Physiologic Adaptation
Newborn Reflexes
Nursing Assessment
Nursing Interventions
100

The brief physical exam performed 1min and 5mins immediately after birth

What is Apgar Score

100
Touch the infants cheek or corner of the mouth and the baby will turn their head toward the stimulus.
What is rooting?
100
This is black and tarry and formed in utero.
What is meconium or baby's first stool?
100
One of the best ways for the nurse to prevent the spread of infection.
What is handwashing?
200
This is a type of fat tissue that has a dark pigment, is highly vascular, and has a high nerve supply. It is found mostly in newborns and helps them to create heat through non-shivering thermogenesis.
What is brown fat?
200
Insert finger in to baby's mouth. Practitioners use this opportunity to check for intact palate and gag reflex as well.
What is suck reflex?
200
This is a yellowish-white cream that protects the skin in utero.
What is vernix?
200

Instillation antibiotic ointment into eyes to prevent ophthalmia neonatorum

What is Erythromycin

300
The loss of body heat via vapor.
What is evaporation?
300
A diminished response to this reflex can indicate hypotonia. Hold baby up and allow one foot to touch the surface of the bed.
What is the stepping reflex?
300
This is an increased area of pigmentation and usually presents in those of darker skin tones.
What is Mongolian spots.
300

If a baby seems irritable and jittery the nurse should do this.

What is a heel stick to check a blood glucose?

400

Newborn babies often have blue hands and feet as they transition to extra-uterine life.

What is acrocyanosis?

400
Grasp the baby's hands and lift the arms allowing baby's head to stay on bed, but taking weight off and then let go suddenly. A decreased response may indicate a neurological or hearing deficit.
What is the Moro or startle reflex?
400
This is bleeding that occurs between the periosteum and the skull and does not cross suture lines.
What is a cephalohematoma?
400

Administer IM into vastus lateralis within 1 hr after birth

What is Vitamin K (phytonadione)

500

The Expected heart rate

What is 110-160

500
Begin at the heel and stroke the foot upward along the sole. The baby should fan toes and hyperextend foot. This should disappear at 4-8 weeks.
What is the Babinski reflex?
500
These are lesions caused by a concentration of immature blood vessels and can be very common in newborns. They are more pronounced when the infant cries.
What is Nevi or Stork Bites.
500

Used for suctioning excess mucus from the mouth and nose

What is bulb syringe

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