NUR 306 Exam QUSTIONS AND WELL
DETAILED ANSWERS
Gestatational age - ANSWER>>time _between conception and birth____
"normal" pregnancy time frame ?
timeframe: 38-42 weeks
longer in uterus is not better, can have just as many health problems
Why do we care about gestational age assessment - ANSWER>>gestational age
can be a warning of health problems (pre-term or post term)
What are the two parts of the gestational age assessment - ANSWER>>1. External
physical characteristics
2. Neurological or neuromuscular development
Term range - ANSWER>>gestational age of _37-41 6/7 wks______
posterm range - ANSWER>>gestational age of __42 weeks or more_________
preterm range - ANSWER>>gestational age of ___less than 37 weeks _____
skin: pre term - ANSWER>>thin and transparent with veins prominent
skin: post term - ANSWER>>long hair and nails, no lanugo or vernix
skin: term - ANSWER>>opaque and disappearance of the vernix caseosa
Indication of maturity
Waxy, white, "cheese like" coating
Lanugo hair - ANSWER>>Found all over except for hands & soles of feet, >20wks
gestation
,peach hair, starts at 20 weeks, then reaches peak, and then decreases
___decreasess_ as gestational age __increases______
Sole (plantar) creases - ANSWER>>As gestation progresses, proceeds to the heel
Must be completed in the first 12 hours of life, why?
Age increases dry foot and creases appear
"Slick heels" = usually preterm
Breast bud - ANSWER>>Term: the tissue will measure between 0.5 and 1 cm
Bud Size determined by amount of subcutaneous fat deposits
LGA vs SGA
term increase fat deposits= increase breast bud tissue
increase with increase of gestational age
Ear form - ANSWER>>Preterm - relatively shapeless and flat, no recoil (34 wks or
less)
Term - some cartilage and slight incurving of the upper pinna, good recoil
Male genitals - ANSWER>>Preterm - small scrotum, few rugae (creases and
ridges) , testes are palpable in the inguinal canal (36 wks or less)
Term - testes are generally in the lower scrotum, which is pendulous and covered
with rugae
female genitals - ANSWER>>Preterm - clitoris is prominent, labia majora are small
and widely separated, and labia minora protrude
Term - labia majora cover the labia minora and clitoris
_Nutritional status_indicator for females ( a variable that could have an impact on
how it looks)
Presence of female genitals depends upon the amount of subcutaneous fat
posture - ANSWER>>Fully flexed = increased gestational age (term)
Fully extended
,*the more term babies have more flexion and resistance (the only exception is
the square window where the preterm has a larger angle and the term is more
flexible)
Square window - ANSWER>>Degree of angle
90 degrees = decreased gestational age (preterm)
30-40 degrees to 0 degrees (term)
recoil of arms - ANSWER>>Extend arms, hold 5 sec. (should "spring back")
Increased recoil = increased gestational age (term)
Popliteal angle - ANSWER>>Push heel with finger toward chest
Smaller degree of angle indicates (more resistance) = increased gestational age
scarf sign - ANSWER>>Draw the arm across the chest to opposite shoulder
__term_ will not cross midline / __preterm__ will cross over
heel to ear - ANSWER>>___term__ will not touch ear
___preterm__ will touch and possibly go beyond ear
gestational age neuromuscular components: how to interpret meaning and when
to perform - ANSWER>>these are all for the new ballard score, lower score =
preterm, you want to do this in the first 12 hours
General appearance - ANSWER>>General appearance
Observe the newborn undisturbed
Dim lights, flat surface
Any signs of distress?
Flexed position
Behavioral state (asleep/awake/self-consoling techniques)
Type of cry: (persistent high pitched shril= pain, maybe withdraw from drugs)
, when do you perform General appearance test - ANSWER>>within the first 2-3
hours
are they able to console themself
general app: skin - ANSWER>>Color - pink tinged (consistent with race/ethnicity)
Why do babies have that pink, ruddy skin color? Pathophysiology?
the vasculature is so superficial, especially if they are crying
Smooth and soft
Dry/peeling hands and feet _increased in term
Vernix presence __decreased__ in term
Turgor
Indication of ?- hydration
Should be? - less than 3 seconds
Location of Assessment? - arm or usually thigh
gen app: head - ANSWER>>Proportionally larger than body
Symmetry of shape and features
Asymmetry? (molding)
Cause?- hard or longer delivery, maybe mom pushed for longer, sat in the canal
for longer
Fontanelles (2) "Soft spots"
Anterior - ___diamond___ shaped
Posterior - _triangular ___ shaped
Indicative of newborn condition
Depressed vs bulging - normal at times?
depressed- not enough hydration or nutrition
bulging- increased cranial pressure, if the baby is crying there will be a temporary
one
ROM - moves freely L to R
gen app: eyes - ANSWER>>Bright, clear and even placement
Tearless crying-why? - do not have mature lacrimal structures
Peripheral vision
DETAILED ANSWERS
Gestatational age - ANSWER>>time _between conception and birth____
"normal" pregnancy time frame ?
