Signs and Symptoms
Restless, may be crying, pale/mottled, cool extremities, Temp < 97.7, tachypnea, Possible RDS or transient distress
What is Hypothermia?
Are at or above 90% or over 400 grams. RF- male, diabetic mother, multipara, congenital defects or syndromes
What is Large for gestational age or LGA?
Frequent Feedings & Phototherapy
What is Hyperbilirubinemia for physiological jaundice?
Determine the difference, Observe for changes in size of head, assess for crossing over suture lines vs not crossing suture lines, Reassure parents
What is Caput vs. Cephalohematoma?
head measurements, serum bilirubin
What is cephalohematoma?
Inform parents that it will reabsorb within 12 hours to a few days after birth
What is caput?
Lethargic, sleepiness, poor feeder, hypothermic with temp instability, apnea, irregular respirations, jitteriness, possible seizures, abnormal cry, hypotonia
What is hypoglycemia of the newborn?
Newborns rely on the metabolism of brown adipose tissue (brown fat). Heat loss form the body surface to the environment happens either through convection, radiation, evaporation, or conduction.
What is thermoregulation?
Feed infant by breastfeeding or formula. If infant cannot stabilize glucose levels by feeding; may need IV glucose or dextrose gel
What is hypoglycemia of the newborn?
Assess for S/S of macrosomia, monitor blood glucose levels, monitor V/S, initiate early feedings, maintain thermal neutral environment, monitor for S/S of respiratory distress
What is infant of diabetic mother?
Pulse oximeter placed on right hand and one foot, needs to be >95% in either extremity with < 3% difference between upper and lower extremity
What is screening for critical congenital heart defects (CCHD)?
Feed infant every 2-3 hours, call nurse before feeding for glucose test
What is infant of diabetic mother?
Yellowing of the skin and sclera before 24 hours of life, elevated bilirubin
What is hyperbilirubinemia for pathological jaundice?
Excessive growth due to high levels of maternal glucose production. The fetus responds by increasing insulin production. Once delivered the infant continues to make high levels of insulin causing hypoglycemia.
What is infant of a diabetic mother?
Erythromycin 0.5%
What is opthalmia neonatorum (Neisseria gonorrhoeae)?
Apply pressure for 3-5 minutes to prevent bleeding, for 1 hour observe for bleeding or hematoma
What is venipuncture in the newborn?
Serum bilirubin levels
What is hyperbilirubinemia for physiological jaundice?
Check site for bleeding, apply petroleum jelly for 7-10 days, do not remove yellow crust
What is care after circumcision?
Plotted on growth chart below the 10th percentile
What is small for gestational age infant?
Collection of fluid, edematous swelling of the scalp usually from long & difficult labor or vacuum extraction. Crosses suture lines & present at birth.
What is Caput?
Dry infant quickly, Skin to skin, radiant warmer
What is preventing heat loss?
From the cord blood determine infant's blood type and Coombs test, monitor bilirubin levels closely, notify HCP if jaundice noted before 24 hours of life
What is hyperbilirubinemia for pathological jaundice
Bedside glucose test, glucose levels < 45 mg/dL
What is hypoglycemia of the infant?
Frequent feedings is important because bilirubin is eliminated in feces, if under phototherapy explain limiting time not under lights (cluster care) and protect eyes
What is treatment for hyperbilirubinemia?
Crying, eyes tightly closed, fist clenched, brow furrowed, tachypnea, tachycardia
What is neonatal pain?
Commonly seen with mothers who smoke or have high blood pressure causing the infant to have an increased incidence of perinatal asphyxia and perinatal mortality
What is small for gestational age or SGA?
Monitor FOC (frontal occipital circumference), resolves in 2-8 weeks
What is cephalohematoma?
Assess gluteal and thigh skinfolds, assess knee levels, have provider perform Ortolani and Barlow test
What is developmental dysplasia of the hips (DDH)?
Heelstick, done after 24 hours, special filter paper, sent to state lab
What is Universal Newborn screening?
Keep accessible, mouth before nose, compress bulb first, clean with warm soapy water after each use
What is suctioning with a bulb syringe?