Chapters 17, 18, 23 and REVIEW OF NEWBORN AND HIGH RISK
24 NEWBORN
Common Skin Variations
a. Stork Bite - salmon patches - superficial vascular areas found on the neck, eyelids,
and between the eyes and upper lip. Caused by concentration of immature blood
vessels. Fade in 1 year
b. Milia - pearly white or pale yellow sebaceous glands found on the nose.
Maybe chin and forehead. Epstein pearls - occur in mouth and gums.
c. Mongolian Spots - benign blue/purple splotches on lower back and buttocks.
Concentration of pigmented cells. Disappear in 4 years. Kinda looks like a bruise.
d. Erythema Toxicum - newborn rash, small papules or pustules on skin. Lack of
pattern. Caused by newborn’s eosinophils reacting to the environment. Disappear
in a few days
e. Nevus Flammeus (Port Wine Stain) - newborn face. Capillary angioma located
directly below the dermis. Purple red. Can be large (covering half a leg). Permanent
and will not fade.Possible Structural malformation such as bony/muscular
overgrowth and certain cancers.They should be monitored with periodic eye
exams, neurologic imaging and extremity measurements.
f. Strawberry Hemangioma - raised rough dark red. Referral if visual, airway, or
ear canal abnormalities.
OB Final Review
Ch. 17
Newborn transitioning
● Circulation - newborns first breath. Air pushes into the lungs and increases pulmonary
blood flow
● Pressure in left atrium becomes higher than in right atrium. This increase left
atrial pressure causes the foramen ovale to close
● Ductus venosus closes because it is no longer needed to shunt blood from the
umbilical vein to the inferior vena cava
● Liver takes over functions of the placenta
● Ductus arteriosus closes due to increase O2 levels in pulmonary circulation
(it's no longer needed to shunt blood away from pulmonary circulation) ***
Newborn values:
Hemoglobin 16-18
Hematocrit 46-
68 Platelet
150-350k RBCs
4.5-7
WBC 10-30k
After respirations are established in the newborn, they are shallow & irregular (30-60/min)
Periodic breathing - cessation of breathing that lasts 5-10 seconds without changes in color
or heart rate (its normal)
● Apnea lasts >15seconds. With cyanosis with rate changes
Thermoregulation - process of maintaining the balance b/w heat loss and heat
production in order to maintain the body's core internal temperature
Conduction - cold surface
Convection - cold air blowing over
infant Evaporation
Radiation - in fault losing heat toward the cold source
, Chapters 17, 18, 23 and REVIEW OF NEWBORN AND HIGH RISK
24 NEWBORN
Cold Stress - excessive heat loss that requiring a newborn to use compensatory
mechanisms such as nonshivering and tachypnea. All newborns are at risk for cold stress
especially within first 12 hours
● babies have lack of shivering ability
● Less active, lethargic, hypotonic, and weak
Glucose - essential fuel for brain metabolism. Serum levels DECREASE at birth but
newborn learn to regulate and adjust to feeding schedule
Initiating early breast or bottle feedings helps stabilize glucose
levels Principle source of bilirubin in the newborn is hemolysis
of erythrocytes
Failure of the liver cells to breakdown and excrete bilirubin can cause the levels in blood
stream to rise called jaundice (icterus)
Very high levels can cause brain damage in even healthy infants
6.8 voidings daily is average and indicates adequate fluid intake. Baby cannot
concentrate urine until 3 months
A reflex is an involuntary muscular response to a sensory stimulus. It is an imd. Indication
of neurological development.
Newborns Patterns of Behavior
● 1st: overactivity birth 30-2hrs awake/alert
● 2nd phase - decreased responsiveness. Infant sleeps
● 3rd - second period of reactivity: lasts 2-8 hours. It is not uncommon for the
newborn to pass meconium or void during this period
Orientation - response of newborns to stimulus
Habituation - newborns ability to process and respond to visual and auditory stimuli. Also
ability to block out external stimuli.
Major source of IgA = breast milk. Works for
immunity IgE = allergic
IgG = immunoglobulin
Motor maturity - evaluation of posture time coordination, movements. Bringing the hand up
to the mouth is a good example of motor organ
Self quieting - ability of newborn to quiet/comfort themselves
CHAPTER 18
Apgar Score given at 1 minute and 5 minute
● After birth normal score 8-10…. 4-7 is moderate difficulty…. 0-3 severe distress
● Sneezing is 2 points
Term newborns weight 2500-4000 grams
Newborn can lose up to 10% of initial birth weight by 3-4 days of age
24 NEWBORN
Common Skin Variations
a. Stork Bite - salmon patches - superficial vascular areas found on the neck, eyelids,
and between the eyes and upper lip. Caused by concentration of immature blood
vessels. Fade in 1 year
b. Milia - pearly white or pale yellow sebaceous glands found on the nose.