timeframe: 38-42 weeks
longer in uterus is not better, can have just as many health problems
Why do we care about gestational age assessment - ANSWER>>gestational age
can be a warning of health problems (pre-term or post term)
What are the two parts of the gestational age assessment - ANSWER>>1. External
physical characteristics
2. Neurological or neuromuscular development
Term range - ANSWER>>gestational age of _37-41 6/7 wks______
posterm range - ANSWER>>gestational age of __42 weeks or more_________
preterm range - ANSWER>>gestational age of ___less than 37 weeks _____
skin: pre term - ANSWER>>thin and transparent with veins prominent
skin: post term - ANSWER>>long hair and nails, no lanugo or vernix
skin: term - ANSWER>>opaque and disappearance of the vernix caseosa
Indication of maturity
Waxy, white, "cheese like" coating
Lanugo hair - ANSWER>>Found all over except for hands & soles of feet, >20wks
gestation
,peach hair, starts at 20 weeks, then reaches peak, and then decreases
___decreasess_ as gestational age __increases______
Sole (plantar) creases - ANSWER>>As gestation progresses, proceeds to the heel
Must be completed in the first 12 hours of life, why?
Age increases dry foot and creases appear
"Slick heels" = usually preterm
Breast bud - ANSWER>>Term: the tissue will measure between 0.5 and 1 cm
Bud Size determined by amount of subcutaneous fat deposits
LGA vs SGA
term increase fat deposits= increase breast bud tissue
increase with increase of gestational age
Ear form - ANSWER>>Preterm - relatively shapeless and flat, no recoil (34 wks or
less)
Term - some cartilage and slight incurving of the upper pinna, good recoil
Male genitals - ANSWER>>Preterm - small scrotum, few rugae (creases and
ridges) , testes are palpable in the inguinal canal (36 wks or less)
Term - testes are generally in the lower scrotum, which is pendulous and covered
with rugae
female genitals - ANSWER>>Preterm - clitoris is prominent, labia majora are small
and widely separated, and labia minora protrude
Term - labia majora cover the labia minora and clitoris
_Nutritional status_indicator for females ( a variable that could have an impact on
how it looks)
Presence of female genitals depends upon the amount of subcutaneous fat
posture - ANSWER>>Fully flexed = increased gestational age (term)
Fully extended
,*the more term babies have more flexion and resistance (the only exception is
the square window where the preterm has a larger angle and the term is more
flexible)
Square window - ANSWER>>Degree of angle
90 degrees = decreased gestational age (preterm)
30-40 degrees to 0 degrees (term)
recoil of arms - ANSWER>>Extend arms, hold 5 sec. (should "spring back")
Increased recoil = increased gestational age (term)
Popliteal angle - ANSWER>>Push heel with finger toward chest
Smaller degree of angle indicates (more resistance) = increased gestational age
scarf sign - ANSWER>>Draw the arm across the chest to opposite shoulder
__term_ will not cross midline / __preterm__ will cross over
heel to ear - ANSWER>>___term__ will not touch ear
___preterm__ will touch and possibly go beyond ear
gestational age neuromuscular components: how to interpret meaning and when
to perform - ANSWER>>these are all for the new ballard score, lower score =
preterm, you want to do this in the first 12 hours
General appearance - ANSWER>>General appearance
Observe the newborn undisturbed
Dim lights, flat surface
Any signs of distress?
Flexed position
Behavioral state (asleep/awake/self-consoling techniques)
Type of cry: (persistent high pitched shril= pain, maybe withdraw from drugs)
, when do you perform General appearance test - ANSWER>>within the first 2-3
hours
are they able to console themself
general app: skin - ANSWER>>Color - pink tinged (consistent with race/ethnicity)
Why do babies have that pink, ruddy skin color? Pathophysiology?
the vasculature is so superficial, especially if they are crying
Smooth and soft
Dry/peeling hands and feet _increased in term
Vernix presence __decreased__ in term
Turgor
Indication of ?- hydration
Should be? - less than 3 seconds
Location of Assessment? - arm or usually thigh
gen app: head - ANSWER>>Proportionally larger than body
Symmetry of shape and features
Asymmetry? (molding)
Cause?- hard or longer delivery, maybe mom pushed for longer, sat in the canal
for longer
Fontanelles (2) "Soft spots"
Anterior - ___diamond___ shaped
Posterior - _triangular ___ shaped
Indicative of newborn condition
Depressed vs bulging - normal at times?
depressed- not enough hydration or nutrition
bulging- increased cranial pressure, if the baby is crying there will be a temporary
one
ROM - moves freely L to R
gen app: eyes - ANSWER>>Bright, clear and even placement
Tearless crying-why? - do not have mature lacrimal structures
Peripheral vision
