NCLEX OB/Maternity/peds Study Guide. 76
Comprehensive Questions and Answers 100%
Accuracy|Updated 2024|.
Newborn reflexes
1.palmar grasp, moro, tonic neck (fencing): fades 3-4 months
2.rooting and sucking: turns to any object that touches mouth/cheek, disappears 4-7months
3.stepping reflex:fades 4-5months
4.plantar grasp: pressure on sole behind toes elicits flexion (lessens by 8months)
4.pupillary: constricts to light
6.babinski:reverts to adult response by 12months
Normal Newborn Assessments
>weight 6-9 lbs, 19-21 inches, head circumference 13-14 inches, chest 12-13 inches
>anterior fontanel: diamond shaped, easily felt, flat and open (moderate bulging with crying/stooling).
Sustained bulging = incr ICP, depressed =dehydration. closes 18 months
>posterior fontanel: not easily palpated, close 8-12 weeks
>cephalhematoma: collection of blood under periosteum of a cranial bone on 1st and 2nd day, doesn't
cross suture line, disappears in wks-mos
>caput succedaneum: localized soft swelling of the scalp, assoc with long and difficult birth, overrides
suture line, fluids is reabsorbed w/i hours to days
>eyes edematous, pupils equal and reactive to light, absence of tears, corneal reflex, blink reflex, areas of
subconjunctival hemorrhage
>breast enlarge up to 2 wks
>umbilical cord white and gelatinous, 2 Arteries 1 Vein. Shriveled and black 2-3 days, falls off in 1-2 wks.
Foul smelling discharge =infection
>may not void for 12-24 hrs (may be brick-red spots on diaper from passing uric acid crystals), then 6-
10x/day void
>females may have thick white discharge; white cheese-like substance (smega) and/or blood-tinged
(pseudomenstruation)
Normal newborn stool transition
1. first stool - black and tarry, passed w/i 12-24hrs. 2. 3rd day - green-brown
3. then 1-2 formed pale yellow to light brown stools a day with (formula feeding). loose golden yellow
with sour milk odor (breast feeding)
Newborn circumcision care
>whitish yellow exudate is normal. If plastibell is used, report to pediatrician if it has not fall off in 8 days
>Area red with small bleeding is normal
>informed consent
, >monitor bleeding, voiding, and swelling. swelling interfere with urination
>apply A&D ointment or petroleum jelly (except when plastibell is used)
>Wash with warm water squeezed over penis
Newborn umbilical cord care
>cord should be dry and hard, no tub baths until it falls off. Don't cover with a shirt or diaper. Fold diaper
below it to maintain dry area
>redness, drainage/exudate, foul odor =infection and needs to be reported
>clamp can be removed 24 hrs if cord is dried and not bleeding
>clean with soap and water, wash newborn with sponge bath after cord falls off (w/i 2 wks)
GPTAL
G-gavidity (# of pregnancies)
P-preterm births
T-term births
A-abortions/miscarraiges
L-living children
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