Summary NSG 3500 Exam 4 Study Guide Fall - Update with complete Solutions.

April said in Class April said in Review Normal Newborn Vital Signs: ● HR: 110-160 ● RR: 40-60 rpm ○ Tachypnea: more than 60 rpm ● BP: 2000g=50/35mmHg 2000g -3000g=60/35mmHg 3000g=51/40mmHg ● Temp: 97 and up ● Normal Newborn Blood Sugar → 40-60 mg/dL Mila (Milk Spots) Small white papules or sebaceous cysts on infant’s face that resembles pimples Vernix White naturally occurring biofilm that covers skin of newborn ● Can be present in axillary & genital areas (large = preterm) Lanugo Fine, downy hair noted on infant’s back, shoulders, head (large = preterm) Mongolian Spots → Are Benign ● Areas that appear gray, dark, blue or purple ● Commonly located on back/buttocks can also be found on shoulders, wrists, forearms, & ankles ● Mostly in infants ethnic background: Mediterranean, Latin America, Asia or Africa ● Will fade/disappear usually as infant gets older ● b/c can be mistaken for bruises, important to document on infant’s chart Telangiectatic Nevus AKA Stork Bite: ● Red birthmark often seen at nape of neck & commonly referred to as a “stork bite” or “angel kiss” ● Can occur on face b/w the eyebrows or on eyelids, nose, or upper lip Epstein Pearls - whitish hardened nodules on gums or roof of mouth, may be visualized or palpated 1 Red Reflex: ● Tested by viewing pupil through an ophthalmoscope from a distance of 10 inches ● If pupil appears red, the finding is normal ● A white retinal reflex may indicate cataracts, retinoblastoma or chorioretinitis 2 Normal Newborn Assessment: ● Hands = clenched = normal finding ○ If the baby is clenched w/ the thumb is tucked inside their fist = abnormal ● Skin: ○ POSTTERM → normal for fingernails to be long & skin is cracked & peely ■ Cracked & peely not normal finding in a TERM baby! ● Baby’s suture lines are together: ○ Is it normal for a diamond shape where it all comes together: yes normal in a term newborn ● Preterm: ○ Ears push down/ slow recoil ○ Large amount of vernix or lanugo ○ Skin is thin & translucent ○ Males → both testicles have not distended ○ Females → labia mejora (fatty tissue) would be flat ● Term Baby female could have vagina discharge from mom’s hormones Newborn Reflexes: ● Sucking - place finger or object in mouth and baby will suck ● Rooting - stroke baby cheek will turn head to suck ● Palmar - infant curls fingers around object in hand ● Moro - extension of both arms along with flexion of legs when baby is startled ● Plantar - infant curls toes around an object at sole of foot ● Babinski - stroke sole of foot from heel to toes, toes should fan out APGAR → know categories ● A score lower than 7 → LOW ● Assigned at: ○ 1 min ○ 5 min ○ 10 min → don’t usually do if baby is doing great, but can do ● 5 minute APGAR score of 7-10 is NORMAL ● If baby gets a low APGAR @ 1 min & 5 min ○ Doing resuscitation → bagging baby & call NICU (brings their equipment) ● When baby is crying vigorously → acrocyanosis can go away & baby can get an APGAR score of 10 Acrocyanosis: Most newborns exhibit cyanosis of extremities at 1-min APGAR check, and this normal finding is termed acrocyanosis 3 Heat: ● Babies are not swaddled in nursery warmer beds b/c they can get too hot! ● Do not put several layers on just one onesie! Newborn Medications: ● Eye Prophylaxis: ○ Has to be done within first hour of birth ○ Place ointment at inner canthus → outer canthus ○ It prevents eye infection ○ One time dose ● Vitamin K → p. 313 ○ Given within (1hr) 2 hr after birth ○ Injected in Vastus Lateralis → CAN MASSAGE IN to promote absorption & decrease discomfort ○ Med!! Not vaccine ○ Given b/c newborn has absence of Vitamin K at birth & risk of developing a blood clotting deficiency → prevent hemorrhagic disease! ■ If family refuses then male baby can not get circumcised