Newborn Transition and Rashes
45 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the recommended frequency for breastfeeding on demand?

  • 6-10 times daily
  • 10-15 times daily
  • 5-8 times daily
  • 8-12 times daily (correct)

What is a suggested method for relieving engorgement in non-breastfeeding clients?

  • Applying cold compresses and fresh cabbage leaves (correct)
  • Engaging in regular breast stimulation
  • Using warm compresses and massage
  • Taking hot showers to relieve pressure

What should be done to ensure complete breast emptying during breastfeeding?

  • Feed for a minimum of 10 minutes on each breast
  • Limit feeding sessions to 20 minutes each
  • Only offer one breast per session
  • Allow feeding until the breast softens (correct)

Which is the correct way to assess a newborn's heart rate?

<p>Check apical for 1 full minute (A)</p> Signup and view all the answers

What is the normal range for a newborn's axillary temperature?

<p>36.4-37.2 C (C)</p> Signup and view all the answers

What is the primary role of fetal lung fluid during birth?

<p>It aids in the expansion of alveoli. (C)</p> Signup and view all the answers

At what gestational week is surfactant typically detectable?

<p>24-25 weeks (A)</p> Signup and view all the answers

Which factor is NOT associated with the baby's first breath during vaginal delivery?

<p>Chemical factors from anesthesia (A)</p> Signup and view all the answers

What occurs to the patent foramen ovale after birth?

<p>It closes permanently as lung resistance decreases. (B)</p> Signup and view all the answers

What characterizes the first hour after birth, known as the golden hour?

<p>Baby is most alert and benefits from skin to skin contact. (A)</p> Signup and view all the answers

Which of the following bypasses is responsible for connecting the two atria in fetal circulation?

<p>Patent foramen ovale (B)</p> Signup and view all the answers

What does an APGAR score of 4-6 indicate for a newborn?

<p>Below normal condition (C)</p> Signup and view all the answers

What is the purpose of performing the APGAR score at 1 and 5 minutes after birth?

<p>To monitor adaptation to extrauterine life (A)</p> Signup and view all the answers

What is NOT a characteristic of the period of relative inactivity following birth?

<p>Increased alertness and activity. (C)</p> Signup and view all the answers

Why is vitamin K administered to newborns within the first hour of birth?

<p>To aid in clotting factor synthesis (A)</p> Signup and view all the answers

What is the main purpose of the ductus venosus in fetal circulation?

<p>To bypass the liver. (C)</p> Signup and view all the answers

Which assessment is NOT typically included in the head-to-toe assessment performed on a newborn?

<p>Hearing evaluation (C)</p> Signup and view all the answers

What does acrocyanosis in a newborn indicate?

<p>Normal physiological response (A)</p> Signup and view all the answers

How often should vital signs be monitored in a newborn during the initial 24 hours?

<p>Every 30 minutes, then hourly (B)</p> Signup and view all the answers

What is the primary focus of evaluations during the first 24 hours before discharge?

<p>Nutritional status and feeding ability (A)</p> Signup and view all the answers

When is the newborn metabolic screening typically performed?

<p>After 24 hours of age, before discharge (C)</p> Signup and view all the answers

What is a key characteristic of a cephalohematoma?

<p>It is blood under the scalp caused by pressure. (A)</p> Signup and view all the answers

Which statement is true regarding voiding patterns in newborns?

<p>Most infants void 24 hours after birth. (A)</p> Signup and view all the answers

What is the typical stool appearance for a breastfed infant?

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

What is significant about assessing jaundice in newborns?

<p>Jaundice assessment involves checking every 8-12 hours. (D)</p> Signup and view all the answers

What is the initial bladder volume of a newborn?

<p>6-44 mL (C)</p> Signup and view all the answers

What describes the stool of a formula-fed infant?

<p>Formed and pasty with a typical odor. (A)</p> Signup and view all the answers

When promoting stooling in newborns, which of the following is crucial?

<p>Providing colostrum as a laxative. (D)</p> Signup and view all the answers

What risk is associated with cephalohematoma in newborns?

<p>Higher likelihood of jaundice. (C)</p> Signup and view all the answers

What is the peak bilirubin level typically reached in physiologic jaundice before it begins to decrease?

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

Which group of newborns is at a higher risk of developing physiologic jaundice?

<p>Both term and preterm newborns (B)</p> Signup and view all the answers

Which factor is a significant contributor to early onset breastfeeding jaundice?

<p>Insufficient breast milk intake (B)</p> Signup and view all the answers

What is the primary intervention for managing late onset breastfeeding jaundice?

<p>Ensure minimum of 8-12 feedings per day (C)</p> Signup and view all the answers

What is true about pathologic jaundice in newborns?

