NSG 210 - Newborn Care Questions And Answers With Verified Solutions Graded A+

5 areas of CV adaptations in newborn - 1-Increases aortic pressure and decreased venous pressure 2-Increased systemic pressure and decreased pulmonary artery pressure 3-Closure of the foramen ovale 4-Closure of ductus arteriosis 5-Closure of ductus venosus APGAR score - System used to evaluate a newborn infant's physical status at 1 min and 5 minutes after birth. Appearance, Pulse, Grimace, Activity, Respirations. at-risk newborn - one susceptible to illness or death because of dysmaturity, immaturity, physical disorders, complications during or after birth Cardiopulmonary physiology - -Increase in PO2 stimulated pulmonary arteries to relax, triggers decrease in pulmonary vascular resistance. -Vascular flow into lungs increases rapidly, normal flow achieved within 24 hrs. -Heart must deliver enough blood to functional, open alveoli Care of the newborn following transition - -Assess vital signs every 4-8 hrs or more -Back to sleep -Vigorous finger stroking of spine stims respiratory activity -Record caloric food intake -Early, frequent feedings, Record voiding/stool patterns -Skin integrity -Promote safety -Circumcision - after, assess every 30 min and first void -Prepare family for dischargecharacteristics of newborn respiration - -initial ones are diaphragmatic, shallow, irregular in depth, rhythm -periodic breathing, pauses last 5-15 secs -Apnea (up to 20 secs) -Nose breathers -RR 60-70/mins birth to 2 hrs, then 30-60/mins Clamping of the cord - -Place clamps after identifying vessels -1.3-2.5 cm from abdomen -Remove 24 hrs after cord has dried -Delayed clamping (at least 30-60 secs) has benefits: increased BV, decreased possibility of intracranial hemorrhage, lower frequency of iron deficiency anemia Coagulation - _Low levels of Vit K in newborn gut, rise from low point at 2-3 days -Transient neonatal thrombocytopenia in newborns of mothers with HELLP or severe HTN Conjugation of bilirubin - Conversion of yellow lipid-soluble pigment into water-soluble pigment. -Unconjugated bilirubin not excretable so potential toxin -Conjugated can change back to unconjugated (recycled), esp. babies w/ very high beta-D-glucuronidase activity levels, exclusively breastfed, or delayed bacterial colonization ( from antibiotics) Establishing gestational age - Neuromuscular maturity characteristics - -Resting posture -stronger flexion 35 weeks -Square window sign: wrist angle, 28-32 wks 90 degrees -Recoil: arm flexion -Popliteal angle: angle of knee in supine newborn -Scarf sign: pulling arm across chest -Heel-to-ear extension: more resistance in advanced age-Head lag: total lag up to 34 weeks -Ventral suspension: horizontal position -Major reflexes Establishing gestational age - Physical maturity characteristics - -Skin, Lanugo, Vernix, Hair, Nails -Sole creases -Areola/breast bud tissue -Ear form, cartilage distribution -Genitals -Skull firmness