Newborn Growth and Development Quiz

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Questions and Answers

What is the primary difference between growth and development in a newborn?

Growth refers to physical changes and an increase in size, while development involves the increase in complexity of function and skill progression.

List two indicators of growth in a newborn.

Height and weight are two common indicators of growth in a newborn.

Explain the concept of cephalocaudal development in newborns.

Cephalocaudal development is the principle that development proceeds from the head downward, meaning infants gain control of their head and neck before their lower body.

What does it mean to say that development proceeds from proximal to distal?

It means that development occurs from the center of the body outward, with control of movements closer to the body (like the arms) developing before those farther away (like the fingers). Signup and view all the answers

Why is it important for neonatal reflexes to be lost before further development can occur?

The loss of neonatal reflexes indicates that the nervous system is maturing, which is necessary for the development of more complex skills. Signup and view all the answers

What are the average blood volume and white blood cell count in a newborn?

The average blood volume in a newborn is 300 mL and the white blood cell count is between 15,000 and 30,000 cells/mm3. Signup and view all the answers

What is the normal specific gravity range for a newborn's urine?

The normal specific gravity range for a newborn's urine is 1.008 to 1.010. Signup and view all the answers

Describe the rooting reflex in newborns.

The rooting reflex helps a newborn turn its head towards a stimulus and is triggered by the cheek being stroked. Signup and view all the answers

What are common types of birthmarks seen in newborns?

Common types of birthmarks include hemangiomas and Mongolian spots. Signup and view all the answers

What should a newborn's first stool typically consist of?

The newborn's first stool, usually passed within 24 hours, consists of meconium. Signup and view all the answers

What are the roles of vitamin K in newborn blood coagulation?

Vitamin K is essential for proper blood coagulation in newborns. Signup and view all the answers

How does a newborn's sense of hearing develop after birth?

A newborn's hearing becomes acute within hours after birth, and they can recognize their mother's voice. Signup and view all the answers

What is the significance of the Moro reflex in newborns?

The Moro reflex, also known as the startle reflex, indicates a newborn's response to sudden stimuli. Signup and view all the answers

What is one common sign of ineffective thermoregulation in newborns?

A sign of ineffective thermoregulation can be the infant feeling cold or showing signs of hypothermia. Signup and view all the answers

What does it imply if a newborn has low-set ears?

Low-set ears in a newborn may indicate potential chromosomal abnormalities. Signup and view all the answers

What are Epstein pearls, and where do they typically appear?

Epstein pearls are white or gray cystic lesions that appear on the gums and roof of the mouth. Signup and view all the answers

What recommendations are made regarding the sleeping position for newborns?

Newborns should be placed on their backs to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS). Signup and view all the answers

What is the purpose of administering the hepatitis B vaccine to newborns?

The hepatitis B vaccine protects newborns from potential exposure to hepatitis B, a serious liver infection. Signup and view all the answers

Explain the term meconium and what it indicates.

Meconium is the term for a newborn's first stool, indicating that the gastrointestinal system is functioning. Signup and view all the answers

Study Notes

Module 2.4: Nursing Care of a Family With a Newborn

Learning Objectives: Differentiate growth and development; Describe growth and development principles; Describe normal characteristics of a term newborn; Assess a newborn for normal growth and development.

Growth

Growth is a physical change and increase in size.
Indicators include height, weight, bone size, dentition, sensory adaptation, and development of sexual organs and characteristics.
Growth rate is rapid during prenatal, neonatal, infancy, and adolescence.

Development

Development is an increase in complexity of function and skill progression.
Development involves behavioral aspects of growth, such as the ability to walk, talk, run, and think.

Principles of Growth and Development

Growth and development are continuous from conception to death.
Growth and development follow an orderly sequence.
Children develop at different rates.
Body systems do not develop at the same rate.
Development is cephalocaudal (head to toe).
Development proceeds from proximal to distal body parts.
Development proceeds from gross to refined skills.
There is an optimal time for initiating experiences or learning.
Neonatal reflexes must disappear before development continues.
Skills and behaviors are learned through practice.

