Chapter 21 Assessment of the Newborn
Assessment of cardiorespiratory status includes.
Hint: There are 6
history, airway, color, heart sounds, pulses, and blood pressure.
Nurses can prevent heat loss in newborns by.
keeping them dry and covered, avoiding contact between newborns and cold objects or surfaces, and keeping newborns away from drafts and exterior windows and walls.
The parent should feed the infant with hunger cues __ to __ times per day, watching for nutritive sucking, audible swallowing, and infant satiety.
8 to 12
_______ infants are subject to cold stress because they have thin skin with blood vessels near the surface, little subcutaneous white fat or brown fat, a large surface area, a limp position, and an immature temperature control center.
Preterm
Meconium in amniotic fluid enters the lungs before birth during gasping movements or is drawn in during the first breaths after birth, causing obstruction, air trapping, and inflammation.
meconium aspiration syndrome
The nurse’s role in meconium aspiration is to notify caregivers when meconium is discovered in amniotic fluid, prepare equipment, assist with intubation if necessary, and observe for further respiratory difficulty, infection, and other problems.
Molding of the head is expected during birth and may cause the head to appear misshapen. _____ _____ (localized swelling from pressure against the cervix) or a _________ (bleeding between the periosteum and the bone) may be present.
Caput succedaneum
cephalohematoma
Parents of ______ infants should be taught not to retract the foreskin until it becomes separated from the glans later in childhood.
uncircumcised
Suckling at the breast causes release of _______, which triggers the _______ reflex. It also causes the release of _______, which increases milk production.
oxytocin
let-down
prolactin
These infants may have birth injuries such as fractures, nerve damage, or bruising as a result of their size. They may have hypoglycemia or polycythemia.
Large-for-gestational-age (LGA)
A condition in which pulmonary vascular resistance remains high after birth and right-to-left shunting of blood occurs, causing severe respiratory difficulty.
Persistent pulmonary hypertension
Early signs of hypoglycemia include.
Hint: There are 6.
jitteriness, poor muscle tone, respiratory distress, sweating, low temperature, and poor suck.
Usually occurs in the afternoon or evening and often disappears after 3 to 4 months. The cause is unknown, and infants with colic grow and develop normally.
Colic—crying without obvious cause which lasts 3 or more hours a day.
The American Academy of Pediatrics recommends exclusive breastfeeding for the first __ months and continued breastfeeding with the addition of complementary foods until the infant is __ months old or longer, and thereafter, as long as mutually desired.
12
Infants with _____ _____ _____ may be small for gestational age at birth. In _____ _____ ______, the infant is proportionately small; in _____ ____ ____, the head and length are normal, and the body is thin.
fetal growth restriction
symmetric growth restriction
asymmetric growth restriction
The nurse’s role in this is to decrease situations such as cold stress or hypoglycemia that might further elevate bilirubin levels, ensure that lights are used properly, protect the eyes, observe for excessive fluid loss or skin impairment, ensure adequate oral intake, and teach parents.
phototherapy
The newborn’s first void occurs within __ to __ hours. Infants may void only __ or __ times during the first 2 days and at least ___ times daily by the fourth day.
12 to 48
1 or 2
6
Solid foods should be started at 6 months of age when the extrusion reflex is gone, and solids can be digested by infants. What is the Extrusion reflex?
The extrusion reflex, in which infants push the tongue out against anything that touches it.
The nurse can help the client with engorged breasts by.
encouraging frequent nursing,
application of warm compresses prior to nursing
and cold compresses between feedings,
massaging the breasts,
and expressing milk to soften the areola.
Infants with _______ ______ may appear thin, with loose skin folds, cracked and peeling skin, and meconium staining. They may have respiratory difficulties at birth and suffer from hypoglycemia and inadequate temperature regulation.
dysmaturity syndrome
Nursing responsibilities in caring for the infant with a diabetic mother include:
early identification and follow-up of complications,
monitoring of blood glucose levels,
ensuring early and adequate feedings,
and support of the parents.
The initial feeding provides information about the neonate’s ability to coordinate _____, _____, and _____ and tolerance to feeding.
sucking, swallowing, and breathing
hemorrhage, infection, unsatisfactory cosmetic effect, urinary retention, urethral stenosis or fistulas, adhesions, necrosis, injury to the glans, and pain during and after surgery.
Risks of circumcision
Full-term breastfed infants need ___ to ___ kcal/kg (39 to 45 kcal/lb), and formula-fed infants need ___ to ___ kcal/kg (45 to 50 kcal/lb) daily. They may lose weight in the first few days after birth as a result of ______ ______ and ____ ____ ____ ______ ___ and __________.
85 to 100
100 to 110
insufficient intake and normal loss of extracellular fluid and meconium.
Common complications of preterm birth are.
respiratory distress syndrome,
bronchopulmonary dysplasia,
intraventricular hemorrhage,
retinopathy of prematurity,
necrotizing enterocolitis,
and short bowel syndrome.
_______ _______ _______ include left-to-right shunting defects, defects with obstruction of blood outflow, defects with decreased pulmonary blood flow, and cyanotic defects with increased pulmonary blood flow.
Congenital Heart Defects