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What would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn before discharge?
Apical heart rate of 90 beats/min, slightly irregular, when awake and active
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When caring for a newborn, the nurse must be alert for signs of cold stress, including:
Increased respiratory rate.
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When weighing a newborn, the nurse should:
Weigh the newborn at the same time each day for accuracy
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Vitamin K is given to the newborn to:
Enhance ability of blood to clot.
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The nurse notes that, when the newborn is placed on the scale, he immediately abducts and extends his arms and his fingers fan out with the thumb and forefinger forming a "C." This response is known as a:
Moro reflex.
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A newborn male, estimated to be 39 weeks of gestation, would exhibit:
Testes descended into scrotum.
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The nurse must administer erythromycin ophthalmic ointment to a newborn after birth. The nurse should:
Cleanse eyes from inner to outer canthus before administration.
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Following circumcision of a newborn, the nurse provides instructions to his or her parents regarding postcircumcision care. The nurse should tell the parents to:
Expect a yellowish exudate to cover the glans after the first 24 hours.
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When placing a newborn under a radiant heat warmer to stabilize temperature after birth, the nurse should:
Prewarm the radiant heat warmer and place the undressed newborn under it. (The thermistor probe should be placed on the upper abdomen away from the ribs.)
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maintenance of balance b/t heat loss and heat production
thermoregulation
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what is heat production
thermogenesis
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what is heat production process unique to the newborn accomplished primarily by brown fat and secondarily by increased metabolic activity in the brain, heart, and liver
nonshivering thermogenesis
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flow of heat from the body surface to cooler ambient air. 2 measures to reduce heat loss by this method would be to keep the ambient air at 24 C and wrap the infant
convection
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loss of heat from the body surface to a cooler, solid surface not in direct contact but in relative proximity. To prevent this type of heat loss, cribs and examining tables are placed away from outside windows and care is taken to avoid direct air drafts
radiation
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loss of heat that occurs when a liquid is converted to vapor, in the newborn heat loss occurs when moisture from the skin is vaporized. this heat loss can be intensified by failure to dry the newborn directly after birth or by drying the newborn slowly after a bath
evaporation
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loss of heat from the body surface to cooler surfaces in direct contact. When admitted to the nursery, the newborn is placed in a warmed crib to minimize heat loss. Placing a protective cover on the scale when weighing the newborn will also minimize heat lost by this method
conduction
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high body temp that develops more rapidly in the newborn than in the adult. Newborn has a decreased ability to increase evaporative skin water losses b/c sweat glands do not function sufficiently to allow the newborn to sweat; serious overheating can cause cerebral damage from dehydration or heat stroke and death
hyperthermia
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pinkish, easily blanched areas on the upper eyelids, nose, upper lip, back of head and nape of neck. Known as stork bites
telangiectatic nevi
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overlapping of crainal bones to facilitate passage of the fetal head through the maternal pelvis during the process of labor and birth
molding
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generalized, easily identifiable edematous area of the scalp usually over the occiput area
caput succedaneum
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collection of blood b/t skull bone and its periosteum as a result of pressure during birth
cephalhematoma
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white, cheesy substance that coats and protects the fetus's skin while in utero
vernix caseosa
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white facial pimples caused by distended sebaceous glands
milia
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yellowish skin discoloration caused by increased levels of serum bilirubin
jaundice
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thick, tarry, dark green-black stool usually passed w/in 24 hours of birth
meconium
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sudden, transient newborn rash characterized by erythematous macules, papules, and small vesicles
erythema toxicum
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transient cross-eyed appearance lasting until 3rd or 4th month of life
pseudostrabismus
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color variation related to vasoconstriction on one side of the body and vasodilation on the other side of the body.
harlequin sign
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accumulation of fluid in the scrotum, around the testes
hydrocele
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monilial infection of the oral cavity resulting in white plaques on buccal mucosa and tongue that bleed when touched
thrush
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Membranous area formed where skull bones join
fontanel
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soft, downy hair on face, shoulders and back
lanugo
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flat red to purple birth mark composed of a plexus of newoly formed capillaries in the papillary layer of the corium, varies in shape, size and location, usually found on neck and face
port wine stain
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birth mark consisting of dilated newly formed capillaries occupying the entire dermal and subdermal layers with associated connective tissue hypertrophy
strawberry hemangioma
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slightly blood-tinged mucoid vaginal discharge associated with an estrogen decrease after birth
pseudomenstruation
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white cheesy substance commonly found under the foreskin
smegma
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small, white, firm cysts seen at the tip of the foreskin
epithelial pearls
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extra digits, fingers or toes
polydactyly
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fused fingers or toes
syndactyly
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variations in the state of consciousness of newborn infants
sleep-wake cycles
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what does the apgar score consist of
- HR
- RR
- muscle tone
- reflex irritability
- color
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device used to suction mucus and secretions from the newborn's mouth and nose immediately after birth and when needed
bulb syringe
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automatic sensor usually placed on the upper quadrant of the ab immediately below the R or L costal margin, attached to the radiant warmer and monitors the newborn's skin temp
thermistor probe
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inflammation of the newborn's eyes from gonorrheal or chlamydial infection due to passage through birth canal
ophthalmia neonatorum
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One of the products derived from the hemoglobin released with the breakdown of RBCs and the myoglobin in muscle cells, its accumulation in the blood results in a yellowish discoloration of the skin, sclera and oral mucous membranes
bilirubin
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yellowish discoloration of the integument and sclera that first appears after the 1st 24 hours of life and disappears by the end of the 7th day of life
physiologic jaundice
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test performed to distinguish cutaneous jaunidice of the skin from normal skin color
blanch test
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level of serum bilirubin which if left untreated, can result in sensorineural hearing loss, mild congnitive delays, and deposition of bilirubin in the brain, appears during 1st 24 hours after birth
pathologic jaundice
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yellow staining of brain cells that may result in bilirubin encephalopathy
kernicterus
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serum Ca+ levels less than 7.8-8 in the term infant and less than 7 in preterm infant
hypocalcemia
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structures in the breast that are composed of alveoli, milk ductules and myoepithelial cells
lobes
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milk-producing cells
alveoli
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breast structure that connects several alveoli
ductules
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breast structure that connects a duct to the lactiferous sinus
lactiferous duct
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process of milk production
lactation (lactogenesis)
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lactogenic hormone secreted by the anterior pituitary gland in response to the infant's suck and emptying of the breast
prolactin
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posterior pituitary hormone that triggers the let-down reflex
oxytocin
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reflex triggered by the contraction of myoepithelial cells. Colostrum, and later milk, is ejected toward the nipple
let down or milk ejection
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reflex stimulated when a hungry baby's lower lip is touched. Baby opens its mouth and begins to suck
rooting reflex
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what reflex is described: place infant supine on flat surface and make a loud abrupt noice (symmetric abduction and extension of arms, fingers fant out and thumb and forefinger form a C, arms are then adducted into an embracing motion and return to relaxed felxion and movement)
moro reflex
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place finger in palm of hand or at base of toes - infant's fingers curl around examiner's finger, toes curl downward
grasp
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use finger to stroke sole of foot beginning at heel, upward along lateral aspect of sole, then across ball of foot - all toes hyperextend, with dorsiflexion of big toe
Babinski
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touch infant's lip cheeck, or corner of mouth with nipple - turns head toward stimulus, opens mouth, takes hold and sucks
rooting
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