Exam (elaborations)
PN 131 NEWBORN EXAM
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PN 131 NEWBORN EXAM...
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Neonatal Transition to Extrauterine Life - ANSWER Phase 1: Period ofreactivity, 0-30 minutes after birth
Phase 2: Decreased responsiveness, 30 minutes to 2 hours after birth
Phase 3: Second period of reactivity, 2 to 8 hours after birth
Immediate care after birth - ANSWER -Airway maintenance #1
-Maintaining body temperature #2
-Immediate interventions
-Eye prophylaxis
-Vitamin K prophylaxis
-Promoting parent-infant interaction
-Apgar scoring (1 min & 5 min) and initial assessment
Physical Assessment of Newborn - ANSWER -General Appearance
-Vital signs
-Baseline measurements
-Weight 2500-4000g (5.5-8.8 lb)
-Head circumference 32-36.8 cm (12.6-14.5")
-Length 45-55 cm (17.7-21.7")
-Neurologic assessment
First period of reactivity - ANSWER 30-60min after birth
-Heart rate increases to 160 to 180 beats/min
-Decreases after 30 minutes to baseline
-Alert and has spontaneous startles, crying, and head movement
-Best time to initiate 1st breastfeeding
Period of decreased responsiveness - ANSWER lasts 60-100min
-Infant is pink
-Respirations rapid and shallow up to 60 breaths per minute
-Sleeps or has a marked decrease in motor activity
Second period of reactivity - ANSWER Lasts 10min-several hours
-Occurs between 2 and 8 hours after birth
, -Tachycardia, tachypnea occur
-Meconium passed
-Increased muscle tone, changes in skin color,
and mucus production
Neonatal responses to pain - ANSWER - Heartrate & Respiratory
Changes
- BP Increases
- BG levels rise
- Clenched fist
- Increased muscle tone
- Tightly closed eyes
- Rapid, shallow respirations
Nonpharmacologic management of neonatal pain - ANSWER -
Swaddling with hand near the mouth
-Cuddling
-Rocking
-Nonnutritive sucking
-Quiet environment
Pharmacologic management of neonatal pain - ANSWER -Oral sucrose
for minor procedures
-Morphine, fentanyl, and topical anesthetics can be used safely for
severe pain
Normal Temperature for newborn - ANSWER 97.1- 99.8
(Rectal or Axilla)
Normal Pulse for newborn - ANSWER 110-160
(Take first with resp, count apically for 60 secs)
Normal Respirations for newborn - ANSWER 30-60
(Take first manually for 60 secs
Quality important: irregular, shallow, retractions, nasal flaring, noisy
respirations)
Normal O2 Sat for newborn - ANSWER 98-100%
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