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NUR 113 Exam With 100% Correct Answers Latest UpdateNewborn assessment- abdomen - Answer Abdomen
Umbilical cord
One vein and two arteries- should be able to see those vessels
Single artery may be associated with renal and GI anomalies; SGA infants
Whitish blue-gray, contains a gelatinous tissue called Wharten's jelly
Inspect for bleeding, infection, inflammation, drainage, and redness
Auscultate bowel sounds
Reflexes
Rooting, sucking, gag, Moro, tonic neck, Babinski, swallow, blink, burp, hiccup, palmar
grasp, plantar and sneeze
A two vessel cord often means nothing but other times is associated with small for
gestational age babies or other defects-variation in their normal makeup that is not quite
normal-like an anus that is not patent and sometimes associated with a heart defect
These reflexes tell us that their neuro system is intact
Some girls have a mucous or blood-tinged discharge due to mother's residual hormones
and should reassure parents
Newborn assessment- genitalia - Answer Genitals
Scrotum of males and labia of females may be swollen due to fluid accumulation.
The penis should be observed for the position of the urethral meatus.
Girls may have a mucus discharge tinged with blood
Observe anus for patency. Presence of meconium indicates patency
We no longer do a rectal thermometer, now we wait for them to pass meconium and if
has been over 24 hours without it then we will check but we do not want to traumatize
the anus with the temperature probe unnecessarily
,Newborn assessment-extremities and back- Answer Extremities
Arms and hands are generally flexed against the body, both arms should move evenly
Limbs: of equal length, hips freely movable
Hands and Feet: to be inspected for syndactyly and polydactyly
Spine
Straight with no curvature
Also, check for a sacral dimple or pit at the base of the spine: this may be within normal
variant, but if it is very deep and there is something that resembles a tuft of hair in the
bottom of it, it must be investigated to ensure that that pit doesn't communicate all the
way to the spinal cord.
Shoulder dystocia may lead to clavicle injury and they believe it is the force of labor that
fracture the clavicle rather than the dystocia shoulder
Polydactyl-extra number of fingers or syndactyl-fingers joined together
Newborn care- testing - Answer Laboratory and diagnostic tests
Universal newborn screening
Serum Bilirubin
Congenital heart disease- O2 sat on babies left hand and O2 sat on one of the feet and
making sure that those values are very close together to help screen for congenital
heart issues before they go home
Newborn hearing screening
Normal levels for serum bilirubin will depend upon the infant's age in hours.
Baby gets a heel stick to get blood drawn
Most all the enzyme deficiencies they test for, like sickle cell traits, PKU, and a lot of the
disorders, are all checked in universal newborn screening. Blood goes on little circles of
paper and to test the blood they hole punch the paper off to test it.
This means if the baby has PKU (Phenylketonuria) that you are unable to process phenal
ketones and this is important to know right away because there is a lot of food that has
those ketones in it.
Every baby also receives a bilirubin test in the blood because of an immature liver.
Jaundiced hyperbilirubinemia is the most common issue with babies.
,Hearing screen - Answer The one that is most commonly used assesses the auditory
brainstem response to ensure that the brainstem is responding to the sound rather than
looking for the baby to turn toward the sound.
Newborn care- hygiene - Answer Hygiene
Diaper changes- clean the diaper area well with each change
No lotions or powders- been associated with some reproductive cancers
Care of the umbilical area avoid getting wet
Circumcision care
First bath for the new born:
Stabilization of body temperature
An opportunity for detailed examination
Relaxation/ comfort
Teaching for parents/child/family
For circumcision care first priority assessment is to check for bleeding followed by
urinary output
We wait for at-least 24 hours before bathing
Newborn care- bonding -Answer Parent Child Bonding
Vasoconstriction of the placental decidua - Answer The spiral arteries in preeclamptic
women are constricted and cause decreased perfusion to the placenta
Proteinuria: False Positives - Answer Urine dipstick is routine but is unreliable. False
positives result from:
Vaginal discharge/blood
SG and pH
Bacteria
Renal disease
Clinical Management for Reproduction - Answer Primary Prevention: disease prevention
, and wellness-related approaches to promoting sexual health
Patient education
Counseling
Referral
Secondary Prevention
Screening - diagnose existing disease in its early stages.
This is referred to as screening with a goal of reducing morbidity and
mortality and preserving quality of life.
Primary Prevention focus areas: abstinence, contraception, safer sex practices, STIs
healthy relationships, and community resources.
Featured Exemplars for Reproduction - Answer Menstrual Dysfunction
PCOS
Endometriosis, Uterine Fibroids
Sexually Transmitted Infections
Family Planning
Menstrual Cycle- Proliferative Phase: - Answer Proliferative (Follicular) Phase
Days 1-12 (Stimulation to Ovulation)
Low estrogen/progesterone production in ovaries signals hypothalamus to produce
gonadotropin-releasing hormone (GnRH).
GnRH orders ant. pituitary to release follicle stimulating hormone (FSH)
FSH stimulates follicle production in ovary (10-20 start to develop but usually only 1
matures).
Developing follicles in ovary produce estrogen.
Estrogen stimulates endometrial cells (lining of uterus) to enlarge: endometrial spiral
arteries dilate, lining thickens 6-8 fold, cervical mucus thins and becomes more alkaline
to allow sperm to penetrate
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