🌙 Midterm Cram Sheet (Ch. 17–24)
Newborn Transitioning (Lecture Chapter 17)
Respiratory rate: 30–60/min, irregular, shallow, apnea <15 sec.
Heart rate: 110–160/min (avg ~120–130).
Axillary temperature: 36.5–37.5 °C.
Heat loss mechanisms: conduction, convection, evaporation, radiation.
Brown fat: forms in 3rd trimester, effective 3–5 weeks.
Wet diapers: Day 1 = 1, Day 2 = 2, Day 3+ = 6–8/day.
Stool progression: meconium → transitional → milk stool.
o Breastfed: yellow-gold, loose, seedy, sour smell.
o Formula-fed: yellow/green, firmer, stronger odor.
Immunity: immunoglobulins G, A, and M.
Behavioral states:
o First reactivity: 30 min–2 hr, alert, hungry.
o Decreased activity: 30–120 min, sleep.
o Second reactivity: 2–8 hr, alert again.
Postpartum Physiological Adaptations (ATI Chapter 17)
Uterus involution:
o Immediate: 2 cm below umbilicus.
o 1 hr: at umbilicus.
o 12 hr: 1 cm above.
o Descends ~1 cm/day.
o Day 6: midway to pubis.
o 2 wk: nonpalpable, in pelvis.
Lochia:
o Rubra: days 1–3.
o Serosa: days 4–10.
o Alba: day 10–6 wk.
Lochia amounts: scant <2.5 cm, light 2.5–10 cm, moderate >10 cm, heavy pad <2 hr,
excessive pad <15 min.
Blood loss: vaginal 300–500 mL; cesarean 500–1000 mL.
White blood cells: up to 30,000 postpartum.
Heart rate: may be as low as 40/min.
Temperature: up to 38 °C first 24 hr (normal dehydration).
Return of ovulation/menstruation:
o Breastfeeding: ovulation ~6 mo.
This study source was downloaded by 100000898062787 from CourseHero.com on 09-30-2025 01:55:50 GMT -05:00
https://www.coursehero.com/file/251448144/midterm-cram-sheetdocx/
, Not breastfeeding: ovulation 7–9 wk, menses by 12 wk.
o
Vaccines:
o Rubella/MMR if nonimmune, avoid pregnancy 4 wk.
o Varicella if nonimmune, avoid pregnancy 1 mo, repeat 4–8 wk.
o Tdap postpartum if not received.
o Rho(D) immune globulin within 72 hr if Rh negative mother with Rh positive
baby.
Newborn Management (Lecture Chapter 18)
Red flags: nasal flaring, retractions, grunting, cyanosis, flaccid tone, abnormal heart or
respiratory rate, abnormal size.
Apgar score: at 1 and 5 min (10 min if <7).
o 7–10 = good; 4–6 = moderate; 0–3 = severe.
Ballard score: assesses physical (skin, lanugo, creases, breasts, eyes/ears, genitalia) +
neuromuscular maturity (posture, square window, arm recoil, popliteal angle, scarf sign,
heel-to-ear).
Immediate meds: vitamin K (0.5–1 mg IM vastus lateralis), erythromycin eye ointment.
Transient tachypnea (TTN): oxygen, warmth, resolves in 24–72 hr.
Physiologic jaundice: appears after 24 hr, frequent feeding, phototherapy if needed.
Hypoglycemia: blood glucose <45 mg/dL; treat with dextrose gel + feeding.
Energy needs: 108–120 kcal/kg/day.
Feeds: breastfeed 8–12/day; formula every 3–4 hr.
Elimination:
o Day 1: 1 wet diaper.
o Day 2: 2 wet diapers.
o Day 4+: 6–8 wet diapers/day.
o Stool: breastfed = yellow, seedy, ≥3/day; formula = firmer, less frequent.
Newborn Assessment (ATI Chapter 23)
Weight: 2500–4000 g.
Length: 45–55 cm.
Head circumference: 32–36.8 cm.
Chest circumference: 30–33 cm.
Heart rate: 110–160/min.
Respiratory rate: 30–60/min.
Temperature: 36.5–37.5 °C.
Blood pressure: 60–80 systolic / 40–50 diastolic.
Reflexes:
o Rooting/sucking: disappears by 3–4 mo (up to 1 yr).
