Podcast
Questions and Answers
Which feeding cue is considered the LAST hunger cue for a newborn?
Which feeding cue is considered the LAST hunger cue for a newborn?
What is colostrum and when is it produced?
What is colostrum and when is it produced?
What is a major hormonal factor involved in milk production during breastfeeding?
What is a major hormonal factor involved in milk production during breastfeeding?
Which of the following statements about mature milk is correct?
Which of the following statements about mature milk is correct?
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Which of the following is a benefit of breastfeeding for infants?
Which of the following is a benefit of breastfeeding for infants?
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What occurs if human milk is not removed effectively from the breast?
What occurs if human milk is not removed effectively from the breast?
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What is one of the benefits of oxytocin release during breastfeeding?
What is one of the benefits of oxytocin release during breastfeeding?
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What is indicated by an APGAR score of 4?
What is indicated by an APGAR score of 4?
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When should the vitamin K injection be administered to the newborn?
When should the vitamin K injection be administered to the newborn?
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What is the purpose of skin-to-skin contact immediately after birth?
What is the purpose of skin-to-skin contact immediately after birth?
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Which assessment should be performed every 30 minutes during the first hours after birth?
Which assessment should be performed every 30 minutes during the first hours after birth?
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What is the normal finding for acrocyanosis in newborns?
What is the normal finding for acrocyanosis in newborns?
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What assessment should be made regarding gestational size/age?
What assessment should be made regarding gestational size/age?
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During which time frame is the newborn most alert for assessments?
During which time frame is the newborn most alert for assessments?
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What is a characteristic of physiologic jaundice in newborns?
What is a characteristic of physiologic jaundice in newborns?
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Which of the following is included in the complete assessments within the first 24 hours?
Which of the following is included in the complete assessments within the first 24 hours?
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What is the main purpose of the heel stick screening performed after 24 hours of age?
What is the main purpose of the heel stick screening performed after 24 hours of age?
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Which factor increases the risk of early onset breastfeeding jaundice?
Which factor increases the risk of early onset breastfeeding jaundice?
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What intervention is recommended for late onset breastfeeding jaundice?
What intervention is recommended for late onset breastfeeding jaundice?
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Which of the following is true regarding pathologic jaundice?
Which of the following is true regarding pathologic jaundice?
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What causes late onset breastfeeding jaundice in infants?
What causes late onset breastfeeding jaundice in infants?
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What characterizes caput succedaneum?
What characterizes caput succedaneum?
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What is a key feature of cephalohematoma?
What is a key feature of cephalohematoma?
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What should a nurse assess if a newborn does not void within 24 hours?
What should a nurse assess if a newborn does not void within 24 hours?
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How many times per day should a breastfed baby typically void during the first two days?
How many times per day should a breastfed baby typically void during the first two days?
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What is the typical stool appearance for a breastfed infant?
What is the typical stool appearance for a breastfed infant?
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How often should jaundice be assessed in newborns?
How often should jaundice be assessed in newborns?
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What is one benefit of colostrum in newborn feeding?
What is one benefit of colostrum in newborn feeding?
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What is a common stool frequency for formula-fed infants?
What is a common stool frequency for formula-fed infants?
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What is a typical initial bladder volume for a newborn?
What is a typical initial bladder volume for a newborn?
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When should the first feed of a newborn ideally occur?
When should the first feed of a newborn ideally occur?
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What role does fetal lung fluid play in the initiation of respiration?
What role does fetal lung fluid play in the initiation of respiration?
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What is a key factor that helps force out remaining fetal lung fluid during the baby's first breath?
What is a key factor that helps force out remaining fetal lung fluid during the baby's first breath?
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How does the placenta function in fetal circulation?
How does the placenta function in fetal circulation?
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Which of the following factors is NOT associated with the baby's first breath?
Which of the following factors is NOT associated with the baby's first breath?
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What is significant about the 'golden hour' after birth?
What is significant about the 'golden hour' after birth?
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During which period does relative inactivity occur post-birth?
During which period does relative inactivity occur post-birth?
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What is NOT a characteristic of small for gestational age (SGA) infants?
What is NOT a characteristic of small for gestational age (SGA) infants?
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What function does the patent foramen ovale serve in fetal circulation?
What function does the patent foramen ovale serve in fetal circulation?
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Which factor influences the closure of bypasses in fetal circulation post-birth?
Which factor influences the closure of bypasses in fetal circulation post-birth?
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Which structure bypasses the lungs in fetal circulation?
Which structure bypasses the lungs in fetal circulation?
