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NURP 531 Exam Latest Update
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NURP 531 Exam LatestUpdate
Variations in Newborn Skin:
Acrocyanosis - Answer Definition:
Bluish discoloration of the hands and feet after birth.
Comment:
Peripheral cyanosis is normal in the first 24-48 hours due to the immature cardiac
circulation.Presence after 24-48 hours is usually due to cold stress.
Variations in Newborn Skin:
Harlequin sign - Answer Definition:
Unilateral color change on one side of the body. Half of the newborn turns red, with a
line of demarcation appearing down the baby's midline.
Comment:
Transient, harmless color change lasting for 10-20 minutes. It is more common in
low-birth-weight infants. Autonomic vasomotor instability results in a red color on the
dependent side of the body and pallor on the superior side of the body.
Variations in Newborn Skin:
Erythema toxicum - Answer Definition:
Normal newborn rash abruptly occurs as yellow or white papules over an erythematous
base, usually 1 to 3 mm in diameter, over the baby's body except for palmar surfaces.
Occurs in 30-70% of newborns.
Comment:
Unknown cause, but may be the result of an awakening of the immune system.
Variations in Newborn Skin:
Milia - Answer Definition:
Exposed sebaceous glands that look like whiteheads on the infant's face, nose, or chin.
,Comment:
Disappear within the first month of life. No treatment is needed.
Variations in Newborn Skin:
Mongolian spots (slate-colored spots) - Answer Definition:
Bluish-gray pigmentation of the skin occurring on the lower back and across the
shoulders, hips, and legs.
Comment:
Due to uneven pigmentation, Mongolian spots are most common in dark-skinned
neonates.They resemble bruising, fade over time (months to years), and can be
confused with bruising of non-accidental trauma (NAT). Documentation of location and
size is necessary.
Variations in Newborn Skin:
Strawberry hemangioma - Answer Definition:
Raised capillary nevi, occurring anywhere on the body, that increases in size for the first
few months of life, slowly decreases in size over time, and disappears by 10 years of
age.
Comment:
No referral is necessary unless the hemangioma is near the eye or interferes with vision.
Variations in Newborn Skin:
Stork bites - Answer Definition:
Telangiectatic nevus or nevus simplex that appears as a pale pink or reddish
discoloration of the skin at the nape of the neck, the lower axilla, around the nasal
bridge, and on the eyelids.
Comment:
More noticeable when the infant is crying. Usually disappears by the second birthday,
and requires no intervention.
Variations in Newborn Skin:
Lanugo - Answer Definition:
Fine, soft hair that covers the newborn's back, shoulders, cheeks, forehead, and scalp.
Lanugo is more common in the premature infant and disappears within the first 4 weeks
of life.
,Comment:
Normal—no referral is required.
Variations in Newborn Skin:
Linea nigra - Answer Definition:
Line of increased pigmentation from umbilicus to genitalia.
Comment:
Normal; more common in dark-skinned infants.
Variations in Newborn Skin:
Vernix caseosa - Answer Definition:
Cheesy, gray-white substance covering and protecting the skin during fetal life.
Coverage at birth is directly related to gestational age.
Comment:
Gradually diminishes near term.
Variations in Newborn Skin:
Acne neonatorum - Answer Definition:
Appears at several weeks of age as an acne-like rash; caused by maternal hormones'
stimulation of sebaceous glands. More common in males.
Comment:
Lotions, creams, and ointments worsen the rash.
Variations in Newborn Skin:
Petechiae - Answer Definition:
Pinpoint-sized hemorrhage on the skin.
Comment:
Normal on the presenting part, but its presence on the body on other than the
presenting part may be symptomatic of infection.
Abnormal Findings in Newborn Skin:
Jaundice - Answer Examination Findings:
Yellowing of the skinMost visible after blanching. Progression is head-to-toe.
, Clinical Significance:
Physiologic or pathologic jaundice.
Blood incompatibility (ABO; Rh).
Immature liver function.
Diseases involving the liver.
Action Required:
Blood type and Coombs test.
Direct and total bilirubin.
Abnormal Findings in Newborn Skin:
Circumoral or periorbital cyanosis;
cyanosis of the chest or abdomen - Answer Examination Findings:
Bluish discoloration around the lips, eyes, or torso and abdomen.
Clinical Significance:
Central cyanosis, pathologic cyanosis, caused by hypoxemia.
Because of fetal hemoglobin, a neonate must have an oxygen saturation < 60% to be
visibly cyanotic.
Action Required:
Requires assessment for respiratory, cardiac, infectious, or neurologic conditions.
Evaluation of PO oxygenation—preductally and postductally.
Abnormal Findings in Newborn Skin:
Café-au-lait spots - Answer Examination Findings:
Hyperpigmented lesions, usually macules; typically irregular in shape and light brown
color
Clinical Significance:
Most likely benign.
Neurofibromatosis.
Tuberous sclerosis.
Gaucher disease.
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