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if bilirubin is slightly elevated, try to correct it through breast feeding !vitamin K shot IMhelp prevent babies from bleeding out; 25 G 5/8 needles (similar to insulin needles); 90 degrees in the thigh osynthesized in intestinal flora which is absent in neonates !GI system in newborns are slow; bowel sounds can be hypoactive !Characteristics of stools oMeconium – sticky, thick, black, odorless; may take up to 2 days for newborn to pass oTransitional – little bit of meconium and little bit of how stool will look like in the future; day 3-4 of life
12oBreastfeed – pasty stool, golden yellow, semi-formed stool oFormula feed – pale yellow, formed stool oDIARRHEA IS NEVER NORMAL "loose and green o* * BREASTFED NEONATES TEND TO HAVE MORE STOOLS PER DAY THAN FORMULA-FED NEONATES * * !glomerular filtration rate is initially low but doubles by 2 weeks of age !Delay/decrease urinary output "mothers received magnesium sulfate during labor (blocks neuromuscular transmissions and can cause urinary retention) !Will lose 5%-10% of birth weight within first week of life; will regain weight within 10 days !Active immunity – acquired type through vaccinations; body produces antibodies !Natural immunity– exposure to antigens after which the individual produces antibodies (flu) !Passive immunity – obtain from mothers via uterine !Lymphocytes function at immature level !Colostrum – IGA !Head to toe assessment in newborn –latex gloves, measuring tape, thermometer, weighing scale, stethoscope, warm environment, 14 French catheter oMother’s history – Magnesium sulfate(baby will be sleepy) oHow long did bag of water rupture – would like to deliver within 12 hours oNormal for newborns to have irregular breathing, apnea (under 15 seconds is normal), O2sat can stay under 90% for first 10 minutesoFlexed posture, best time to do assessment is after feeding when baby is more calm oAssess skin for color, birthmarks, birth trauma #Swollen eyes for chemical pressure oHypertonic, can be hypoglycemic oHead circumference : above ears and eyebrows (33 cm – 35.5 cm) #Microcephaly: head circumference is below the 10thpercentile #Macrocephaly: head circumference is above 90thpercentile oChest circumference – across nipple line (2 cm – 3 cm lesser than head circumference "30.5 cm - 33 cm) oLength (19-21 inches; 45 cm – 53 cm) oWeight (2500 - 4000 g is normal) oThermoregulation – assessed in 15 minutes interval for first hour oRespirations may be irregular; can hear crackles due to amniotic fluids; 30-60 normal range oBlood pressure is usually never done in postpartum setting; usually in NICU oMilia will go away on its ownoLanugo – fine downy hair; usually seen mostly in premature babiesoMongolian spots – similar to a bruise; will go away within couple of yearsoPilonidal dimple - right dimple above the sacrum; associated with sinus problemsoMolding oFontanels – anterior (diamond)/posterior(triangle); anterior takes longer to close#Will be sunken if dehydrated#Bulging may indicate intracranial bleedingoCaput succedaneum #