This study source was downloaded by 100000898062787 from CourseHero.com on 09-30-2025 01:55:50 GMT -05:00
https://www.coursehero.com/file/251448144/midterm-cram-sheetdocx/
Newborn Transitioning (Lecture Chapter 17)
Respiratory rate: 30–60/min, irregular, shallow, apnea <15 sec.
Heart rate: 110–160/min (avg ~120–130).
Axillary temperature: 36.5–37.5 °C.
Heat loss mechanisms: conduction, convection, evaporation, radiation.
Brown fat: forms in 3rd trimester, effective 3–5 weeks.
Wet diapers: Day 1 = 1, Day 2 = 2, Day 3+ = 6–8/day.
Stool progression: meconium → transitional → milk stool.
o Breastfed: yellow-gold, loose, seedy, sour smell.
o Formula-fed: yellow/green, firmer, stronger odor.
Immunity: immunoglobulins G, A, and M.
Behavioral states:
o First reactivity: 30 min–2 hr, alert, hungry.
o Decreased activity: 30–120 min, sleep.
o Second reactivity: 2–8 hr, alert again.
Postpartum Physiological Adaptations (ATI Chapter 17)
Uterus involution:
o Immediate: 2 cm below umbilicus.
o 1 hr: at umbilicus.
o 12 hr: 1 cm above.
o Descends ~1 cm/day.
o Day 6: midway to pubis.
o 2 wk: nonpalpable, in pelvis.
Lochia:
o Rubra: days 1–3.
o Serosa: days 4–10.
o Alba: day 10–6 wk.
Lochia amounts: scant <2.5 cm, light 2.5–10 cm, moderate >10 cm, heavy pad <2 hr,
excessive pad <15 min.
Blood loss: vaginal 300–500 mL; cesarean 500–1000 mL.
White blood cells: up to 30,000 postpartum.
Heart rate: may be as low as 40/min.
Temperature: up to 38 °C first 24 hr (normal dehydration).
Return of ovulation/menstruation:
o Breastfeeding: ovulation ~6 mo.
This study source was downloaded by 100000898062787 from CourseHero.com on 09-30-2025 01:55:50 GMT -05:00
https://www.coursehero.com/file/251448144/midterm-cram-sheetdocx/
, Not breastfeeding: ovulation 7–9 wk, menses by 12 wk.
o
Vaccines:
o Rubella/MMR if nonimmune, avoid pregnancy 4 wk.
o Varicella if nonimmune, avoid pregnancy 1 mo, repeat 4–8 wk.
o Tdap postpartum if not received.
o Rho(D) immune globulin within 72 hr if Rh negative mother with Rh positive
baby.
Newborn Management (Lecture Chapter 18)
Red flags: nasal flaring, retractions, grunting, cyanosis, flaccid tone, abnormal heart or
respiratory rate, abnormal size.
Apgar score: at 1 and 5 min (10 min if <7).
o 7–10 = good; 4–6 = moderate; 0–3 = severe.
Ballard score: assesses physical (skin, lanugo, creases, breasts, eyes/ears, genitalia) +
neuromuscular maturity (posture, square window, arm recoil, popliteal angle, scarf sign,
heel-to-ear).
Immediate meds: vitamin K (0.5–1 mg IM vastus lateralis), erythromycin eye ointment.
Transient tachypnea (TTN): oxygen, warmth, resolves in 24–72 hr.
Physiologic jaundice: appears after 24 hr, frequent feeding, phototherapy if needed.
Hypoglycemia: blood glucose <45 mg/dL; treat with dextrose gel + feeding.
Energy needs: 108–120 kcal/kg/day.
Feeds: breastfeed 8–12/day; formula every 3–4 hr.
Elimination:
o Day 1: 1 wet diaper.
o Day 2: 2 wet diapers.
o Day 4+: 6–8 wet diapers/day.
o Stool: breastfed = yellow, seedy, ≥3/day; formula = firmer, less frequent.
Newborn Assessment (ATI Chapter 23)
Weight: 2500–4000 g.
Length: 45–55 cm.
Head circumference: 32–36.8 cm.
Chest circumference: 30–33 cm.
Heart rate: 110–160/min.
Respiratory rate: 30–60/min.
Temperature: 36.5–37.5 °C.
Blood pressure: 60–80 systolic / 40–50 diastolic.
Reflexes:
o Rooting/sucking: disappears by 3–4 mo (up to 1 yr).
This study source was downloaded by 100000898062787 from CourseHero.com on 09-30-2025 01:55:50 GMT -05:00
https://www.coursehero.com/file/251448144/midterm-cram-sheetdocx/
