if bilirubin is slightly elevated, try to correct it through breast feeding
!
vitamin K shot
IM
help prevent babies from bleeding out; 25 G 5/8 needles (similar to insulin needles); 90 degrees in the
thigh
o
synthesized in intestinal flora which is absent in neonates
!
GI system in newborns are slow; bowel sounds can be hypoactive
!
Characteristics of stools
o
Meconium – sticky, thick, black, odorless; may take up to 2 days for newborn to pass
o
Transitional – little bit of meconium and little bit of how stool will look like in the future; day 3-4 of life
12
o
Breastfeed – pasty stool, golden yellow, semi-formed stool
o
Formula feed – pale yellow, formed stool
o
DIARRHEA 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
o
Mother’s history – Magnesium sulfate(baby will be sleepy)
o
How long did bag of water rupture – would like to deliver within 12 hours
o
Normal for newborns to have irregular breathing, apnea (under 15 seconds is normal), O
2
sat can stay
under 90%
for first 10 minutes
o
Flexed posture, best time to do assessment is after feeding when baby is more calm
o
Assess skin for color, birthmarks, birth trauma
#
Swollen eyes for chemical pressure
o
Hypertonic, can be hypoglycemic
o
Head circumference : above ears and eyebrows (33 cm – 35.5 cm)
#
Microcephaly: head circumference is below the 10
th
percentile
#
Macrocephaly: head circumference is above 90
th
percentile
o
Chest circumference – across nipple line (2 cm – 3 cm lesser than head circumference
"
30.5 cm - 33 cm)
o
Length (19-21 inches; 45 cm – 53 cm)
o
Weight (2500 - 4000 g is normal)
o
Thermoregulation – assessed in 15 minutes interval for first hour
o
Respirations may be irregular; can hear crackles due to amniotic fluids; 30-60 normal range
o
Blood pressure is usually never done in postpartum setting; usually in NICU
o
Milia will go away on its own
o
Lanugo – fine downy hair; usually seen mostly in premature babies
o
Mongolian spots – similar to a bruise; will go away within couple of years
o
Pilonidal dimple - right dimple above the sacrum; associated with sinus problems
o
Molding
o
Fontanels – anterior (
diamond
)/posterior(
triangle
); anterior takes longer to close
#
Will be sunken if dehydrated
#
Bulging may indicate intracranial bleeding
o
Caput succedaneum
#
