Newborn Health and Rashes
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Questions and Answers

What is the recommended breast feeding frequency for clients?

  • 6-8 times daily
  • 4-6 times daily
  • 8-12 times daily (correct)
  • 10-15 times daily

    • Which of the following methods can help prevent clogged ducts in breastfeeding clients?

  • Wear a nonbinding bra (correct)
  • Wear a supportive bra at all times
  • Avoid breastfeeding on demand
  • Limit hydration

    • What is the appropriate axillary temperature range for a normal newborn?

  • 37.2 - 38.5 C
  • 36.4 - 37.2 C (correct)
  • 35.5 - 36.4 C
  • 34.0 - 35.5 C

    • What is an effective relief method for engorgement in non-breastfeeding clients?

    <p>Cold compresses and fresh cabbage leaves</p> Signup and view all the answers

    What is the typical respiratory rate for a normal newborn?

    <p>30-60 breaths per minute</p> Signup and view all the answers

    Which of the following is NOT a feeding cue in newborns?

    <p>Loud vocalization</p> Signup and view all the answers

    What is the primary characteristic of colostrum?

    <p>Thick and high in protein</p> Signup and view all the answers

    Mature milk primarily consists of what percentage of water?

    <p>90%</p> Signup and view all the answers

    Which hormone is primarily responsible for milk production in breastfeeding?

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

    What is the role of hind milk in breastfeeding?

    <p>Higher in fat content</p> Signup and view all the answers

    Which of the following is NOT a benefit of breastfeeding for the infant?

    <p>Improves vision</p> Signup and view all the answers

    What is the consequence of not removing human milk during breastfeeding?

    <p>Negative feedback mechanism</p> Signup and view all the answers

    What is the relationship between oxytocin and breastfeeding?

    <p>It delays the return of menstruation and ovulation</p> Signup and view all the answers

    What is the APGAR score range that indicates a normal condition for a newborn?

    <p>7-10</p> Signup and view all the answers

    What intervention is performed to stimulate a newborn to cry and breathe right after birth?

    <p>Drying the newborn</p> Signup and view all the answers

    How often should vital signs be taken for a newborn in the first hours after birth?

    <p>Every 30 minutes</p> Signup and view all the answers

    What is the purpose of administering erythromycin eye ointment to a newborn?

    <p>To prevent eye infections</p> Signup and view all the answers

    Which best describes the timing for the administration of Vitamin K after birth?

    <p>Within 1 hour</p> Signup and view all the answers

    What does a Ballard score assess in a newborn?

    <p>Gestational size and age</p> Signup and view all the answers

    What is acrocyanosis in newborns?

    <p>Normal blue/grayish hands and feet</p> Signup and view all the answers

    What is a key assessment to perform within the first 24 hours before discharge?

    <p>Conducting a full physical exam</p> Signup and view all the answers

    Which treatment is specifically used for jaundice in infants?

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

    What type of immunity is conveyed through breastfeeding?

    <p>Passive immunity</p> Signup and view all the answers

    During which stage of play do children engage in similar activities without direct interaction?

    <p>Parallel play</p> Signup and view all the answers

    What change in an infant's condition is a more reliable indicator of infection than fever?

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

    What is true about caput succedaneum?

    <p>It causes localized edema over the sagittal suture.</p> Signup and view all the answers

    At what age do breast buds typically begin to develop in females?

    <p>8-13 years</p> Signup and view all the answers

    Which statement regarding cephalohematoma is correct?

    <p>Blood pooling is caused by pressure.</p> Signup and view all the answers

    Which developmental stage follows the release of androgens responsible for pubic hair development?

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

    What should be assessed if a newborn does not void within 24 hours?

    <p>Adequacy of fluid intake and bladder distention.</p> Signup and view all the answers

    Which type of play involves children working together, following rules or goals?

    <p>Cooperative play</p> Signup and view all the answers

    What is a common characteristic of stool in breastfed infants?

    <p>Yellow, gold, soft, and mushy.</p> Signup and view all the answers

    What does the passive immunity provided during pregnancy primarily constitute?

    <p>Immunoglobulin (IgG)</p> Signup and view all the answers

    How many times do infants typically void by the end of day 5?

