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Then term newborn
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- 1Adjustment to life outside uterus is dependent uponGenetic background
Health of the recent uterine environment
A safe delivery
Care during the first month of life - 2Respirations stimulated due tochilling and chemical changes in the blood
- 3the first breath:opens alveoli
- 4Ability to metabolize food hamperedby immaturity of digestive system
- 5digestive system is immature because of ______ in ________ from the ________diffiency, enzymes, pancreas and liver
- 6The kidney's ability to ________ and maintain fluid balance is limited due to decreased ______________ and limited __________________ reabsorptionsconcentrate urine, rate of glomerular flow, renal tubular
- 7directs most of the body's activitythe nervous system
- 8infants moves arms and legs but cannotcontrol them
- 9full term infants are born with these reflexesblinking, sneezing, gagging, sucking, grasping
- 10if crib is jarred infants draw their legs up and the arms fan out and then come toward midline in an embrace position, this is called the:moro reflex
- 11infants head falls back because they cannot lift ithead lag
- 12ReflexesMoro
Rooting
Tonic neck
Dancing - 13absence of the moro reflex may indicateabnormalities of the nervous system
- 14postural reflex that is sometimes assumed by sleeping infants, the head is turned to one side, the arm and leg are extended on the same sid and the opposite arm and leg are flexed in a fencing positiontonic neck reflex
- 15tonic neck reflex disappears by5-7th month
- 16moro reflex disappears by3-6 months
- 17palmar grasp reflex disappears by3 months
- 18babinski reflex diappears byvariably when the infant begins walking
- 19swelling of the soft tissues of the scalp as a result of the delivery processcaput succedaneum
- 20a collection of blood beneath the periosteum of the cranial bonecephalohematoma
- 21ccheplahematoma does not crosssuture line
- 22protect the head during deliver and allow further brain growthfontanelles
- 23normal limits of head circumference32 to 36 cm
- 24diamond shaped and is located at the junction of the two parietal and two frontal bonesanterior fontanellw\e
- 25anterior fontanelle usually closes by12 to 18 months
- 26triangular and is located between the occiptial and parietal bonesposterior fontanelle
- 27the new born can recognizemother's milk on the breast pad
- 28most newborns appear _________ because their __________ is not fully developedcross-eyed, eye muscle coordination
- 29permanent eye coloring becomes fixed at about ages6 to 12 months
- 30tears to not appear until _______ due to immaturity of the _________1 to 3 months, lacrimal gland ducts
- 31Infant responds to voices by decreasing _________ and ______________motor activity, sucking activity, turning head toward the sound
- 32the eye should be even with the __________upper tip of the pinna
- 33the ability to discriminate between the mother's voice and the voices of others may occurs as early asage 3 days
- 34analzyes hearing by sending a series of soft clicks into the sleeping infant's earALGO hearing screening test
- 35when the infant's brain responds with a specific brain wave that is referred to as anauditory brainstem response
- 36measures sounds from the cochlea in response to sound stimulationotoacoustic emissions test
- 37this is expecially vulnerable to injurytympanic membrane
- 38neonate sleeps approx15 to 20 hours
- 39Phases of sleep-wake cycle used to adjust to sleep wake cycle outside of uterusFirst reactive
Sleep
Second reactive
Stability - 40Specific pattern of reactivity that can influence response to stimuli and bondingQuiet sleep
Rapid eye movement sleep
Active alert
Quiet alert
Crying
Transitional - 41during the first 30 minutes of life the newborn is alert and this is the best time to initiate bonding between the parent and newbornfirst reactive phase
- 42During the next few hours of love the infant gradually become sleepier and less responsiveSleep phase
- 43After age 24 hours the sleep wake pattern becomes more stabilized the pattern sleep gradually develops into one which the newborn is awake during the day and they sleep during the nightStability phase
- 44an infant held ________ on the _________ and rocked in a __________ is more likely to maintain an alert stateupright, shoulder, vertical position
- 45infant sleeps and does not movequiet sleep
- 46respirations are more _____ during REM sleepirregular
- 47infant displays diffuse motor activityactive alert
- 48infant is awake relaxed and quiet, most responsive to testing and bodning effortsquiet alert
- 49pain producescatecholamines and cortisol
- 50Pain pathways and structures required for long-term memory are well developed by24 weeks gestation
- 51Unrelieved pain can causeexhaustion, irritability, and delay the healing process
- 52ComfortAlertness calmness muscle tone movement facial tension and respiratory response into physiological items
- 53a 7-point scale that scores each item from 1 to 5 with a high cumulative score indicating increased distressCOMFORT
- 54CRIEcry, requires o2, increased vital signs, expressions
- 55Crie is a 10-point scale includes:facial expression, cry, movement of arms and legs, consolability, o2 sat
- 56FLACC parameters includeface, legs, activity, cry and consolability
- 57each parameter of flacc is scored from0 to 2
- 58PIPPpremature infant pain profile
- 59based on scales similar to CRIEPIPP
- 60PIPP ratieseye squeeze, nasal labial furrow, HR, o2 sat, and brow furro on a scale of 0 to 3
- 61NIPSneonatal infant pain scale
- 62NIPS is similar to the _____ scaleCRIES
- 63the NIPS scale rates:facial expression, arm movement, cry, leg movement, respiration, and arousal on a scale of 0 to 2
- 64A nips score of ______ indicates worst level of pain7
- 65NPASSneonatal pain, agitation, sedation, scale