Predictable Sequence

Cephalocaudal (head down to toes)
Proximodistal (center of the body to peripheral areas)
General to specific

Profile of a Newborn #1

Length: 46 to 54 cm
Head circumference: 34 to 35 cm
Temperature: 97.6°F to 98.6°F (axillary)
Chest circumference: 32 to 33 cm
Heart rate: 120 to 140 beats/min
Respirations: 30 to 60 breaths/min
Weight: 2.5 to 3.4 kg

Heat Loss in the Newborn

Diagram of different types of heat loss in a newborn

Profile of a Newborn #2

Cardiovascular System: Blood Values
- Blood volume: 300 mL
- Hemoglobin (Hgb): 17 to 18 g/100 mL
- Hematocrit (Hct): 45%–50%
- Red blood cells (RBCs): 6 million cells/mm³
- White blood cells (WBCs): 15,000 to 30,000 cells/mm³
- Blood coagulation
- Vitamin K
Other Systems: Respiratory System

Profile of a Newborn #4

Gastrointestinal System: Stools
- Usually passed within 24 hours
- Consist of meconium
Urinary System
- Newborn voids within 24 hours of birth
- Specific gravity (1.008–1.010)
- Urinary output: 30 to 60 mL (1–2 days), 300 mL (1st week)
Immune System
- Born with passive antibody (IgG)

Profile of a Newborn #5

Neuromuscular System
- Blink reflex
- Rooting reflex
- Sucking reflex
- Swallowing reflex

Profile of a Newborn #6

Neuromuscular System (Continued)
- Extrusion reflex
- Palmar grasp reflex
- Step-in-place reflex
- Placing reflex
- Plantar grasp reflex

Palmar Grasp Reflex

Description of the Palmar Grasp Reflex

Step-in Place Reflex

Description of the Step-in Place Reflex

Profile of a Newborn #7

Neuromuscular System (Continued)
- Tonic neck reflex
- Moro reflex
- Babinski reflex
- Magnet reflex
- Crossed extension reflex
- Trunk incurvation reflex
  - Reflexes used to assess spinal cord integrity

Tonic Neck Reflex

Description of the Tonic Neck Reflex

Moro Reflex

Description of the Moro Reflex

Babinski Reflex

Description of the Babinski Reflex

Trunk Incurvation Reflex

Description of the Trunk Incurvation Reflex

Profile of a Newborn #8

Neuromuscular System (Continued)
- Landau reflex
- Deep tendon reflex (e.g., patellar reflex)
- Biceps reflex

Profile of a Newborn #9: Senses

Hearing: Becomes acute within hours as fluid is absorbed from the eustachian tube. Newborns appear to recognize their mother's voice.
Vision: Present from birth, but limited. Focus on black/white objects a few inches away.
Touch: Well-developed at birth
Taste and Smell: Present and functional

Profile of a Newborn #10: Periods of Reactivity

Assessment Table summarizing first, resting, and second period of reactivity in a newborn. Includes vital signs and other behaviors

Assessing a Newborn #1: APGAR Scoring

Newborn assessment performed at 1 and 5 minutes post delivery.
Scoring criteria include heart rate, respiratory effort, muscle tone, reflex irritability, and color.

Assessing a Newborn #5: Appearance

Skin:
- Color (cyanosis, hyperbilirubinemia [physiological jaundice], kernicterus, pallor)
- Harlequin sign

Assessing a Newborn #6: Additional Skin Findings

Birthmarks (hemangiomas, Mongolian spots)

Types of Hemangioma

Description of types of hemangiomas seen in newborns (Nevus flammeus, telangiectasia, strawberry)

Assessing a Newborn #8: Additional Skin Findings

Vernix caseosa (white, cream cheese-like substance)
Lanugo (fine, downy hair)
Desquamation (dryness)
Milia (small, white bumps on the bridge of nose)
Erythema Toxicum (skin rash, flea-bite rash)
Forceps marks

Milia, Erythema Toxicum, Forceps Marks, Lanugo, Desquamation

Detailed descriptions of each condition

Vernix Caseosa

Detailed description of the substance.

