CHAPTER 10:physiologic adaptation of the newborn and nursing assesment

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marshelej_6
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CHAPTER 10:physiologic adaptation of the newborn and nursing assesment
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2015-01-20 23:43:01
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nursing nrewborn assesment eastern suffolk boces
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eastern suffolk boces maternity nursing
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ob nursing
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  1. To live independently from mother, the newborn must immediately establish pulmonary ventilation ( translate/ dumbed down meaning)
    breathe on its own
  2. what must the newborn adapt to do the following: (7)
    • 1) quickly breathe and maintain respiration rat
    • 2) replace fluid in the lungs with air
    • 3) close fetal shunts
    • 4)allow pulmonary blood flow and increase cardiac out put
    • 5)maintain body temp (thermoregulation)
    • 6) pass first stool
    • 7)detoxify substances entering from the external environment
  3. In utero the lungs are filled with ____ and _____
    secretions of alveolar cells of lungs and amniotic fluid
  4. functions of surfactant
    • 1) reduces force between moist surfaces of alveoli
    • 2) prevents collapse with expiration
    • 3) promotes lung expansion
  5. clamping the umbilical cord is the most powerful ____ stimulus
    chemical
  6. when cord is clamped the fetus experiences temporary ____ , b/c placental blood flow is stopped
    hypoxia
  7. another word for excessive cooling
    cold stress
  8. cold stress will increase the need for o2 and can produce ___.
    acidosis
  9. describe mechanical stimuli
    the chest is compressed as it passes through the birth canal and recoils or expands as it leaves the mother's body.
  10. as the neonate emerges from the dark warmth of the uterus to the externl enviromnt are cold, touch, light and sound. stimulated by tactile drying, wrapping the neonate in warm blankets and skin to skin contact. DESCIRBES WHICH STIMULUS
    sensory
  11. internal cause of respirations are the ___ changes at birth. ( which stimulus?)
    chemical
  12. External causes of respirations
    sensory, thermal and mechanical
  13. why is an infant delivered by cesarean birth at greater risk for respiratory distress?
    C-section infant does not experience chest compression followed y chest recoiil
  14. potential consequences of cold stress
    look at pg 165 figure 9-3)
    • -increased o2 consumption
    • - increased glucose utilization
    • -decreased surfactant production
  15. factors contributing to heat loss
    • -large body surface area
    • -thin skin
    • -blood vessels close to the surface
    • -little subq fat
    • -wet skin with amniotic fluid
  16. how can heat be lost to the environment? (4)
    convection conduction radiation and evaporation
  17. Nursong assesent of newborn phase 1
    assessment and care of newborn ttake place in delivery room
  18. nursing assessment of newborn phase 2
    take place 1-4 hrs of age detailed exam performed on admission to the nursery
  19. nursing assessment of newborn phase 3
    care of newborn 4 hours of age until discharge
  20. normal general appearance of baby
    • -flexion and symmetry
    • -hips abducted and flexed at elbow, hand in fist position
  21. define opisthotonos
    extension of th neck with an arched back
  22. are respirations for more than 20 seconds ok?
    no it should be further assessed
  23. signs that indicate respiratory distress
    nasal flaring, sucking in of chest wall with the sternum moving inward with inspiration, grunting sound on expiration
  24. overheating can cause the neonate to break out in a pinpoint, reddish rash ofte referred to as prickly heat or___
    miliaria
  25. swelling on the head of the newborn, symmetric ad result of edema under the scalp, condition will disappear without treatment is called _____. increased urinary output may result from this.
    caput succedaneum
  26. a collection of blood between the periosteum and the cranial bone. Swelling DOES NOT cross the suture line. with no treatment indicated and puts baby at risk for jaundice is called ___.
    Cephalhematoma
  27. molding
  28. anterior fontanelle
  29. posterior fontanelle
  30. microcephaly
  31. ballard scoring system pg 173
  32. how far can a newborn see
    7-10 inches
  33. pg 175-176 copy read and type flash cards
  34. low sett ears may indicate congenital anomaly is present in ___ system
    renal
  35. describe first meconium stool
    dark greenish black tarry stool
  36. behavioral states of newborn
    • SLEEP STATE: quiet sleep, active sleep
    • TRANSITIONAL STATE: drowsiness
    • AWAKE STATE: quiet alert, active alert, crying
  37. _____ test is used to detect the presence of an abnormal condition before symptoms appear
    screening
  38. screening for ____ and ____ is mandated in all states
    hypothyroidism and phenylketnuria
  39. what is PKU (phenylketonuria)
    condition in which the newborn cannot metabolize phenylalanine, it accumulates in the blood causing mental retardation

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