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Study Notes
Normal Newborn Transition
- Pulse: 120-160 bpm (may be as low as 100 bpm during sleep, up to 180 bpm when crying). Apical pulse counted for a full minute due to fluctuations.
- Respirations: 30-60 breaths per 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 temperature 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% in a central venous sample.
Normal Newborn Rashes
- Congenital dermal Melanocystosis: Bluish-black pigmentation, commonly found on the back or buttocks of newborns. Typically fades over a year, more common in darker skin tones.
- Nevus Simplex: Also known as salmon patches, these are telangiectatic nevi, which are superficial capillary defects. Often found on the face, neck, and eyelids. They typically fade within the first 1-2 years of life, but occasionally persist into adulthood.
- Erythema Toxicum Neonatorum: Transient rash, appearing in the first 24-72 hours, and lasting up to three weeks. Can appear anywhere on the body. It's an inflammatory response, and no treatment is needed.
- Hemangioma: Dilated newly formed capillaries, these are superficial, raised lesions that are bright red in color. Often seen on the scalp, face, back, or anterior chest.
- Milia: Small, white sebaceous glands, appearing as small white bumps. They are a normal finding.
Infant Feeding
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Feeding Cues:
- Rapid eye movement under eyelids
- Sucking movements
- Hand-to-mouth movements
- Body movements
- Small sounds
- Rooting reflex
- Crying (the last hunger cue)
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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% carbs, protein, and fat, 90% water. Foremilk and hind milk differ in fat content.
Breastfeeding
- Colostrum development: Begins as early as 12-16 weeks.
- Milk produced: In alveoli of breasts. Most milk production happens during infant sucking.
- Hormones involved: Prolactin and oxytocin.
- Supply and demand: If milk isn't removed, negative feedback will happen.
Breastfeeding Benefits
- Reduces allergies, infections, and lowers risks of various diseases.
- Tailored to meet specific needs.
- Easily digestible, reduces constipation.
- Promotes healthy portion control.
- Not reliant on clean water.
- Oxytocin release enhances uterine involution, reduces blood loss, and delays the return of menses.
Discharge Teaching (Breastfeeding)
- Wear nonbinding bra: To prevent clogged ducts.
- Breastfeed on demand: 8-12 times daily.
- Allow feeding until breast softens: Offer both breasts per session.
- Use warm/cold compresses: pre/post feeding for comfort.
- Ensure complete breast emptying.
- Nipple care
- Hydration
Discharge Teaching (Non-breastfeeding)
- Lactation suppression: Supportive bra continuously for 72 hours, avoid breast simulation and warm water.
- Engorgement relief: Cold compresses, fresh cabbage leaves, analgesics/anti-inflammatories.
Normal Newborn Transition (Vitals)
- Heart rate: 120-160 bpm (apical), checked for 1 minute.
- Respiration rate: 30-60 breaths per minute.
- Temperature (Axillary): 36.4-37.2°C (97.5-99°F).
- Blood pressure: (Brachial or Apical) 90-60/50-40 mmHg.
Other Topics
- APGAR score: Assess newborn at 1 and 5 minutes after birth (color, heart rate, reflex irritability, muscle tone, respiratory effort). Scores of 0-3 are critical, 4-6 below normal, 7-10 normal if scores less than 7 repeat checking every 5 min for up to 20min
- Wet diapers and poopy diapers
- Gestational age/size: Ballard or other scales assess physical maturity.
- High-risk problem assessment: Vitals (every 30-60 min), identify infant, assess name band, length, wt, and head circumference.
- Heat loss: Conduction, convection, radiation, evaporation
- Newborn reflexes: Blinking, Babinski, grasping, Moro (startle), rooting, stepping, sucking, swimming, tonic neck.
- Elimination/Voiding: Urine should be produced within 24 hours of birth (approx 93%).
- Jaundice: Assess every 8-12 hours (visual or universal predischarge screening). Physiologic jaundice, early-onset breastfeeding jaundice, pathologic jaundice and treatment options.
- Immunizations: Scheduled immunizations for infants (e.g., HepB, RV, DTaP, etc.)
- Development milestones for 0-12 months.
- Immunoglobulins (IgG): Crosses the placenta; provides passive immunity.
- Active Immunity: Development through exposure to pathogens.
- Hypothermia: Reliable indicator of infection instead of fever as it would be for adults. Additional signs include altered activity, tone, color and feeding.
- Types of Play: Unoccupied, solitary, onlooker, parallel, associative, cooperative
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Description
This quiz covers essential concepts regarding the normal physiological parameters of newborns and common rashes they may present with. From heart rate to skin pigmentation, test your knowledge on the vital signs and dermatological conditions of newborns.