If the crib is jarred, infants draw their legs up and arms fan out and then come toward midline in an embrace position
**Absence may indicate abnormalities of the nervous system. **
Moro Reflex
**Birth to 3-6 months
What is the APGAR scoring system?
A quick assessment done on a newborn baby at 1 minute and 5 minutes after birth to evaluate the baby’s physical condition and determine whether any immediate medical care is needed.
TRUE!
Indicates respiratory distress.
THINK ABOUT ABCs WHEN GIVEN OTHER OPTIONS TO CHOOSE!
Sleep
True or False: A neonate sleeps approximately 15-20 hours a day.
True.
Cyanosis of the hands and feet in the first week of life is caused by a combination of a high hemoglobin level and vasomotor instability.
What is the intervention?
Acrocyanosis.
Parent education concerning this normal phenomenon is helpful.
What is normal bilirubin level (mg/dL) for a newborn?
6
Turn the infant's head to one side, and the arm and leg will extend on that side, with flexion of the opposite arm and leg.
Tonic Neck Reflex
**Birth to 5-7 months
True or False: Sternal retractions are reported immediately
True.
Sternal retractions indicate respiratory distress
True or False: You would report quiet respirations.
False.
You would report NOISY RESPIRATIONS!
Head:
What is molding?
Does this subside on its own without treatment?
When the baby's head conforms to the size and shape of the birth canal.
Yes!
A collection of capillaries in the skin. It is a flat, red-purple lesion that does not blanch on pressure.
Intervention?
Port wine stain.
It is permanent and darkens with age. Laser surgery may be an option.
What is normal bilirubin level (mg/dL) for a 7-day old?
12.
Place object in the hand of the newborn, and he or she will grasp it tightly
Palmar grasp
**Birth to 3 months
How often is the APGAR system used?
1 minute after birth and 5 minutes after birth
What pulse rate values would you need to report to the doctor?
Pulse rate greater than 160 beats/minute or less than 110 beats/minute.
Head:
What is caput succedaneum?
Does this subside on its own without treatment?
Swelling of the soft tissues of the scalp.
Yes!
Dark blue or slate gray discolorations most commonly found in lumbosacral area; intensity and hue or color remain until fading occurs.
Interventions?
Mongolian Spots.
Will gradually disappears in a few years. nurse must distinguish these lesions from hematoma of child abuse.
What is normal bilirubin level (mg/dL) for a 3-month-old?
1
Stroke the sold of the foot; the big toe will dorsiflex, and the toes will flare out
Babinski reflex
**Birth to variable, but before the infant begins walking
True or False: An Apgar score of 3 is good.
False.
APGAR Score 0-3 indicates that an emergency intervention may be needed.
What respiration values would you need to report to the doctor?
Respirations greater than 60 breaths/min or less than 30 breaths/min.
Head:
What is cephalohematoma?
Does this usually subside on its own without treatment?
Condition caused by a collection of blood beneath the periosteium of the cranial bone. It may be seen on one or both sides of the head but does not cross the suture line.
Yes! This condition usually recedes within a few weeks without treatment.
Pearly white pinpoint papules on face and nose of newborn.
Interventions?
Milia
No treatment. Will spontaneously disappear. Educate parents not to attempt to "squeeze out" the white material because infection can occur.
What is a normal WBC for a newborn?
18,000
7 days- 12,000
3 months- 10,800
Hold the infant upright above a table; he or she will lift the foot up on contact with the firm surface of the table
Stepping or dance reflex
Birth to 4-5 months
What does APGAR stand for?
A- Appearance (Skin color)
P- Pulse (Heart rate)
G- Grimace (Reflex response)
A- Activity (Muscle tone)
R- Respirations (Breathing)
What temperature values would you want to report to the doctor?
Temperature elevated above 37.7 (99.8) or below 36.2 (97.1)
Stools
What is the first stool called. Explain how they look and how they change over time.
Meconium. Mixture of amniotic fluid and secretions of the intestinal glands. It is a dark greenish black, thick, tarry (sticky) and is passed 8-24 hours after birth.
The stools gradually change during the first week. The become loose and are greenish yellow with mucus.
**The stools of a breastfed infant are bright yellow, soft, and pasty**
Deep red color over half of body; pallor on the longitudinal half of body; usually occurs with preterm infants who are placed on their sides.
Harlequin Color Change
Disappears with muscular activity. Changing position of infant is helpful. Condition is temporary and does not usually indicate a problem.
What is normal hgb/hct for a newborn?
18.5/56
7 days- 17/44
3 months- 11.3/35