Newborn Care in First 24 Hours

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Questions and Answers

What is the maximum suction pressure used to clear a blocked airway in newborns?

  • 120 mmHg
  • 60 mmHg
  • 100 mmHg (correct)
  • 80 mmHg

The APGAR score does not assess the color of the newborn.

False (B)

What is indicated by a heart rate of less than 100 in the APGAR scoring system?

Score 1

Newborns are physiologically hypoprothrombinemic due to a lack of __________ in the intestines.

<p>bacterial flora</p> Signup and view all the answers

Match the following APGAR criteria with their score definitions:

<p>Heart Rate: Absent = Score 0 Good strong cry = Score 2 Some flexion = Score 1 Blue/Pale = Score 0</p> Signup and view all the answers

Which of the following is NOT a sign of respiratory distress in newborns?

<p>Cyanosis (A)</p> Signup and view all the answers

Vitamin K administration in newborns is primarily to prevent infections.

<p>False (B)</p> Signup and view all the answers

What score in the Silverman Anderson Index indicates severe respiratory distress (RDS)?

<p>7-8</p> Signup and view all the answers

What is a primary purpose of administering Vitamin K to newborns?

<p>Prevent bleeding/hemorrhage (D)</p> Signup and view all the answers

The Silverman Anderson Index is used to assess the heart rate of newborns.

<p>False (B)</p> Signup and view all the answers

What is the normal range for a newborn's heart rate?

<p>120-160</p> Signup and view all the answers

Newborns are placed in a __________ position to maintain a clear airway.

<p>prone</p> Signup and view all the answers

Match the following interventions with their purposes:

<p>BCG = Protect against tuberculosis Silver nitrate = Prevent eye infections Vitamin K = Prevent bleeding Crede's prophylaxis = Prevent gonococcal conjunctivitis</p> Signup and view all the answers

Which score on the APGAR indicates good muscle tone?

<p>Score 2 (C)</p> Signup and view all the answers

Acrocyanosis is characterized by all parts of the body being blue.

<p>False (B)</p> Signup and view all the answers

The first period after birth consists of the newborn being __________, with rapid respiratory and heart rates.

<p>alert</p> Signup and view all the answers

Flashcards

APGAR Score

A scoring system used to assess the health of a newborn immediately after birth.

Newborn ABCs

A framework for evaluating and addressing the most important aspects of newborn health (Airway, Breathing, and Circulation).

Vitamin K injection

Given to newborns to prevent bleeding disorders due to low vitamin K levels at birth.

Respiratory Distress

Signs of difficulty breathing in a newborn, including chest retractions and nasal flaring.

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APGAR Score Criteria

Assessment of heart rate, respiratory effort, muscle tone, reflex irritability, and color to determine baby's health.

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Newborn Head Circumference

Measurement of the newborn's head size. Normal range is 33-35cm.

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Silverman-Anderson Index

A test used to evaluate respiratory status, especially in premature newborns.

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Physiologic Hypoprothrombinemia

A low level of prothrombin (a protein needed for blood clotting) found in newborns due to lack of gut bacteria.

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Crede's Prophylaxis

A routine eye care procedure for newborns to prevent ophthalmia neonatorum, an eye infection commonly caused by gonorrhea. It's typically done with silver nitrate drops or antibiotic ointment.

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Silver Nitrate

A chemical used in Crede's prophylaxis to prevent eye infections in newborns. It's applied as drops to the baby's eyes immediately after birth.

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Why Vitamin K?

Newborns are given a Vitamin K injection to prevent bleeding. They lack the necessary bacterial flora in their gut to produce enough Vitamin K which is essential for blood clotting.

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Large Head Circumference

A head circumference greater than 37 cm in newborns can be a sign of hydrocephalus, a condition where excess fluid builds up in the brain.

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Small Head Circumference

A newborn's head circumference less than 10% percentile can indicate dehydration. This may be caused by insufficient breastfeeding or formula feeding.

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HRMRC

An acronym for heart rate, respiratory effort, muscle tone, reflex irritability, and color. It's used to assess the condition of a newborn during the first minutes of life.

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Study Notes

First 24 Hours of Life

  • Transition from intrauterine to extrauterine life
  • APGAR scoring used to assess newborn
  • Physical adjustments to extrauterine life

Physical Adjustment to Extrauterine Life

  • First Period (15-30 minutes):

    • Alert state
    • Rapid respiratory rate (RR) and heart rate (HR)
    • Sucking sounds

  • Resting Period (30-120 minutes):

    • Slow respiratory rate (RR) and heart rate (HR)
    • Periods of sleep

  • Second Period (2-6 hours):

    • Wakes up again
    • Responsive to stimuli
    • Mucus, gagging, or choking
    • Airway maintenance important, suction-blocked not more than 5 sec. (100 mmHg max)

Newborn ABCs

  • Airway
  • Breathing
  • Circulation

APGAR Scoring

  • Criteria are evaluated
  • Scoring 0-2 for each criterion
  • Criteria include
    • Heart rate assessment
    • Respiration assessment
    • Muscle tone
    • Reflex assessment
    • Color assessment

Non-Time Bound Interventions

  • Immunizations given

    • BCG (tuberculosis)
    • Hep B
    • Eye care

  • Vitamin K administration

  • Prevention of bleeding/hemorrhage

  • Promote blood coagulation/clotting, with injection into vastus lateralis.

  • Other information like delayed bathing.

HRMRC

  • 1-minute and 5-minute heart rate:
    • Most important factor
  • Color: Least important

Silverman Anderson Index

  • Evaluation of respiratory status of premature infants
  • RDS/Hyaline membrane disease evaluation

Signs of Respiratory Distress

  • Three types of signs need to be noted:
    • Chest lag
    • Retractions
    • Nasal flaring
    • Respiratory grunting
  • Scoring classification:
    • 0-3 = normal or no RDS
    • 4-6 = moderate RDS
    • 7-8 = severe RDS

Anthropometric Measurements

  • Head circumference (33-35 cm)
    • Eyebrow to head circumference
  • Chest Circumference (31-33 cm)
  • Nipple line to chest circumference
  • Abdomen circumference (31-33 cm)
  • Umbilicus to abdomen circumference
  • Length (average 50 cm, 45-55 cm)
  • Weight (2.5-3.5 kg)
  • Physiological weight loss (5-10% loss)
  • Dehydration (more than 10%)

Heart Rate

  • 120-160 is the standard rate

Blood Pressure

  • 80/46 mmHg
  • Congenital heart disease (CHD) bp to be taken regularly.

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