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Newborn assessment NORMAL

-HR 160/min
-calcium 9.2 mg/dl
-axillary temp 97.7 F
-voiding should occur within the first 24 hours
-umbilical cord 2 arteries and 1 vein
Newborn Assessment abnormal
--blood glucose < 40 mg/dl indicates hypoglycemia
-Jaundice within the first 24 hours can lead to hearing
loss
-one artery of umbilical cord newborn might have renal
anomaly
Normal findings of breeched baby
-scrotum appears edematous
Normal findings gestation
-second trimester = 0.9 lb / week
increased leukorrhea
hyperpigmentation of the face
varicose veins
-fundal height should be the same number of weeks of
gestation
Abnormal findings gestation
-Second Trimester = frequent uterine contractions =
preterm labor

Feeding
-newborns eat 8 12 times per day
-6 day olds should have 6 wet diapers per day
-breastfed babies should have 2 stools per day
-breast milk can be stored in the freezer for up to 6 mo
Safe newborn care:
-avoid baby powder
-avoid comforters and pillows in cribs SIDs
-use a firm mattress NOT SOFT MATTRESS SIDs
-place on back to sleep
-avoid cotton tipped swabs
-keep newborn wrapped while washing her hair to
prevent heat loss
-avoid running water during bathing water temp
could change
-set water heater to 120
-space between the mattress and the sides of the crib
should be ess than 2 fingerbreadths
-check smoke detectors once per month
-crib slats should be no more than 6.4 (2 in) apart

Magnesium toxicity
- deep tendon reflexes
- respiratory rate
-oliguria
- LOC
double vision
fundus that is 2 cm above the umbilicus and
deviated to the right
-assist to the bathroom

Nipple Shield: recommend for women who have flat


or inverted nipples.
Mastitis:
-can still breast feed
-empty the breast frequently to increase comfort

Hyperesmesis Gravidarum
-persistent vomiting and ketonuria indicates
development of hyperemesis gravidarum
-tachycardia
Tachypnea can indicate hypoglycemia
Proteinuria can indicate preeclampsia
Breastfeeding a 12 hr newborn teaching
-do not remove colostrum contains IgA passive
immunity for newborn
-wake baby up in the night feed every 4 hours for
the first 24 to 48 after birth. Once the newborn is
gaining weight adequately progressing to demand
feedings is appropriate
-Breastfeeding the newborn is the best means of
stimulation of milk production use breast pump only
when infant is latching well
Medroxyprogesterone increase calcium intake,
administer every 3 months, administer the first dose of
medro during the first 5 days of the clients menstrual
cycle.
Reactive nonstress test: 2 FHR accelerations of
15/min over a 20 min period lasting at least 15 seconds
Nonreactive: no accelerations in a 20 min period
Hypoglycemia in Infant:
-hypothermia
-twitching
-tachypnea
Hypocalcemia in infant
-abdominal distention
ABSENT BOWEL SOUNDS INFANT CAN INDICATE
ALTERATION IN GI
Uterine Bleeding: relaxed, distended uterus with the
presence of blood and clots
Cervical Laceration: slow, oozing trickle of blood,
during which the fundus can remain firm
Retention of Placental Fragments:
1 hr oral glucose tolerance test: avoid caffeine the
morning of test no need to fast, not necessary to
provide urine sample at the start of the test,
Phytonadione in newborn: admn IM

Respiratory distress: tachypnea, coarse crackles,


retractions, expiratory grunting
postpartum client risk for postpartal atony

-due to when there is an increased overstressed uterus


or is overstretched.
-precipitous delivery: occurs less than 2 to hr
-distended bladder
-macrosomic delivery: over 9 lbs
Morning sickness: caused b/c of the build up of HCG.
Continues to increase until about the 12th week. After
that HCG levels decrease, and morning sickness will
decrease.
Urinary freq: usually disappears after 1st trimester
cephalohematoma: soft spot on left side, with bluish
discoloration and edema. resolves within 2 to 6
weeks without treatment will close spontaneously.
RhoGAM given following a voluntary termination of a
pregnancy at 12 weeks
40 weeks (posterm babies): creases covering the
entire bottom of both feet little lanugo or vernix
Lanugo: fine hair covering is the greatest between 28
and 30 weeks gestation. (preterm)
Vernix: cheese like substances greatest in preterm
babies
Potassium chloride (Apo-K): administered to
depressed newborns who require resuscitation
following delivery.
Methylergonovine (Methergine): check blood
pressure prior to adm. Ergot alkaloids stops excessive
bleeding that sometime occurs after an abortion or
delivery. Works by causing the muscles of the uterus to

contract. High BP is a common side effect. Should not


be given 140/90 mm HG
Phototherapy: do not swaddle the infant infant
must have as many body surfaces as possible exposed
to the light. (the infant would at risk for hyperthermia
not hypothermia due the high intensity lights)
Breastfeeding: client should add 300 calories to diet
during prego. Then 200 calories following delivery.
-drinking milk does not promote breast milk
-increase fluids to promote breast milk production 8
to 10 8 oz of fluid per day.
-to promote milk production, women are encouraged to
nurse frequently (every 2 to 3 hr) for the first few days
after delivery.
Congenital hip dysplasia
-Ortolani click is heard when the head of the femur
slips in the acetabulum in congenital hip dysplasia.
-asymmetrical folds would be indicative of congenital
hip dysplasia.
-limited abduction indicates that the head of the femur
may have slipped out of the acetabulum.
cervical lacteration postpartum findings
-continuous vaginal bleeding in the presence of a firm
fundus.

Newborn normal ranges


blood glucose: 40 to 95 mg/dL
Respiratory: 40 to 60 / min