ch. 15 physiological and behavioral responses of the neonate

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silvisaj44
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ch. 15 physiological and behavioral responses of the neonate
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2013-02-19 20:43:47
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  1. head circumference
    33-35.5 (13-14 inches)

    microcephaly: below the 10th percentile

    macrocephaly: above 90th percentile
  2. chest circumference
    30.5-33 cm (12-13 inches)

    or 2-3 cm less than the head
  3. length
    45-53 cm (19-21 inches)
  4. weight
    2,500-4,000 (5lbs 8oz-8lbs 13oz)

    weight loss 5%-10% of birth weight during the first week is normal.

    will regain birth weight within 10 days
  5. temperature
    axillary is preferred

    36.4-37.2 celcius

    97.5-99 fahrenheit
  6. respirations
    30-60 breaths per minute

    irregular

    diaphragmatic and abdominal breathing

    periods of apnea less than 15 seconds
  7. pulse
    120-160 (110-160)

    increases to 180 when crying and to 100 when sleeping

    tachycardia (greater than 160)

    bradycardia (less than 100)
  8. blood pressure
    arm and leg

    50-75/30-45 mm Hg
  9. anterior fontanel
    closes by 18 months
  10. posterior fontanel
    closes btwn 2-4 months
  11. hypospadias
    urethral opening is on the ventral surface of the penis
  12. epispadias
    the urethral opening is on the dorsal side of the penis
  13. undescended testes
    testes not palpated in the scrotum
  14. hydrocele
    enlarged scrotum due to excess fluid, no urination in 24 hrs
  15. polydactyly
    extra digits may indicate a genetic disorder
  16. syndactyly
    webbed digits may indicate a genetic disorder
  17. hypotonia
    floppy, limp extremities may indicate possible nerve injury related to birth, depression of CNS
  18. hypertonia
    tightly flexed arms and stiffly extended legs with quivering indicates possible drug withdrawal
  19. acrocyanosis
    hands and feet are blue
  20. circumoral cyanosis
    benign localized transient cyanosis around mouth
  21. mottling
    benign transient pattern of pink and white blotches on the skin
  22. harlequin sign
    one side of body is pink and the other side is white
  23. mongolian spots
    flat bluish discolored area on the lower back or buttocks.

    more often african american, asian, latin and native americans
  24. erythema toxicum
    rash with red macules and papules that appear in different areas of the body, usually the trunk area

    can appear 24 hours to 2 weeks
  25. milia
    white papules on the face, more on the bridge of the nose and chin

    exposed sebaceous glands/white heads
  26. lanugo
    fine downy hair that develops 16 weeks of gestation
  27. vernix caseosa
    protective substance secreted from sebaceous glands that covered the fetus during pregnancy
  28. jaundice
    • -yellow coloring of skin
    • -first appears on face and extends to the trunk

    • -within 24 hours =liver
    • -after 24 hrs=physiological jaundice related to increased amount of unconjugated bilirubin in the system
  29. molding
    elongation of the fetal head as it adapts to the birth canal

    resolves within 1 week
  30. caput seccedaneum
    localized soft tissue edema of the scalp, feels spongy and can CROSS SUTURE LINES
  31. cephalhematoma
    formation btwn the periosteum and skull with unilateral swelling

    appears within a few hours of birth and can increase in size over a few days

    CAN NOT CROSS SUTURE LINES
  32. epsteins pearls
    white pearl like epithelial cysts on gum margins and palate
  33. natal teeth
    immature caps of enamel and dentin with poorly developed roots
  34. moro
    present at birth and disappears within 6 months

    let the head slightly drop back, need to see symmetrical abduction and extension of arms and legs flex up against the trunk

    makes a C with thumb and index finger
  35. startle
    make a loud sound near neonate

    same as moro response
  36. tonic neck
    btwn birth and 6 weeks-disappears 4-6 months

    supine, turn head to one shoulder, neonate should make a "fencing" position with arms and legs
  37. rooting
    present at birth-disappears 3-6 months

    brush the side of a cheek near the corner of mouth, neonate turns head near finger and opens mouth
  38. sucking
    present at birth-disappears 10-12 months

    place a gloved finger or nipple in neonates mouth, sucking motion occurs
  39. palmar grasp
    present at birth-disappears 3-4 months

    place a finger in the palm of neonates hand, neonate grasps the finger
  40. plantar grasp
    present at birth-disappears at 3-4 months

    place a thumb firmly against the ball of the infants foot, toes flex tightly down in a grasping motion
  41. babinski
    present at birth-disappears at 1 yr

    stroke the lateral surface of the sole in an upward motion, hyperextension and fanning of the toes
  42. stepping or dancing
    present at birth-disappears 3-4 weeks

    hold the neonate upright with feet touching a flat surface, the neonate steps up and down in place

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