maternity exam 3

• neonatal respiratory distress


  periods of apnea are normal in infants, if apnea is longer than 20 seconds that is abnormal and needs intervention

  first thing to do- stimulate baby
• med of choice for neonate respiratory distress


  caffeine
• what is the med given to the MOTHER to enhance surfactant production in preterm babies?

  betamethasone

  2 doses, 24 hours apart
• normal newborn pulse


  110-160
• normal newborn respiration rate 


  30-60
• normal newborn temperature


  36.5-37.2 C
• Barlow's test 


  a test to see if the newborn has hip dysplasia, provider will adduct and flex the hips to see if they dislocate
• what can hypothermia in a newborn cause?

  hypoglycemia

  respiratory distress
• how can you manage thermal regulation of the newborn?

  BEST way- skin to skin with mother

  wrap baby in dry cloth and hat
• caput succedaneum 


  boggy edematous swelling of the fetal scalp across suture lines caused by pressure of the fetal head during labor

  • disappears within a few hours to several days
  • complications rare
• cephalohematoma 


  condition marked by soft, fluctuant localized swelling of blood on fetal head

  -caused by subperiosteal hemorrhage

  complications can include defective blood clotting, underlying skull fracture, intercranial bleeding, jaundice
• moro refelx

  • loud noise to cause the infant to symmetrically extend and abduct the arms and adduct
  • should disappear within 3-6 months
• tonic neck reflex


  turn the infants head to one side, arms and leg will extend on that side and flexion will happen on opposite side
• palmar grasp reflex


  placing an object in the hand of the newborn and they will grasp it tightly
• stepping reflex 


  holding the infant upright above a table, newborn will lift foot up on contact with the firm surface
• Babinski reflex 


  stroking the sole of the foot- baby's big toe will dorsiflex and toes will flare out
• what does APGAR stand for and what is it used for?

  Appearance, Pulse, Grimace, Activity, Respiration

  used to see how well the baby is/will adapt to extrauterine life
• breastfeeding is contraindicated when


  mother is HIV positive

  newborns with galactosemia
• ABO incompatibility 


  when the baby has the blood type of which the mother has antibodies to
• Rh incompatibility

  when Rh negative mother gives birth to Rh positive baby

  -mother will create antibodies to that blood type and spontaneous abortion can occur

  -Rh immune globin is given postpartum 72 hours after birth
• neonatal abstinence syndrome (NAS)


  behaviors exhibited by baby's who were exposed to drugs in utero
• Nursing care for babies with NAS

  • reduce stimulation
  • swaddle with legs flexed and arms midline at side
  • maintain fluid and electrolyte balance
• feeding newborns with NAS


  newborns with NAS require smaller feeding volumes more frequently

  hold infant in sitting position with chin tucked
• uterine atony 


  when the uterus fails to contract after birth and leads to postpartum hemorrhage
• retained placenta


  when the placenta has not been delivered for 30 min after birth

  may need to be surgically or manually removed
• bleeding associated with firm hard uterus can indicate


  laceration that was missed
• intense peritoneal pain can indicate


  hematoma
• what is milia and what should you educate the parents about milia?

  Milia are small, white bumps that commonly appear on a newborn's face. Parents should be educated that milia are harmless and typically resolve on their own without treatment.

  tell parents to NOT pick at the milia

  
• what is acrocyanosis?


  Peripheral cyanosis in the newborn that is common for first 24 hours after birth due to temperature change
• nevus symplex 


  small vessel dilation, easily blanched and fade over time

  
• vernix caseosa


  thick white substance

  has antimicrobial properties

  
• Mongolian spots 


  bluish discoloration of the skin

  common in darker skin babies

  disappear or lighten overtime

  
• hemangioma 


  dilated capillaries, will grow 1st six months then involute next 5-10 years

  avoid picking or rubbing at them

  
• lanugo


  happens more to premature babies

  
• what is phototherapy used for in newborns?

  hyperbilirubinemia
• what is the first action you take after phototherapy?

  take the babies temperature
• what does PKU stand for?

  Phenylketonuria
• what is PKU?

  rare genetic disorder that causes severe nerve and brain damage to newborn

  body lacks enzyme phenylalanine hydroxylase
• important education for infants with PKU

  special formula is needed

  avoid high protein and iron foods: meat, dairy, eggs or peanut butter jelly sandwich
• what would the signs and symptoms be for a newborn who was exposed to heroin in utero?

  irritability, poor sucking, jittery