Download NEONATAL NURSING EXAM|LATEST UPDATE 2025|QS & AS|A+ RATED and more Exams Nursing in PDF only on Docsity!
NEONATAL NURSING EXAM|LATEST UPDATE 2025|
QS & AS|A+ RATED
Normal Newborn Vital Signs Includes temperature range of 97.7-99.5°F (36.5-37.5°C) when taken axillary, heart rate of 120-160 bpm (beats per minute) when awake, 100 bpm when sleeping, and 180 bpm when crying, respirations at 30- breaths per minute, and blood pressure at 70/45 mmHg. Newborn Weight Typically ranges from 2.5-3.4 kg (5.5-7.5 lbs), with a normal weight loss of 5-10% in the first few days. Newborn Length Averages between 46-54 cm (18-21 inches). Head & Chest Circumference
Head circumference is around 34-35 cm (13.4-13.8 inches), with the chest measuring approximately 2 cm less than the head. The chest should be measured at the level of the nipples. Anterior Fontanel Posterior Fontanel
- Diamond shaped soft spot on cranium of fetus or infant. Located at front of head
- Triangle shaped soft spot near back of head Cephalohematoma blood collection/ bleeding that does NOT cross suture lines caput succedaneum edema and swelling that crosses the suture lines Newborn Skin Inspection
Newborn Feeding Involves understanding the stomach capacity of 60-90 mL, limited fat and starch digestion, immature sphincter control, the role of prolactin (hormone for milk production), and the presence of colostrum (first milk). Circumcision Cons -May reduce transmission risk of certain sexually transmitted diseases -Reduces risk of some pathologies -Altering genitals without consent -Loss of sensitive tissue -Possible damage -Unnecessary surgery -Post circumcision: monitor urine output, hemorrhage, infection, pain, apply petroleum gauze Newborn Neck & Clavicles
Assessing for a short neck, creased skin, free rotation of the head, and straight, smooth clavicles (collarbones). Newborn Chest & Abdomen Involves checking for a symmetrical chest, intact clavicles, engorged breasts (due to maternal hormones), a slightly protuberant abdomen is normal and a scaphoid (concave) appearance of the abdomen indicates missing abdominal contents or a diaphragmatic hernia. 3 umbilical vessels Hip Subluxation When the baby's hip joint seems to lock short of this distance (160 to 170 degrees). May be bilateral or unilateral. "Inner thigh folds" Newborn Genitals Examining for an edematous (swollen) scrotum, palpable testes, small penis, swollen vulva, and mucus vaginal secretion. Avoid retracting foreskin
palmar grasp reflex in response to stroking a baby's palm, the baby's hand will grasp. -This reflex lasts until about 6 weeks to 3 months Plantar Grasp Reflex reaction to stimulation of the sole of the foot that causes the toes of the feet to "grasp" -disappears at 8 to 9 months when they prepare to walk tonic neck reflex turning the head to one side, extending the arm and leg on that side, and flexing the limbs on the opposite side -disappears between 2nd and 3rd month of life Moro reflex (startle reflex)
occurs when a baby is startled by a loud noise, a sudden movement, or the head falling back. The arms are thrown apart. The legs extend and then flex. A brief cry is common -strong for 8 weeks the is replaced by adult startle reflex after 3 months Babinski reflex Infant reflex where if its foot is stroked, the baby's toes fan out
- lasts for about 3 months Newborn senses -senses well developed at birth include TASTE: prefer sweet over salty , TOUCH, SMELL -hearing functional but not fully developed. Better once ears have dried -vision is least functional sense at birth. term infants can see 9- inches away. focus better on black and white objects Routine Newborn Medications
Phenylketonuria (PKU) An inherited metabolic disorder caused by a deficiency of the liver enzyme phenylalanine hydroxylase, leading to brain damage and intellectual disability if not managed through a special low phenylalanine diet diet. -newborn screening done 12-24 hrs of age GDM infant risk hypoglycemia: normal blood glucose (40 or above)
- hypocalcemia, respiratory distress, increased insulin production, decreased surfactant production, temp instability, birth injuries -provide early feedings Newborn hyperbilirubinemia jaundice in the palms, sclera, and sternum.