<p>It can result from excessive hemolysis of RBCs (D)</p> Signup and view all the answers

What factor can cause late onset breastfeeding jaundice?

<p>Breast milk substance interfering with bilirubin conjugation (D)</p> Signup and view all the answers

Which is NOT a common cause of pathologic jaundice?

<p>Breastfeeding issues (C)</p> Signup and view all the answers

What is the possible consequence if a newborn's total serum bilirubin levels are dangerously high?

<p>Pause breastfeeding for 1-3 days (B)</p> Signup and view all the answers

Which treatment for jaundice involves the use of special blue light?

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

Passive immunity for infants mainly comes from which source?

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

What is considered a more reliable indicator of infections in infants rather than fever?

<p>Hypothermia (D)</p> Signup and view all the answers

At what age does solitary play typically occur?

<p>0-2 years (C)</p> Signup and view all the answers

What is the term for the onset of breast development in females during puberty?

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

What occurs about 2-6 months after thelarche during puberty?

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

Which type of play involves children playing together with rules and possibly a winner?

<p>Cooperative Play (C)</p> Signup and view all the answers

What is the role of breastfeeding in relation to passive immunity in infants?

<p>It continues passive immunity by transferring antibodies from the mother. (B)</p> Signup and view all the answers

Flashcards

Breastfeeding Frequency

Breastfeed on demand, 8-12 times a day.

Infant Heart Rate

Normal newborn heart rate is 120-160 bpm, checked for a full minute at the apical pulse.

Newborn Respiration Rate

Normal newborn respiration rate is 30-60 breaths per minute, often with diaphragmatic breathing.

Post-feeding Breast Care

For breastfeeding mothers, apply cold compresses after feeding to reduce swelling.

Signup and view all the flashcards

Lactation Suppression for Non-Breastfeeding

Wearing a supportive bra continuously for 72 hours to stop milk production.

Signup and view all the flashcards

APGAR score

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

Signup and view all the flashcards

APGAR score range

Scores range from 0-10, with 7-10 considered normal; 0-3 critical; 4-6 below normal.

Signup and view all the flashcards

Vitamin K injection

A crucial injection given to newborns within one hour of birth to enable blood clotting.

Signup and view all the flashcards

Newborn metabolic screening

A test performed on newborns (usually heel prick) to screen for inherited metabolic disorders.

Signup and view all the flashcards

Initial newborn assessment

Assessment immediately after birth that includes APGAR scoring and airway clearance.

Signup and view all the flashcards

Newborn head circumference

Measurement from supraorbital ridges to the most prominent part of the occiput.

Signup and view all the flashcards

Acrocyanosis

Blue or grayish discoloration of hands and feet in newborns, typically normal.

Signup and view all the flashcards

First 24 hours assessment

Comprehensive examination of the newborn's overall health within the first 24 hours, before discharge.

Signup and view all the flashcards

Caput Succedaneum

Swelling on the head, over the sagittal suture, caused by pressure during delivery. It disappears within a few days.

Signup and view all the flashcards

Cephalohematoma

Blood under the scalp, but doesn't cross the suture lines. Caused by pressure during delivery. It resolves slowly and increases jaundice risk.

Signup and view all the flashcards

Newborn Voiding: Assessing First 24 Hours

Most babies void within 24 hours of birth. If not, assess fluid intake, bladder distention, restlessness, and discomfort.

Signup and view all the flashcards

Newborn Voiding: Initial Bladder Volume

A newborn's bladder can hold 6-44 mL. Assess feeding as you assess voiding frequency.

Signup and view all the flashcards

Newborn Voiding: Frequency - Day 1-2

Typical voiding frequency is 2-6 times a day.

Signup and view all the flashcards

Newborn Voiding: Frequency - Day 3-4

Typical pee frequency increases to 6-8 times a day.

Signup and view all the flashcards

Newborn Voiding: Frequency - Day 5+

Typical frequency remains at 6-8 times a day.

Signup and view all the flashcards

Breastfed Stool: Color

Yellow, gold, soft or mushy, seedy. Typically 3+ stools per day in the first 6 weeks.

Signup and view all the flashcards

Fetal Lung Fluid

A fluid that fills the alveoli of the fetal lungs, aiding in lung development. About 65% is absorbed before birth, leaving 80-100 cc remaining.

Signup and view all the flashcards

Surfactant

A substance produced by the lungs that helps prevent the alveoli from collapsing during breathing. It becomes detectable around 24-25 weeks gestation.

Signup and view all the flashcards

Baby's First Breath: C-Section

A Cesarean section can delay the removal of fetal lung fluid due to less squeezing and compression of the fetal chest.