Assessing a Newborn #9: Head

Fontanelles: Open spaces in the skull
Sutures: Joints in the skull bones
Molding: Shaping of the head during birth
Caput succedaneum: Edema of the scalp
Cephalohematoma: Collection of blood between periosteum and skull bone
Craniotabes: Localized softening of the cranial bones (often normal)

Molding

Description of Molding and illustrations of skull changes.

Caput Succedaneum and Cephalohematoma

Descriptions of these conditions. Illustrations showing location and appearance.

Assessing a Newborn #10

Eyes: Subconjunctival hemorrhage, low-set ears (potential abnormalities)
Ears: Low set ears and potential issues
Nose: Choanal atresia test
Mouth: Epstein pearls, thrush
Neck: Short neck, head lag
Chest: Witch's milk, retraction

Epstein Pearls, Subconjunctival hemorrhage

Descriptions and illustrations of these conditions.

Sternal retractions

Description and illustration of the condition.

Assessing a Newborn #11

Abdomen: Slightly protuberant
Anogenital area: Male (cryptorchidism, epispadias, hypospadias), Female (pseudomenstruation)
Back: Inspect for position, spine, dermal sinus, spina bifida occulta
Extremities: Assess for simian crease, syndactyly, polydactyly, clonus, clubfoot

Hypospadias, Epispadias

Illustrations and definitions

Spina Bifida

Classification of spina bifida (occulta, meningocele, meningomyelocele, myeloschisis)
Illustrations of different levels of spina bifida

Simian Crease, Syndactyly, Polydactyly, Clubfoot

Descriptions and illustrations of each condition.

Assessing a Newborn #12: Laboratory Studies

Hematocrit: Normal = 50%–55% at 1 hour of life
Hemoglobin: Normal = 17–18 g/100 mL
Hypoglycemia: Glucose higher than 40 mg/100mL is considered normal in NB

Assessing Family Readiness to Care for Newborn at Home

Daily home care
Sleep patterns
Crying
Parental concerns related to breathing
Health maintenance
Car safety

Figure 18.29

Correct car seat placement for newborns

Nursing Care of a Newborn at Birth #1

Identification and registration
- Identification band
- Birth registration
- Birth record documentation

Figure 18.23: Security Band

Security band for newborn identification

Birth Record Documentation

Baseline for a newborn's health
Time of birth
Feeding/Breastfeeding
Respirations (spontaneous or aided)
Apgar score (at 1 minute and 5 minutes)
Eye prophylaxis
Vitamin K administration
Condition of the infant
Number of umbilical cord vessels
Cultures
Stool passage/Voiding

Nursing Care of a Newborn at Birth #2

Ineffective thermoregulation
- Keep infant warm and dry
- Skin-to-skin contact
Ineffective airway clearance
- Promote adequate breathing pattern
- Prevent aspiration
- Record first cry

Nursing Care of a Newborn at Birth #3

Risk for infection
- Inspect, care of umbilical cord
- Administer eye care
- Infection precautions

Nursing Care of Newborn and Family in the Postpartal Period

Initial feeding
Bathing
Infant sleeping position (on back)
Diaper care
Metabolic screening tests

Nursing Care of Newborn and Family in the Postpartal Period (continued)

Hepatitis B vaccination
Vitamin K administration
Circumcision

Nursing Diagnoses: Newborn Period

Ineffective airway clearance (related to mucus)
Ineffective thermoregulation (related to heat loss)
Imbalanced nutrition (related to poor sucking reflex)
Readines for enhanced family coping (related to birth)
Health-seeking behaviors (related to newborn needs)

Outcomes: Newborn Period

Infant establishes respirations of 30 to 60 breaths per minute.
Infant maintains temperature at 97.8–98.6°F (36.5–37°C)
Infant breastfeeds well with a strong sucking reflex.

Reference

Silbert-Flagg, J., & Pillitteri, A. (2018). Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family (8th ed.). Wolters Kluwer.

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Description

Test your knowledge on the essential aspects of growth and development in newborns. This quiz covers key concepts such as cephalocaudal development, neonatal reflexes, and indicators of growth. Enhance your understanding of the critical early stages of life.