    <p>6-8 times a day.</p> Signup and view all the answers

    Which of the following indicates a potential risk for jaundice in newborns?

    <p>Presence of cephalohematoma.</p> Signup and view all the answers

    What is the usual appearance of stool in formula-fed infants?

    <p>Pale yellow to light brown and formed.</p> Signup and view all the answers

    How often should jaundice be assessed in newborns?

    <p>Every 8-12 hours.</p> Signup and view all the answers

    What is the typical peak bilirubin level in physiologic jaundice in newborns?

    <p>5-6 mg/dL</p> Signup and view all the answers

    Which factor is a significant risk for early onset breastfeeding jaundice?

    <p>Insufficient intake</p> Signup and view all the answers

    What is one characteristic of late onset breastfeeding jaundice?

    <p>It lasts from 3 weeks to 3 months</p> Signup and view all the answers

    Which intervention is recommended for managing late onset breastfeeding jaundice?

    <p>Minimum of 8-12 feedings per day</p> Signup and view all the answers

    Pathologic jaundice in newborns typically appears at what time after birth?

    <p>Within 24 hours</p> Signup and view all the answers

    What is one common cause of pathologic jaundice?

    <p>Excessive hemolysis of RBCs</p> Signup and view all the answers

    Which symptom is associated with increased risk for early breastfeeding jaundice?

    <p>Sleepiness and poor suck</p> Signup and view all the answers

    What is a potential consequence of insufficiently addressed late onset breastfeeding jaundice?

    <p>Phototherapy treatment may be required</p> Signup and view all the answers

    Study Notes

    Normal Newborn Transition

    • Pulse: 120-160 bpm (may be as low as 100 bpm during sleep and up to 180 bpm while crying). Apical pulse should be counted for a full minute.
    • Respirations: 30-60 respirations/minute, predominantly diaphragmatic, but synchronous with abdominal movements. Brief periods of apnea (less than 15 seconds) are normal.
    • Temperature: Axillary: 36.4°C - 37.2°C (97.5°F - 99°F), Skin: 36°C-36.5°C (96.8°F to 97.7°F).
    • Blood Pressure: 90-60/50-40 mmHg at birth, 100/50 mmHg at day 10.
    • Blood Glucose: Greater than or equal to 40 mg/dL.
    • Hematocrit: Less than 65%-70% (central venous sample).

    Normal Newborn Rashes

    • Congenital Dermal Melanocystosis: Bluish-black pigmentation, common on back or buttocks, fades over a year. More prevalent in darker skin tones.
    • Nevus Simplex: Also known as salmon patches, superficial capillary defects, often found on face, neck, or eyelids. Usually fades within the first 1-2 years, though some can persist into adulthood.
    • Telangiectatic nevi: Similar to salmon patches, these are superficial capillary defects common on the face, neck, or eyelids; they gradually fade within several first/second years.
    • Erythema Toxicum Neonatorum: Transient rash developing in the first 24-72 hours, lasting up to three weeks. Found on any part of the body as an inflammatory response, does not require treatment, and often disappears without intervention.
    • Hemangioma: Newly formed capillary lesions, superficial and raised appearing; often a bright red color common on scalp, face, back, and anterior chest, they usually begin to fade after six months, but treatment may be considered in relation to size or location.
    • Milia: Small white sebaceous glands, normal finding, commonly found in the nose, chin and forehead areas.

    Infant Feeding

    • Feeding Cues: rapid eye movement under eyelids, suckling movements, hand-to-mouth movements; body movements; small sounds; rooting; crying (is the last hunger cue).
    • Types of Milk:
      • Colostrum: First 2-3 days, yellow, thick, high in protein, fat-soluble vitamins, minerals, and immunoglobulins.
      • Transitional Milk: 3-4 days to 2 weeks, higher concentration of fat, lactose, and water-soluble vitamins.
      • Mature Milk: After 2 weeks, 10% carbohydrates, protein, and fat, and 90% water. Foremilk (higher in water, vitamins, and protein), and hindmilk (higher in fat).