- 66scores for NPASS are given forcrying or irritability, behavioral state, facial expression, tone of extremities, vital signs, o2 sat
- 67NPASS scores range from-2 to +2 for agitated infants
- 68Pain Assessment ToolsCOMFORT
CRIES
FLACC
PIPP
NIPS
NPASS - 69Evaluation of pain in the neonate can be based on changes in:VS and behavior of infant, decreased o2 sat
- 70pain can be relieved bySwaddling
Cuddling
Rocking
Non-nutritive sucking
Quiet environment
Oral sucrose
Morphine, Fentanyl, topical anesthetics - 71Measures inherent neurological capacities and response to selected stimuliNeonatal Behavioral Assessment Scale
- 72behavioral areas tested includeAlertness
Response to visual and auditory stimuli
Motor coordination
Level of excitement
Organizational process in response to stress - 73Most critical period for newbordfirst hour of life
- 74First breath helps toexpand the collapsed lungs
- 75Full expansion does not occurfor several days
- 76Five objective signs measured for apgarHeart rate
Respiration
Muscle tone
Reflexes
Color - 77Nurse monitors for respiratory distress as evidenced byRate and character of respirations
Color (cyanosis)
General behavior - 78must be reported immediately to the health care providerSternal retractions
- 79Has approximately _____ of circulating blood volume300 mL
- 80If ducts fail to close when they're supposed to the neonate may become _______ because the blood that by passes the _________ does not pick up any _____________cyanotic, lungs, o2
- 81result from blood passing through normal valvesfunctional murmurs
- 82caused by blood passing through abnormal openingsorganic murmurs
- 83body temp falls immediately after birth but eventually climbs back up between97.8 to 98.9
- 84metabolism of brown fatnonshivering thermogenisis
- 85Acrocyanosis is evident because ofsluggish peripheral circulation
- 86room for infant is kept at69-75 f
- 87humidity for infant is kept at45-55%
- 88a _______ may develop in the overheated infantred skin rash
- 89a quivering or shivering like tremor of the chin is not evidence of col but evidences of _________immature neurological system
- 90count _________ before taking tempresp rates
- 91The nurse should reportTemperature elevations >99.8° F or <97.1° F
Pulse rates >160 or <110 beats/min
Respirations >60 or <30 breaths/min
Noisy respirations
Nasal flaring or chest retraction - 92average infant bp80/46
- 93infant resp are usually30 to 60
- 94infant HR usually110-160
- 95first muscles under controlhead and neck
- 96Because the infants bones are easily _______ position changes must be oftenmolded by pressure
- 97infant's resistance to attempts ot bring one elbow farther than the midline of the chestscarf's sign
- 98Average length19 to 21.5 inches (46 to 56 cm)
- 99Average weight6 to 9 pounds (2722 to 4082 g)
- 100In the first 3 to 4 days after birth, the infant loses about5% to 10% of its birth weight
- 101Preterm wt. loss may be as high as15%
- 102Renal blood flow is abouta third of an adult
- 103newborn has about ______ wet diapers/day6
- 104renal tubules are short and have limited capacity for absorbing substances such asglucose, phosphate, bicarb
- 105Testes descend into scrotum beforebirth
- 106opening of the urethra is on the undersurface of the penishypospadias
- 107infants with congenital anomalies of the penisshould not be circumsized
- 108patroleum jelly is used with thegomco clamp
- 109plastibell should fall off within5-8 days
- 110jewish faith waits ______ before circumsion and hebrew name is given8 days after birth
- 111—made of cells and glandular secretions; thought to protect skin from irritation and effects of a watery environmentvernix caseosa
- 112white pinpoint pimples caused by the obstruction of sebaceous glands may be seen on nose and chins, disappear within a few weeksmillia
- 113millia type lesions on the midline of the hard palateepstein's pearls
- 114epsteins pearls are cause bycollection of epithelial cells
- 115flat red areas seen on the nape of the neck and on they eyelidsstork bites
- 116mongolian spots are common innative american, african american, and mediterranean descent
- 117peeling of the skin that occurs during the early weeks of lifedesquamation
- 118normal hgb in newbornsm, 7 days, 3 months,18.5, 17, 11.3
- 119normal hct in newborns, 7 days, 3m56, 44, 35
- 120wbc cound newborn, 7 dys, 3 m,18,000, 12,000, 10,800
- 121bilirubin newborn, 7 day, 3 months6, 12, 1
- 122icterometeruses skin color to measure jaundice
- 123Bath 2-3 times per weekWater should be 37.8C (100F), room 75-80F
Keep infant covered for warmth
Bathe face, then cephalocaudal movement, head(hair) last
Genitalia front to back - 124powders should be avoided because ofrisk of aspiration
- 125stools of breast fed infantbright yellow, soft and pasty
- 126number of stools for breastfed infant3 to 6
- 127stools of formula fed infantvary from yellow to brown
- 128the stomach capacity is90 ml
- 129emptying time is2 to 3 hours
- 130salivary glands do no secret saliva until the infant is age2 to 3 months
- 131infants need extravitamin c and d
- 132umbilical cord stump is:primary site of infection if not kept clean
- 133immunoglobulin that crosses the placenta and provides the newborn with passive immunityImmunoglobulin G
- 134IgG rarely lasts longer than3 months
- 135an immunoglobulin produced after the neonatal period that is contained in breast milk and provides some resistance to resp and gi infectionsImmunoglobulin A
- 136Infants are at risk for resp and gi infections before1 month of age
- 137an immunoglobulin produced by the newborn and an elevated level suggests serious infectionImmunoglbulin M
- 138discharge planning areas may includeBasic infant care
Safety measures
Immunizations
Return appointments
Proper use of a car seat
Signs and symptoms of problems and who to contact
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- Fichas sobre Then term newborn , creado por Ruffled Tulip el 02/05/2022.
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