- can lead to kernicterus (brain damage) -physiological: hematoma, infection, dehydration, sepsis. -pathological: immature liver, hemolytic disease, reposition Q 3 hrs
Unconjugated bilirubin breakdown product of heme, lipid soluble, direct conjugated bilirubin water soluble, indirect transcutaneous bilirubin test non-invasive measurement of bilirubin levels for hyperbilirubinemia Patent Ductus Arteriosus (PDA) A condition common in preterm babies, particularly females, and those born to mothers with rubella, respiratory distress syndrome, preterm or high altitude babies. A blood vessel called the ductus arteriosus fails to close after birth, causing right-sided heart failure and pulmonary congestion.
Imperforate Anus A congenital condition where the opening to the anus is missing or blocked, leading to difficulties in passing stool. Club Foot/Feet A genetic deformity of the foot, where the foot is twisted out of shape or position, and resistance can help differentiate between true clubfoot and other conditions. -feet can be easily returned to midline by manipulation -more common in boys, 1 in 1000 births, and is inherited Importance of Gestational Age Assessment Critical for determining the weeks from conception to birth based on physical and neurological characteristics, guiding appropriate care and interventions for the newborn.
Dubowitz Scoring System A method for assessing newborn maturity rating based on skin texture, the amount of lanugo (fine hair), plantar surface, breast development, eye and ear formation, and genitalia appearance. Score - 10 to 50 Ballard score a test used to estimate gestational age, Most accurate at 12-20 hrs and is based on the sum of neuromuscular and physical maturity scores the higher the number the more mature. Apgar Score A quick assessment of a newborn's well-being, evaluating color (appearance), heart rate (pulse), reflex irritability (grimace), muscle tone (activity), and respiratory effort (respirations), conducted at 1 and 5 minutes after birth. 5 min APGAR >7 repeat at 10 mins AGA Stands for 'appropriate for gestational age', indicating a birth weight between the 10th and 90th percentile.
appearance: large head, weak cry, disorganized responses, little subcutaneous fat, visible veins, covered with vernix , extensive lanugo, few or no plantar creases and no breast tissue. risks: low SES, poor nutrition, twins, smoking, infections Term Refers to babies born between 38-42 weeks of gestation, considered full-term and generally at lower risk for complications. Post-term Refers to babies born at 42 weeks of gestation or more, putting them at risk for hypoglycemia, hypothermia, hypobilirubinemia, meconium aspiration ,respiratory and metabolic complications due to prolonged gestation. appearance: SGA, LGA, placental insufficiency: small and malnourished. considerations: avoid cold stress, monitor blood glucose, give early feedings
Respiratory Assessments Involves evaluating the newborn's respiratory rate, reviewing the labor and delivery history, - normal RR: (30-60 BPM) nose or irregular breathers -checking for abnormal breath sounds: intercostal retractions, flaring, grunting -assessing for signs of respiratory distress syndromes: lack of surfactant (RDS), transient tachypnea of the newborn (rr> 60)- retained lung fluid, Apnea of the newborn: Apnea over 20 seconds, Cardiovascular Assessment Involves assessing the transition from intrauterine to extrauterine circulation: clamp cord to increase vascular resistance and dry the infant for stimulation of breathing
Cold stress and the newborn The biggest concern is increased metabolism leading to respiratory distress, hypoglycemia (possible symptom of sepsis), hypoxia, acidosis, disseminated intravascular coagulopathy, and death Disseminated Intravascular Coagulation (DIC) abnormal blood clotting in small vessels throughout the body that cuts off the supply of oxygen to distal tissues, resulting in damage to body organs Newborn conduction movement of heat away from the body when newborns have direct contact with objects that are cooler than their skin, cold hands, stethoscope, scale, or circumcision board Newborn convection transfer of heat from the infant to cooler surrounding air when drafts come from open doors, air conditioning, or air currents
Newborn evaporation heat loss from loosing moisture on the skin as result of the environment, wet linens, diapers, hair wet from bath or insensible water loss from lungs Newborn radiation the transfer of body heat to a cooler solid object not in contact with the baby, such as a cold window or air conditioner. Moving an infant as far from the cold surface as possible helps reduce this type of heat loss newborn thermoregulation prewarming blankets and hats, keeping the infant transporter (warmed isolette) fully charged and heated at all times, drying the newborn completely after birth to prevent heat loss from evaporation encouraging skin-to-skin contact (kangaroo care) with the mother if the newborn is stable, promoting early breast-feeding to provide fuels for nonshivering thermogenesis using heated and humidified oxygen
