12 Questions
What is a common early sign of hypoglycemia in newborns?
Jitteriness
What is neonatal hypoglycemia defined as in terms of blood glucose level?
Less than 40 mg/dL
Which stressors are mentioned as common causes of neonatal hypoglycemia?
Respiratory distress and cold stress
What is the term used to describe the process of balancing heat production with heat loss?
Thermoregulation
Which of the following is NOT a late sign of hypoglycemia in newborns?
Jitteriness
What is a typical manifestation of late hypoglycemia in newborns?
Coma
Why is the newborn at risk of heat loss?
The amount of muscle and adipose tissue is small compared to the amount of exposed skin.
What could happen if a newborn becomes cold stressed?
Respiratory distress
Why does jaundice occur in newborns?
Liver immaturity and high volume of red blood cells
Why are newborns given vitamin K shortly after birth?
To prevent bleeding problems due to low levels of vitamin K.
Which type of human breast milk is rich in antibodies?
Colostrum
What is a key component of newborn care related to improving bonding between parents and newborns?
Promoting skin-to-skin contact
Study Notes
Newborn Thermoregulation
- Newborns are at risk of heat loss due to their small amount of heat-producing tissue (muscle and adipose tissue) compared to their exposed skin.
- Newborns cannot produce heat by muscle movement and shivering, which requires oxygen.
- Cold stress can lead to respiratory distress.
Hepatic Adaptation
- After birth, the newborn's liver breaks down excess red blood cells, releasing bilirubin.
- Bilirubin is normally conjugated and excreted in the feces, but the newborn's immature liver may be overwhelmed, leading to jaundice.
- The liver produces clotting factors, requiring vitamin K, which is normally produced by gut bacteria.
- Newborns are given vitamin K to prevent bleeding problems.
Newborn Care
- Key components of newborn care include:
- Drying and warming the neonate
- Assessment (AGPAR scoring and physical examination)
- Feeding
- Hygiene (drying and first bath)
- Promoting bonding (skin-to-skin contact, Kangaroo care)
- Vitamin K administration
- Eye care
- BCG and Hepatitis B vaccination
Breastfeeding
- Breastfeeding is the optimal source of nutrition.
- Breast milk types:
- Colostrum (rich in antibodies, produced in late pregnancy to 3 days after delivery)
- Transitional milk (lower protein, produced 3-6 days after delivery)
- Mature milk (produced 7 days after delivery until termination of breastfeeding)
Newborn Transition
- Physiologic adaptation:
- Respiratory adaptation
- Cardiovascular adaptation
- Thermoregulatory adaptation
- Metabolic adaptation
- Hepatic adaptation
- Behavioral and social adaptation
- Nursing assessment of the normal newborn includes:
- General body proportions and posture
- Vital signs
- Physical measurements
- Head-to-toe assessment
- Neurologic assessment
- Behavioral assessment
- Gestational age assessment
Metabolic Adaptation
- A steady supply of blood glucose is necessary for metabolic processes and energy production.
- Neonatal hypoglycemia (blood glucose < 40 mg/dL) can occur due to excessive stress during labor or transition.
- Risk factors for hypoglycemia: respiratory distress, cold stress.
- Early signs of hypoglycemia: jitteriness, poor feeding, listlessness, irritability, low temperature, weak or high-pitched cry, hypotonia.
- Late signs of hypoglycemia: respiratory distress, apnea, seizures, coma.
Thermoregulatory Adaptation
- Thermoregulation is the balance between heat production and heat loss.
- Newborns are susceptible to heat loss due to their small amount of heat-producing tissue.
Learn about the nurse's role in assessing the transition of a newborn, including physiologic adaptations and nursing assessments. Topics include respiratory, cardiovascular, thermoregulatory adaptations, as well as vital signs, gestational age assessment, and metabolic adaptations in a normal newborn.
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