Editing Maternal and Newborn Nursing – LPN Flashcards (section)

== Newborn Care ==

;Normal newborn vital signs
:Heart rate '''110 to 160''' beats per minute while awake, respirations '''30 to 60''' per minute and irregular, axillary temperature '''97.7 to 99.5 degrees F (36.5 to 37.5 degrees C)'''. Always take a newborn temperature under the arm, not rectally, for routine checks.

;Newborn breathing findings that must be reported immediately
:A rate over 60 that stays up, grunting, nasal flaring, chest retractions, pauses in breathing longer than 20 seconds, and cyanosis around the mouth or of the trunk and lips.

;Acrocyanosis versus central cyanosis
:'''Acrocyanosis''' is blue hands and feet with a pink trunk and face in the first 24 to 48 hours, and it is '''normal'''. '''Central cyanosis''', meaning blue lips, tongue, or trunk, is '''never normal''' and is reported at once.

;The four ways a newborn loses heat and how to prevent each
:'''Evaporation''': dry the baby right away and remove wet blankets. '''Conduction''': prewarm the scale, mattress, and your stethoscope and hands. '''Convection''': keep the baby away from drafts, vents, and open doors. '''Radiation''': keep the crib away from cold windows and outside walls.

;Why a cold newborn is a serious problem
:Newborns cannot shiver. Getting cold makes them burn energy and oxygen fast, which leads to '''low blood sugar''', trouble breathing, and acid buildup in the blood. Skin-to-skin contact with the parent is one of the best warming methods, and the first bath is delayed until the temperature is stable.

;Signs of low blood sugar in a newborn and what to do
:Jitteriness or tremors, poor feeding, sleepiness or floppiness, a weak or high-pitched cry, temperature instability, and pauses in breathing. '''Check a blood glucose and report it'''; do not simply swaddle the baby and wait. Babies at highest risk are large or small for their age, preterm, and infants of diabetic mothers.

;Normal newborn skin findings that are '''not''' problems
:Milia (tiny white bumps on the nose and chin), erythema toxicum (a blotchy newborn rash), vernix caseosa, lanugo, congenital dermal melanocytosis (bluish patches formerly called Mongolian spots), and molding of the head from birth.

;Newborn jaundice: the timing rule
:Yellow skin or eyes appearing '''in the first 24 hours must be reported immediately''' because it suggests a serious cause. Jaundice that starts '''after''' 24 hours and peaks around days 3 to 5 is usually normal newborn jaundice. Frequent feeding helps the baby get rid of bilirubin in the stool; plain water does not and is never given.

;First void and first stool expectations
:First urine within '''24 hours''' and first meconium stool within '''24 to 48 hours'''. Report if either does not happen. Stools go from black tarry meconium, to greenish transitional, to yellow and seedy in breastfed babies or pale yellow to tan and firmer in formula-fed babies.

;Newborn cord care
:Keep it '''clean and dry''', fold the diaper down below it, and let it fall off on its own in about 7 to 14 days. Do not pull on it and do not routinely use alcohol. Report spreading redness on the belly, pus, foul odor, or fever.

;Circumcision care with a Plastibell
:'''Do not remove the ring'''; it falls off on its own in about 5 to 8 days. A yellowish film on the tip is normal healing and is '''not''' wiped off. Clean gently with warm water, never alcohol. Report bleeding more than a few drops, no urination within 6 to 8 hours, foul odor, or swelling with fever.

;The heel stick newborn screening
:Usually done at '''24 to 48 hours''' of age after the baby has been feeding. Warm the heel first and use the '''lateral (outer) part''' of the heel to avoid injuring the heel bone. Comfort measures include swaddling, a pacifier, and skin-to-skin contact.

;Safe sleep teaching
:'''Back to sleep every time''', on a firm flat surface with a fitted sheet, in the baby's own crib or bassinet in the parents' room. No pillows, blankets, bumper pads, positioners, or stuffed toys. Avoid overheating and any smoke exposure. Supervised tummy time is for awake play only.

;Breastfeeding basics to reinforce
:Feed '''8 to 12 times in 24 hours''' on demand. Watch for '''early hunger cues''' such as rooting, hand to mouth, and lip smacking, because '''crying is a late cue'''. A good latch has a wide-open mouth taking in the nipple and much of the areola, with lips flanged out and audible swallowing. Break suction with a clean finger before removing the baby.

;How parents can tell the baby is getting enough milk
:At least 6 wet diapers a day by about day 4 to 5, three or more stools a day in the early weeks, audible swallowing during feeds, contentment after feeding, and steady weight gain after the normal early weight loss.

;Safe formula preparation
:Mix '''exactly''' as the label directs. Adding extra water can cause dangerous low sodium and seizures, and too little water strains the kidneys. Never microwave a bottle because of hot spots. Hold the baby semi-upright with the nipple full of formula, never prop the bottle, and discard formula left in the bottle after a feeding.

;When parents must call the provider about a newborn
:An axillary temperature of 100.4 degrees F (38 degrees C) or higher in a baby under about 3 months is an emergency. Also call for poor feeding, unusual sleepiness, fewer wet diapers, repeated vomiting, worsening yellow color, breathing trouble, or a cord or circumcision site that looks infected.

;Car seat teaching
:'''Rear-facing in the back seat''', properly secured, and '''never in front of an active airbag'''. The harness is snug with the chest clip at armpit level, and bulky coats go over the buckled harness, not under it.

[[Category:Maternal and Newborn Nursing]]
[[Category:Licensed Practical Nurse (NCLEX-PN)]]
{{Disclaimer}}