Newborn Assessment Practice Test Questions and Complete Solutions

First assessment (0-2hr post delivery) Initial: Apgar, external (Symmetry!!!), chest rise/fall, abdomen (belly-breathing), neurologic (innate responses), genitourinary (pee/poo) Apgar Done at 1-5 minutes. Rarely see a perfect 10. Respiratory rate and Heart rate are usually great, Newborn usually loses points in skin color and reflex irritability. (Acrocyanosis is common, reflex: grimace (only 1 point) common) First period of reactivity ***(Birth-30 min) Newborns heart rate increases to 160-180 bpm, and decreases after 30 min Respirations are irregular at 60-80 breaths/min Decrease in motor activity after a period followed by 60-100 min of sleep Second period of reactivity (4-8 h PP) Tachycardia and tachypnea occur, meconium passes (newborns first poop!) Increased muscle tone, changes in skin color, mucous production (coughing up a lot of gunk from being in utero). A lot of bonding and feeding From 2 hours of birth until discharge ***Gestational age assessment: Appropriate for gest. age Large for gest. age: Above 90th percentile-- increased risk of being larger if genetic obesity or diabetes Small for gest. age: below 10th percentile ** Preterm: before 37w *late preterm: Between 34-36+6/7 weeks Term: between 38-42w Postterm: After 42w Postmature:After 42w with effects of placental insufficiency Late preterm infant Lots of risks r/t physiological immaturity Often the size and weight of term infant.. Respiratory distress, temp instability, hyperbilibirubinemia(jaundice). Interventions for newborns ** 1st Priority: Airway maintenence- bulb syringe to get rid of secretions. Irregular RR is normal Maintaining an adequate O2 supply (adequate circulation, perfusion, effective cardiac function) Adequate thermoregulation- !!!Keep them warm!!!! A cold baby is a...? Bad baby!! When temp goes down..... Risk for metabolic acidosis, which happens easily if cold and untreated!