Signup and view all the flashcards

Factors that Initiate Respiration

Factors that prompt the baby's first breath include: mechanical (chest compression), chemical (CO2 increase and pH decrease), thermal (temperature change), and sensory.

Signup and view all the flashcards

Fetal Circulation: High Resistance in Lungs

High resistance and pressure in the fetal lungs keep the bypasses (foramen ovale, ductus arteriosus, ductus venosus) open.

Signup and view all the flashcards

Foramen Ovale

An opening between the atria that closes after birth. This bypass helps deliver oxygenated blood to the baby's brain.

Signup and view all the flashcards

Ductus Arteriosus

A blood vessel that bypasses the lungs in the fetus. It carries oxygenated blood to the lower limbs.

Signup and view all the flashcards

Ductus Venosus

A vessel that bypasses the liver in the fetus, allowing blood to go from the umbilical cord directly to the heart.

Signup and view all the flashcards

Phototherapy

Treatment for jaundice in newborns using specialized blue light, not UV rays, to break down bilirubin in the blood.

Signup and view all the flashcards

Passive Immunity

Immunity passed from mother to infant through antibodies, primarily IgG, that cross the placenta during pregnancy and through breastfeeding.

Signup and view all the flashcards

Hypothermia

A lower body temperature than normal, a more reliable indicator of infection in newborns than fever.

Signup and view all the flashcards

Unoccupied Play

Play characterized by infants who are not engaging in any particular activity, often observing their surroundings.

Signup and view all the flashcards

Solitary Play

Play typical of children between 0-2 years old, where they engage in activities independently without interacting with others.

Signup and view all the flashcards

Onlooker Play

Play seen around 2 years old, where children observe others playing but don't actively participate.

Signup and view all the flashcards

Parallel Play

Play seen in toddlers 2+ years, where children engage in similar activities alongside each other but not interacting directly.

Signup and view all the flashcards

Thelarche

The onset of breast development in girls, typically between 8-13 years, triggered by an increase in estrogen levels.

Signup and view all the flashcards

Physiologic Jaundice

A normal, temporary yellowing of the newborn's skin and eyes, occurring between 3-5 days after birth, caused by the breakdown of fetal red blood cells.

Signup and view all the flashcards

Early-Onset Breastfeeding Jaundice

Yellowing of the skin and eyes in breastfed babies within the first week of life, caused by insufficient milk intake due to poor sucking or infrequent nursing.

Signup and view all the flashcards

Late-Onset Breastfeeding Jaundice

Yellowing of the skin and eyes in breastfed babies developing after the first few days of life, likely due to a substance in breast milk that increases bilirubin absorption or interferes with its breakdown.

Signup and view all the flashcards

Pathologic Jaundice

A serious type of jaundice appearing within 24 hours of birth, caused by excessive red blood cell breakdown or problems with bilirubin breakdown, potentially due to infections, blood incompatibilities, or metabolic disorders.

Signup and view all the flashcards

Causes of Pathologic Jaundice

Conditions that cause pathologic jaundice include infections, blood incompatibilities (like Rh incompatibility), metabolic disorders, and head trauma.

Signup and view all the flashcards

Bilirubin & Jaundice

Bilirubin is a yellow pigment produced when red blood cells break down. High levels of bilirubin in the blood lead to the yellowing of the skin and eyes, known as jaundice.

Signup and view all the flashcards

Intervention for Early-Onset Breastfeeding Jaundice

To address early-onset breastfeeding jaundice, parents are assisted with breastfeeding techniques, and milk production may be stimulated through pumping.

Signup and view all the flashcards

Intervention for Late-Onset Breastfeeding Jaundice

Monitoring, frequent breastfeeding, and phototherapy are interventions for late-onset breastfeeding jaundice. In severe cases, breastfeeding may be temporarily paused.

Signup and view all the flashcards

Study Notes

Newborn Transition

  • Normal Findings: Pulse range is 120-160 bpm, but may be as low as 100 bpm during sleep and up to 180 bpm during crying. Apical pulse is counted for a full minute. Respiratory rate is 30-60 breaths per minute, primarily diaphragmatic, but synchronous with abdominal movements. Brief periods of apnea, less than 15 seconds, are normal. Axillary temperature is 36.4-37.2°C (97.5-99°F), and skin temperature is 36-36.5°C (96.8-97.7°F). Blood pressure at birth is 90-60/50-40 mmHg, rising to 100/50 mmHg by day 10. Blood glucose should be at least 40mg/dL and hematocrit should be less than 65-70% in central venous sample.

