NURS 210 Exam Four Study Guide 2024

Neonatal period - first 28 days of life umbilical cord is cut and the neonate takes a first breath Your role as the nurse - -maintaining respiratory and cardiac function -maintaining body heat -decreasing the risk for infection -assessing for signs of complications -assisting parents in providing appropriate nutrition -educating parents in caring for their newborn Normal temp - 97.7-99 Normal respiratory rate - 30-60 Normal heart rate - 110-160 Normal weight - grams 5.5-9.0 lbs Normal glucose - 40-60 mg/dl Normal total bilirubin - 0.3-1.0 mg/dl Apgar score - -appearance (skin color) -pulse -grimace (reflex irritability) -activity (muscle tone) -respirations *check at 1 min and 5 mins. If score is less than 7 at 5 minutes recheck in 10 minutes Mechanical stimuli- Chemical stimuli- Sensory stemuli- - -during labor and birth -po2 level low at birth -sound, light, touch is needed to keep alveoli open for gas exchange (removes co2 and gets o2) - surfactant Signs of respiratory distress - -central cyanosis -tachypnea -apnea -grunting -flaring of nostrils -retractions of the chest wall -hypotonia (late sign) Environment needed for hypothermia and cold stress risk - neutral thermal environment (nte) Neonate responds to cold by: - -increase in metabolic rate and oxygen consumption -increase in muscle activity and flexed position -peripheral vascular constriction -metabolism of brown adipose tissue (bat) Heat lost by fan or air conditioner - convection Heat lost by the walls of a cold isolette - radiation Heat lost by not drying the baby off/no cap on the baby - evaporation Heat lost by setting a cold stethoscope on the baby's chest - conduction High level of unconjugated bilirubin in the neonate's blood - hyperbilirubinemia *jaundice Meconium - sticky, thick, greenish-black, and odorless *passed within first 24-48 hours Transitional stool - black to greenish brown or yellow Breastfed stool - yellow and semiformal, later it becomes golden yellow with a pasty consistency, "seedy" appearance, and sour odor Formula-fed stool - firmer and more formed than breastfed stool, it is a paler yellow or brownish yellow and has an unpleasant odor Diarrhea stool - loose, watery, and green Newborn must void within first - 24 hours Newborn may lose % body weight due to dieresis (normal) - 5-10% Milia - small raised white spots on nose, chin, and forehead Lanugo - fine, soft hair on the fetal body Vernix - a greasy deposit covering the skin of a baby at birth Molding - shaping of the fetal head during movement through the birth canal Mongolian spots - areas of deep bluish-gray pigmentation most commonly on the sacral aspect of a newborn Acrocyanosis - bluish extremities and not true cyanosis; check mucous membranes of mouth, tongue, and nail beds Caput vs cephalohematoma - caput crosses suture lines (creating a cap) Cephalohematoma is subperiosteal so does not cross (bad) Moro reflex - startle in response to a loud sound or sudden movement Tonic reflex - turning head to one side and extends the arm and leg on that side and flexes the arm and leg on other side Rooting reflex - when touched on the cheek, turns toward the touch, opens the mouth, and searches for the nipple Sucking reflex - sucking motions when a finger or nipple if placed in the mouth Babinski reflex - fans out the toes when the sole of the foot is touched Palmar/plantar reflex - grasps finger when stroked against palm/plantar surface of infant