Maybe chin and forehead. Epstein pearls - occur in mouth and gums.
c. Mongolian Spots - benign blue/purple splotches on lower back and buttocks.
Concentration of pigmented cells. Disappear in 4 years. Kinda looks like a bruise.
d. Erythema Toxicum - newborn rash, small papules or pustules on skin. Lack of
pattern. Caused by newborn’s eosinophils reacting to the environment. Disappear
in a few days
e. Nevus Flammeus (Port Wine Stain) - newborn face. Capillary angioma located
directly below the dermis. Purple red. Can be large (covering half a leg). Permanent
and will not fade.Possible Structural malformation such as bony/muscular
overgrowth and certain cancers.They should be monitored with periodic eye
exams, neurologic imaging and extremity measurements.
f. Strawberry Hemangioma - raised rough dark red. Referral if visual, airway, or
ear canal abnormalities.
OB Final Review
Ch. 17
Newborn transitioning
● Circulation - newborns first breath. Air pushes into the lungs and increases pulmonary
blood flow
● Pressure in left atrium becomes higher than in right atrium. This increase left
atrial pressure causes the foramen ovale to close
● Ductus venosus closes because it is no longer needed to shunt blood from the
umbilical vein to the inferior vena cava
● Liver takes over functions of the placenta
● Ductus arteriosus closes due to increase O2 levels in pulmonary circulation
(it's no longer needed to shunt blood away from pulmonary circulation) ***
Newborn values:
Hemoglobin 16-18
Hematocrit 46-
68 Platelet
150-350k RBCs
4.5-7
WBC 10-30k
After respirations are established in the newborn, they are shallow & irregular (30-60/min)
Periodic breathing - cessation of breathing that lasts 5-10 seconds without changes in color
or heart rate (its normal)
● Apnea lasts >15seconds. With cyanosis with rate changes
Thermoregulation - process of maintaining the balance b/w heat loss and heat
production in order to maintain the body's core internal temperature
Conduction - cold surface
Convection - cold air blowing over
infant Evaporation
Radiation - in fault losing heat toward the cold source
, Chapters 17, 18, 23 and REVIEW OF NEWBORN AND HIGH RISK
24 NEWBORN
Cold Stress - excessive heat loss that requiring a newborn to use compensatory
mechanisms such as nonshivering and tachypnea. All newborns are at risk for cold stress
especially within first 12 hours
● babies have lack of shivering ability
● Less active, lethargic, hypotonic, and weak
Glucose - essential fuel for brain metabolism. Serum levels DECREASE at birth but
newborn learn to regulate and adjust to feeding schedule
Initiating early breast or bottle feedings helps stabilize glucose
levels Principle source of bilirubin in the newborn is hemolysis
of erythrocytes
Failure of the liver cells to breakdown and excrete bilirubin can cause the levels in blood
stream to rise called jaundice (icterus)
Very high levels can cause brain damage in even healthy infants
6.8 voidings daily is average and indicates adequate fluid intake. Baby cannot
concentrate urine until 3 months
A reflex is an involuntary muscular response to a sensory stimulus. It is an imd. Indication
of neurological development.
Newborns Patterns of Behavior
● 1st: overactivity birth 30-2hrs awake/alert
● 2nd phase - decreased responsiveness. Infant sleeps
● 3rd - second period of reactivity: lasts 2-8 hours. It is not uncommon for the
newborn to pass meconium or void during this period
Orientation - response of newborns to stimulus
Habituation - newborns ability to process and respond to visual and auditory stimuli. Also
ability to block out external stimuli.
Major source of IgA = breast milk. Works for
immunity IgE = allergic
IgG = immunoglobulin
Motor maturity - evaluation of posture time coordination, movements. Bringing the hand up
to the mouth is a good example of motor organ
Self quieting - ability of newborn to quiet/comfort themselves
CHAPTER 18
Apgar Score given at 1 minute and 5 minute
● After birth normal score 8-10…. 4-7 is moderate difficulty…. 0-3 severe distress
● Sneezing is 2 points
Term newborns weight 2500-4000 grams
Newborn can lose up to 10% of initial birth weight by 3-4 days of age
