Newborn Assessment
- APGAR
- Umbilical Cord
- 2 Arteries 1 Vein
- Eye Prophylaxis
- Fontanels
- Vitamin K Injection (Phytonadione)
- Gestational Age Assessment (GAA)
- Birth Weight
- Head Circumference
- Length
- Keep Warm
- ID Bands
APGAR Score
- 1 and 5 Minutes
- Appearance
- Pulse
- Grimace
- Activity and Muscle Tone
- Respiration
- Total Scores
- Gentle Stimulation
- Oxygen
Mechanism of Labor
- Engagement
- Descent
- Flexion
- Internal Rotation
- Extension
- External Rotation (Restitution)
- Expulsion of Infant
Cesarean Section - Indications
- Active Genital Herpes Infection
- Cervical Cancer
- Eclampsia (Preeclampsia)
- History of Uterine Surgery
- History of C-section (Vertical)
- Malpresentation
- Fetal Distress
- Cord Compression/Prolapse
- Failed Vaginal Delivery
- Cephalopelvic Disproportion
- Abruptio Placentae or Placenta Previa
Magnesium Sulfate
- Muscle Relaxant
- Preterm Labor Contractions
- Preeclampsia
- Warm Feeling
- Hypotension
- Decreased Deep Tendon Reflexes (DTRS)
- Decreased Respiratory Rate
- Decreased Urine Output
- Paralytic Ileus
- Calcium Gluconate
Routes of Administration Part Two (Parenteral)
- Intradermal
- Subcutaneous
- Intramuscular (IM)
- Intravenous
- Epidural
- Intrathecal
- Intraosseous
- Intraperitoneal
TORCHeS Screening
- Toxoplasmosis
- Other
- Rubella
- Cytomegalovirus (CMV)
- Herpes Simplex Virus (HSV)
- Syphilis
- Diagnostic Testing
Neonatal Respiratory Distress Syndrome
- Fetal Lung Immaturity
- Lack of Surfactant
- Respiratory Distress
- Nasal Flaring
- Retractions
- Grunting
- Surfactant
- Oxygen
- Mechanical Ventilation
- Total Parenteral Nutrition (TPN)
Postnatal Circulation
- Infant Breathes
- Decreased Pressure in Pulmonary Vasculature
- Decreased Right Heart Pressure
- Increased Left Atrial Pressure
- Closes Foramen Ovale
- Increased O2
- Decreased Prostaglandins
- Closed Ductus Arteriosus
- Open with Prostaglandins
- Closed with Indomethacin
Vitamin K1 (Phytonadione)
- Synthesizes Clotting Factors II, VII, IX, X
- Hypoprothrombinemia
- Newborn Prophylaxis
- Bleeding from Warfarin Overdose
- Shock
- Kernicterus
- Cardiac Arrest
- Bile Salts required for Intestinal Absorption
- Increased Risks with IV Administration
Hepatitis C
- Enveloped
- RNA Virus
- Flavivirus
- Icosahedral
- SS positive Linear
- Most Cases are Due to IV Drug Use
- Turns to Chronic Hepatitis in Over 70% of Cases
- Cirrhosis
- Hepatocellular Carcinoma
- Most Common Indication for Liver Transplantation
- Associated With Type I MPGN
- Porphyria Cutanea Tarda
Primitive Reflexes
- Integrated Reflexes
- Rooting Reflex
- Sucking/Swallowing Reflex
- Traction
- Moro Reflex
- Palmar Reflex
- Spinal Galant Reflex
- Plantar Grasp
- Asymmetrical Tonic Neck Reflex (ATNR)
- Tonic Labyrinthine Reflex (TLR)
- Symmetric Tonic Neck (STNR)
- Landau
- Neck Righting
- Body Righting
- Babinski Reflex
Reflexes Assessment
- Hyperactive
- Hypoactive
- Biceps
- Triceps
- Brachioradialis
- Patellar (Quadriceps)
- Achilles Tendon
- Plantar Reflex (Babinski Sign)
Hemoglobin
- Hemoglobin Has Four Iron Hemes
- Lots Of Hemoglobin In Red Blood Cells
- High O2 Levels Increase O2 Binding
- High Temperature Reduces O2 Binding
- High CO2 Levels Reduce O2 Binding
- Low pH Reduces O2 Binding
- Myoglobin Binds Oxygen in Muscle
Hematocrit (Hct) Lab Values
- Women: 36% - 46%
- Men: 41% - 53%
Red Blood Cell Count (RBC) Lab Values
- Women: 3.5-5.5 million cells/ MuL
- Men: 4.3-5.9 million cells/ MuL
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
Bilirubin Lab Value
- 0.2-1.2 mg/dL
- Increased Bilirubin Causes Jaundice
Alveolar Gas Exchange
- Pulmonary Artery Blood is O2-Poor, CO2-Rich
- Two-Cell Thick Air-Blood Barrier
- CO2 Diffuses Into Air
- O2 Diffuses Into Blood
- Gases Equilibrate
- Pulmonary Vein is O2-Rich, CO2-Poor
- Thermoregulation
pH - Blood and Urine Lab Value
- Blood
- 7.35 - 7.45
- Urine
- 4.0 - 8.0
Hypoglycemia Assessment
- Too much insulin
- Decreased glucose
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
Hypoglycemia Intervention
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Hypoglycemia Prevention
- Encourage Self-Monitoring
Hyperbilirubinemia
- Increased Unconjugated Bilirubin
- Jaundice
- Kernicterus
- Early Feedings
- Heme Oxygenase Inhibitors
- Phototherapy
- Protect Eyes
- Monitor for Dehydration
- Monitor Bilirubin Levels