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How many weeks when surfactant begins to production
24 weeks
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How many weeks when testicles descend
28 weeks
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How many weeks does the fetus' skin smooth out?
28 weeks
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How many weeks does surfactant reach normal levels?
32 weeks
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How many weeks when finger nails reach its tips?
32 weeks
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Fluid in lungs of infant are absorbed during labor into what systems?
Circulatory & lymphatic systems
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An infant (but also anyone) loses heat in 4 ways. What are they? Give examples & how to keep infant warm
- Evaporation
- Exposure to wet surfaces
- Wash and dry baby after birth
- Keep warm / dry
- Conduction
- Direct contact to objects
- All objects in contact with baby must be warmed
- If weighing infant, place warm blanket on scale
- Convection
- Heat transfer due to heat surrounding infant, replaced by cool air
- No fans
- Don't move around a lot
- Radiation
- Heat transfer from cooler objects
- Keep baby away from windows, doors, outside facing walls
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Why is maintaining the body temperature of an infant so important?
Because not doing so causes...
- Decreased surfactant protection
- Respiratory Distress
- Metabolic Acidosis
- Increases risk of jaundice
- Vasoconstriction
Increased metabolism, causing increased need for oxygen & glucose (hypoglycemia)
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What causes hyperthermia in newborns
Too much heat in the incubators
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Normal intestine flora establishes in an infant in _____ days
a few (2-3)
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Meconium
First stool of infant
- Is thick, sticky, tar like
- Greenish black in color
Must pass within 2 days or suspect obstruction
- Is unlike stool because its contents are things ingested in utero
- (intestinal epithelial cells, lanugo, mucus, amniotic fluid, bile, and water)
ewwww
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Transition Stool
- Stool with meconium still in it
- Greenish brown
- loose in consistency
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What are the differences in the milk Stool of an infant breast vs formula feeding?
- Breast Milk Stool
- Mustard yellow in color
- Soft / liquid like consistency
- Has almost no odor
- Can pass up to 10x a day
- Formula Milk Stool
- Pale yellow
- Has odor
- Pale yellow to light brown
- Firm
- Passed a few times a day
- MUCH less than breast fed
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In an infant, hypoglycemia is a blood glucose level of below
40-45 mg/dL
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The circumference of infant's head should be ____ the infant's length
1/4
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Normal pulse of newborn
- 120-160 bpm
- 100 sleeping
- 180 crying
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Normal respiratory of newborn
Describe the breathing
- 30-60 breaths per minute
- 40 is the average
- Irregular, shallow breaths
- Should NOT be labored
- Rales (crackles) are normal (due to fluid in lungs)
- Chest movement should be symmetric
- Chest movement should be
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Regular BP for newborn
- 65-95 systolic
- 30-60 diastolic
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Normal weight range of infant
A weight loss of _____ is normal in the early days
5 pounds 8 ounces to 8 pounds 13 ounces
10%
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What treatments are immediately given after birth
- Vitamin K injection (IM)
- Erythromycin drops to eyes
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Urine should pass in a newborn ____ to _____ after birth
12-24 hours
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Vaginal bleeding of infant is normal because of
The hormones of the mother in utero
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What vaccination is given at birth
Hep B
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DTaP is first given at what age?
2 months
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MMR vaccine is first given at what age
12 months
Recommended range is 12-15 months
-
Varicella vaccine is first given at what age
12 months
Recommended range is 12-15 months
-
Polio (IPV) vaccine is first given at what age?
2 months
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Acrocyanosis
- Persistentblue or cyanotic discoloration of the extremities
- Most commonly occurring in the hands, feet, distal parts of face
- Common initially after delivery in the preterm and full term newborn
- Intervention normally is not required
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Caput Succedaneum
- Caput succedaneumis swelling of the scalp in a newborn
- Caused by pressure from the uterus or vaginal wall during a head-first (vertex) delivery
-
Cephalohematoma
Is a hemorrhage of blood between the skull and the periosteum of a newborn
- A collection of blood under the skin of the scalp
-
- Stays on top of one of the skull bones, it does not cross the midline.
