b/c newborn has absence of Vitamin K at birth & risk of developing a blood clotting
deficiency → prevent hemorrhagic disease!
■ If family refuses then male baby can not get circumcised
● Hep B Vaccine:
○ Consent needed!
○ Given within 12 hrs after birth
○ Injected in vastus lateralis → DO NOT MASSAGE IN
Oxygenation → Bulb Suctioning Technique:
● 1st mouth (side to side) & 2nd nose (each nostril)
● Steps for Oral:
○ Position infant’s head to side or downward if vomiting/gagging
○ Compress bulb syringe from BOTTOM
○ Insert bulb syringe on 1 side of infant’s cheek
■ Avoid roof of mouth & back of throat → To prevent damage & stimulation of gag reflex
○ Gently release compression of bulb syringe & allow to fill with oral secretions
○ Gently remove bulb syringe - expel drainage
○ Repeat process on other side of cheek & repeat as needed
● Steps for Nasal:
○ Position infant head to side or downward if vomiting/gagging
○ Compress bulb from BOTTOM
○ Insert bulb into tip of infant’s nostril, avoiding obstruction of pathway
○ Gently release compression to allow to fill w/ drainage
○ Gently remove bulb & expel drainage, repeat as needed
Umbilical cord + Vein/Arteries:
● 1 VEIN → that carries food & oxygen from placenta to your baby
3
April said in Class
April said in Review
Normal Newborn Vital Signs:
● HR: 110-160
● RR: 40-60 rpm
○ Tachypnea: more than 60 rpm
● BP: <2000g=50/35mmHg 2000g -3000g=60/35mmHg >3000g=51/40mmHg
● Temp: 97 and up
● Normal Newborn Blood Sugar → 40-60 mg/dL
Mila (Milk Spots) Vernix Lanugo
Small white papules or sebaceous cysts White naturally occurring biofilm that Fine, downy hair noted on infant’s
on infant’s face that resembles pimples covers skin of newborn back, shoulders, head (large =
● Can be present in axillary & preterm)
genital areas (large = preterm)
Mongolian Spots → Are Benign
● Areas that appear gray, dark, blue or purple
● Commonly located on back/buttocks can also be found on shoulders, wrists, forearms, & ankles
● Mostly in infants ethnic background: Mediterranean, Latin America, Asia or Africa
● Will fade/disappear usually as infant gets older
● b/c can be mistaken for bruises, important to document on infant’s chart
Telangiectatic Nevus AKA Stork Bite:
● Red birthmark often seen at nape of neck & commonly referred to as a “stork bite” or “angel kiss”
● Can occur on face b/w the eyebrows or on eyelids, nose, or upper lip
Epstein Pearls - whitish hardened nodules on gums or roof of mouth, may be visualized or palpated
Red Reflex:
● Tested by viewing pupil through an ophthalmoscope from a distance of 10 inches
● If pupil appears red, the finding is normal
● A white retinal reflex may indicate cataracts, retinoblastoma or chorioretinitis
1
,Normal Newborn Assessment:
● Hands = clenched = normal finding
○ If the baby is clenched w/ the thumb is tucked inside their fist = abnormal
● Skin:
○ POSTTERM → normal for fingernails to be long & skin is cracked & peely
■ Cracked & peely not normal finding in a TERM baby!
● Baby’s suture lines are together:
○ Is it normal for a diamond shape where it all comes together: yes normal in a term newborn
● Preterm:
○ Ears push down/ slow recoil
○ Large amount of vernix or lanugo
○ Skin is thin & translucent
○ Males → both testicles have not distended
○ Females → labia mejora (fatty tissue) would be flat
● Term Baby female could have vagina discharge from mom’s hormones
Newborn Reflexes:
● Sucking - place finger or object in mouth and baby will suck
● Rooting - stroke baby cheek will turn head to suck
● Palmar - infant curls fingers around object in hand
● Moro - extension of both arms along with flexion of legs when baby is startled
● Plantar - infant curls toes around an object at sole of foot
● Babinski - stroke sole of foot from heel to toes, toes should fan out
APGAR → know categories
● A score lower than 7 → LOW
● Assigned at:
○ 1 min
○ 5 min
○ 10 min → don’t usually do if baby is
doing great, but can do
● 5 minute APGAR score of 7-10 is NORMAL
● If baby gets a low APGAR @ 1 min & 5 min
○ Doing resuscitation → bagging baby &
call NICU (brings their equipment)
● When baby is crying vigorously →
acrocyanosis can go away & baby can get an
APGAR score of 10
Acrocyanosis: Most newborns exhibit cyanosis of extremities at 1-min APGAR check, and this normal finding is
termed acrocyanosis
2
, Heat:
● Babies are not swaddled in nursery warmer beds b/c they can get too hot!
● Do not put several layers on just one onesie!
Newborn Medications:
● Eye Prophylaxis:
○ Has to be done within first hour of birth
○ Place ointment at inner canthus → outer canthus
○ It prevents eye infection
○ One time dose
● Vitamin K → p. 313
○ Given within (1hr) 2 hr after birth
○ Injected in Vastus Lateralis → CAN MASSAGE IN to promote absorption & decrease discomfort
○ Med!! Not vaccine
○ Given b/c newborn has absence of Vitamin K at birth & risk of developing a blood clotting
deficiency → prevent hemorrhagic disease!
■ If family refuses then male baby can not get circumcised
● Hep B Vaccine:
○ Consent needed!
○ Given within 12 hrs after birth
○ Injected in vastus lateralis → DO NOT MASSAGE IN
Oxygenation → Bulb Suctioning Technique:
● 1st mouth (side to side) & 2nd nose (each nostril)
● Steps for Oral:
○ Position infant’s head to side or downward if vomiting/gagging
○ Compress bulb syringe from BOTTOM
○ Insert bulb syringe on 1 side of infant’s cheek
■ Avoid roof of mouth & back of throat → To prevent damage & stimulation of gag reflex
○ Gently release compression of bulb syringe & allow to fill with oral secretions
○ Gently remove bulb syringe - expel drainage
○ Repeat process on other side of cheek & repeat as needed
● Steps for Nasal:
○ Position infant head to side or downward if vomiting/gagging
○ Compress bulb from BOTTOM
○ Insert bulb into tip of infant’s nostril, avoiding obstruction of pathway
○ Gently release compression to allow to fill w/ drainage
○ Gently remove bulb & expel drainage, repeat as needed
Umbilical cord + Vein/Arteries:
● 1 VEIN → that carries food & oxygen from placenta to your baby
3