    Breast changes during and after breastfeeding

    • Colostrum development: may begin as early as 12-16 weeks.
    • Milk production: in alveoli of breasts; most produced during infant sucking.
    • Hormones: Prolactin, Oxytocin
    • Supply & demand: breastfeeding will regulate the amount of milk produced. If not stimulated, supply decreases.
    • Benefits of breastfeeding for infants Reduced allergies, infections, various diseases, tailoring nutrition, easily digestible, reduces constipation, healthy portion control, not reliant on clean water.
    • Benefits of breastfeeding for the mother Oxytocin release, enhances uterine involution, reduces blood loss, delays return of menses and ovulation.

    Discharge Teaching

    • Breastfeeding Clients: wear loose bras; breastfeed on demand (8-12 times daily); ensure complete breast emptying; use warm compresses before feeding and cold compresses after; and maintain proper nipple care
    • Non-breastfeeding Clients: Lactation suppression.
    • Engorgement relief: Cold compresses, cabbage leaves, analgesics, or anti-inflammatories (as needed)
    • Avoid direct stimulation and warm water

    Normal Newborn Transition

    • Vitals (infants):
      • Heart rate (120-160 bpm, apical, 1-minute count), respiration (30-60 bpm), temperature (36.4-37.2°C axillary), blood pressure (90-60/50-40 mmHg at birth, 100/50 mmHg at day 10).
    • Other Assessment: First 24 hours, full examination of physical condition; nutritional status; feeding practices; and metabolic testing.

    APGAR Scoring

    • Assessment: performed at 1 and 5 minutes after birth; - 0-3 = critical - 4-6 = below normal - 7-10 = normal
    • Repeated assessments: if score is less than 7, repeat every 5 minutes for up to 20 minutes.
    • Aspects assessed: Color, Heart Rate, Reflex Irritability, Muscle Tone, Respiratory Effort.
    • Action: based on outcome.

    Gestational Size/Age/ Maturity

    • Assessment used to assess physical development of the baby at birth
    • Physical Characteristics measured. A score is assigned.
    • Important Considerations: high risk problem assessment; vitals every 30 minutes, then hourly; identify infant, security system, and name band; obtain weight, length, and head circumference; measure BMI starting at 2 years old.

    Heat Loss

    • Conduction: heat loss through contact.
    • Convection: heat loss through air currents.
    • Evaporation: heat loss through moisture on skin.
    • Radiation: heat loss to surrounding environment.

    Immune System

    • Passive Immunity: Immunoglobulin G (IgG) crosses placenta during the third trimester, providing immunity to the infant. Breastfeeding also provides passive immunity.

    Types of Play

    • Unoccupied play: infants show no particular focus or activity.
    • Solitary Play: 0-2 years old, the child plays independently.
    • Onlooker Play: The child watches other children play. (~2 years)
    • Parallel Play: children play with similar activities but do not engage with each other (~ 2 years old)
    • Associative Play: (3 - 4 years) children engage in similar activities but can exchange materials or ideas
    • Cooperative Play: children play together with rules/goals and shared activities (~4 years old).

    Voiding

    • Infants: 93% of infants void within 24 hours of birth, and 99% void within 48 hours. Monitor for inadequate fluid intake, bladder distention, or restlessness.
    • Initial Bladder Volume: 6-44 ml.
    • Assessment: assess voiding as you assess feeding.

    Elimination (Breastfed)

    • Color: Yellow, gold, soft, or mushy, seedy.

    Jaundice

    • Assessment: Assess for jaundice every 8-12 hours. Visual assessment (universal predischarge bilirubin screening), serum levels.
    • Types: Physiologic (normal, 3-5 days after birth), Early/Late Onset Breastfeeding jaundice.
    • Treatment: Depending on severity. Possible phototherapy.

    Newborn Reflexes (and Specifics)

    • Specific Reflexes: blinking, Babinski (fans out toes), grasping (palms when touched), Moro (startle), rooting, stepping, sucking, swimming, tonic neck reflex.
    • Timing: and persistence of reflexes.

    Newborn Genitalia (and Specifics)

    • Normal Findings: specific observations and information.

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    Description

    Test your knowledge on the normal transition parameters of newborns, including vital signs and common newborn rashes. This quiz covers essential information regarding neonatal care that every caregiver should know.

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