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Epstein Pearls
Small white or yellow cystic vesicles (1 to 3 mm in size)
Seen in the median palatal of the mouth of newborns
Occur in 65-85% of newborns
- Typically
- seen on the roof of the mouth (palate) and are filled with fluid
- Caused
- during development of the palate by entrapped epithelium (fissural cyst)
Do not require treatment
Resolve spontaneously over the first few weeks of life
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Erythema Toxicum
Rash of small, yellow-to-white-colored bumps (papules) surrounded by red skin
Appear in half of all normal newborn infants
May appear in the first few hours of life, or it can appear after the first day
Condition can last for several days
Usually on face, middle of the body, upper arms and thighs
Rash can change rapidly
Appearing and disappearing in different areas over hours to days
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Icterus Neonatorum is another term for
Neonatal jaundice
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Lanugo
Very fine,soft, and usually un-pigmented, downy hair
Found on the body of a fetus or newborn baby
The first hair to be produced by the fetal hair follicles
Usually appears at about 5 months of gestation
Normally shed before birth (7 or 8 months of gestation)
Sometimes present at birth and disappears within a few days or weeks
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Milia
- Milia are tiny white bumps or small cysts on the skin
- Almost always seen in newborn babies
- Whitish, pearly bump in the skin of newborns
- Bumps that appear across the cheeks, nose, and chin
- No treatment needed
-
Telangiectatic Nevi (Stork Bites)
Common skin condition of neonates Flat, deep-pink localized areas of capillary dilation
- Occur predominantly on
- Back of the neck Lowerocciput
- Uppereyelids
- Upper lip
- Bridge of the nose
Disappear permanently by about 2 years of age
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Plagiocephaly
Flattening of head of infant
-
Ophthalmia Neonatorum
aka Neonatal conjunctivitis
- baby's eyes are contaminated during passage
- through the birth canal from a mother infected with either Gonorrhea or Chlamydia
-
mottling
baby's arms and legs will develop a marbling pattern
Occurs when the blood flow to the skin diminishes
- Sympathetic nervous system shunts the blood away from our skin so we don't
- loose body heat.
Babies get mottling because their sympathetic nervous system isn't regulated yet
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Erik Erikson’s stages of psychosocial development
- Infancy - Trust vs Mistrust
- Infant must rely on caregiver for basic needs
- Mistrust is result of inconsistent and inadequate care
- Toddler (1-3 years old)
- Autonomy vs Doubt
- Encouragement from caregivers needed to develop basic skills
- Skills include feeding, dressing, & toileting
- Over protection or high expectations cause doubt
- Preschool (4-6 years old)
- Initiative vs Guilt
- Child has new independence and weeks new experiences
- Restrictions and reprimanding this curiosity causes guilt
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- Industry vs Inferiority School Aged
- Child’s self-worth tied to completing projects and receiving
- recognition for it
- Inferiority caused by unacceptance by peers and not reaching parental
- expectations
- Identity vs. Role Confusion - Adolescence
- Trying roles and rebelling normal for acquiring sense of self
- Role confusion occurs when
- unable to establish identity and direction
- Intimacy vs Isolation - Young Aduthood
- Uniting self identity with commitments to others
- Fear of such commitments results in isolation & loneliness
- Generativity vs Stagnation - Middle Adulthood
- Family, friends, & community involvement heavy
- Time of having concerns towards next generation
- Desire to make contribution to the world
- Stagnation result in not achieving these goals
- One become self-absorbed and regresses
- Ego Integrity vs Despair - Later Adulthood
- Older years are filled with reminiscence about life events
- Despair caused by feeling life was series of failures
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What are the 5 things the Apgar measures?
What are the ranges for normal?
- Respiratory
- Heart Rate
- Color
- Muscle Tone
- Reflex (Irritability)
7-10 score is normal
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