Normal Newborn Rashes

  • Congenital Dermal Melanocystosis: Bluish-black pigmentation; common on back or buttocks. Usually fades over a year and more common in darker skin tones.
  • Nevus Simplex: Also called salmon patches. They are salmon-colored patches on the face, neck, and eyelids caused by superficial capillary defects. Fades in the first 1-2 years of life but facial patches may remain into adulthood.
  • Erythema Toxicum Neonatorum: Transient rash appearing in the first 24-72 hours and lasting up to 3 weeks. It appears anywhere on the body as red dots. It is an inflammatory response and generally resolves without treatment.
  • Hemangioma: New, dilated capillaries, usually superficial raised lesions. Appear bright red and grow in size until about 6 months, then start to fade and usually don't require treatment unless they are a significant size or internal.
  • Milia: Small, white sebaceous glands; commonly found on the face and are considered normal.

Infant Feeding

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

Breastfeeding

  • Breast Milk Production: Colostrum development begins between 12-16 weeks, and milk is produced in the alveoli of the breasts, most notably during infant sucking. The hormones prolactin and oxytocin are crucial to milk production.
  • Supply and Demand: Negative feedback is triggered if milk isn't removed from the breasts.

Breastfeeding Benefits

  • Infant Benefits: Breast milk is tailored to the infant's specific needs and is easily digestible, reducing constipation while promoting healthy portion control and avoiding reliance on clean water. Breast milk also reduces allergies, infections, and may lower the risk of various diseases.
  • Mother Benefits: Oxytocin release can enhance uterine involution, reduce blood loss, and delay the return of menses and ovulation.

Discharge Teaching

  • Breastfeeding: Wear comfortable non-binding bras, breastfeed on demand (8-12 times per day), offer both breasts during each feeding session, utilize warm compresses before feeding and cold compresses after feeding, and ensure complete breast emptying.
  • Non-Breastfeeding: Use supportive bras continually for 72 hours, avoid breast stimulation, and employ cool compresses or fresh cabbage leaves to alleviate engorgement. Analgesics or anti-inflammatories may be used to address pain.

Normal Newborn Transition (Vitals)

  • Heart Rate: 120-160 BPM (apical pulse), checked for a full minute.
  • Respiratory Rate: 30-60 breaths per minute.
  • Temperature: Axillary 36.4-37.2°C (97.5-99°F), skin temperature 36-36.5°C (96.8-97.7°F).
  • Blood Pressure: 60-90/40-50 mmHg (apical, which is often easier than brachial) but typically may reach 100/50 mmHg by day 10.

APGAR Scoring

  • APGAR scoring: Assesses newborns at 1 and 5 minutes after birth by evaluating color, heart rate, reflex irritability, muscle tone, and respiratory effort. A score of 0-3 is considered critical, 4-6 below normal, and 7-10 normal. Perform every 5 minutes for up to 20 minutes if initial score is less than 7.
  • Clinical Follow-up: Repeat the APGAR test or evaluate other factors if the initial APGAR score is low

Other

  • Jaundice: Assessing for jaundice every 8-12 hours, with both visual assessments (universal predischarge screening) and serum testing (blood test through a heel stick), or transcutaneous testing when appropriate.
  • Types of jaundice: Evaluating possible causes, whether physiologic or pathological.
  • Elimination: Evaluating stool consistency, frequency, and color. Breastfed infants' stool should be yellow, gold, soft, or mushy (seedy). Formula-fed stools are generally pale yellow to light brown, formed, and pasty.

Newborn Reflexes

  • Reflexes: Summarized description of newborns' common reflexes like blinking, Babinski, grasping, Moro, rooting, stepping, sucking, swimming, and tonic neck reflex. Describes when these reflexes typically disappear.

Newborn Genitalia

  • Normal: Description of normal genitalia and potential abnormalities (e.g., hypospadias, epispadias, undescended testicles, etc) including when to watch for these potential issues and seek healthcare
  • Voiding: Assessing for voiding within 24 hours as a baseline for normal fluid intake and appropriate kidney function

Types of Play

  • Categories of play: Description of types of play categorized by unoccupied, solitary, onlooker, parallel, associative, and cooperative play in infants. The different periods described are typically linked to their specific age group.

Puberty

  • Growth and Development: Description of typical puberty changes in boys and girls (breast development, pubic and axillary hair, menarche, spermarche, etc.).

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Exam 3_ Notes PDF

Description

This quiz covers the vital signs and normal findings during the newborn transition period, including pulse, respiratory rates, and blood pressure. Additionally, it explores common newborn rashes like congenital dermal melanocystosis and nevus simplex. Test your understanding of these essential newborn health aspects.

More Like This

Placental Stage and Newborn Transition
18 questions
Newborn Transition and Assessment
47 questions
Normal Newborn Transition and Rashes
41 questions
Use Quizgecko on...
Browser
Browser