14164216
Description
Flashcards by Elizabeth Then, updated more than 1 year ago
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Created by Elizabeth Then
over 6 years ago
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| Question | Answer |
| Neonatal period | First 28 days after birth, critical time for physiological adjustments |
| Effects of birth-Respiratory Sytem | Foetus is hypoxic during birth increased CO2 A fetus passed through birth canal, forces lung fluid from alveoli to upper resp tract and out chest expands after birth drawing in air increased CO2 levels stimulate resp centre in medulla causing inspiration |
| Effects of birth circulatory system | Cord clamped after birth pressures in left and right sides of the heart cause closure of connecting bv more blood to lungs oxygenation and increase pulmonary vascular resistance closes further blood vessel in heart |
| Resuscitation of new born | most infants resuscitate themselves lung inflation struggle with first breath - need assistance ventilation provided with bag and mask |
| Agpar score | score indicate level of support newborn needs score added overall performed at 1 and 5 minutes after birth 0-3 severe asphyxia 4-6 moderate asphyxia 7-10 good adaptation |
| Newborn assessment | head to toe 4 modes: inspection, percussion, auscultation, observation general: measurements, skin, posture, body proportion, reflexes, movements, vitals, facial expression |
| Newborn reflexes | primitive reflexes are sign of delay in maturation of CNS most disappear with maturation over first 3-4 months needed for: food, safety, transition, grasping |
| examples of primitive reflexes | palmar grasp, moro reflex, rooting, sucking, tonic neck, blinking, stepping, walking |
| Newborn assessment toold | physical: skin, ear, genitals, creases, breast, nipples, hair, oedema neurological: posture, flexion of arms, wrists, feet, legs behavioural characteristics: head lag, cry, colour |
| Brazalton neonatal behaviour assessment | performed 24-36 hours of birth when clinical worried about neurological state assesses: neuro development, reflexes, reactions responses to stimulation/handling: tone, skin colour, able to follow object, consolability, resistant to cuddling and clinging low score- brain stress/damage moderate score- parent taught to interact with infant |
| neurological posture | related to age developes cephalo-caudal direction less than 30 weeks no tone, extension of all limbs 30 weeks - some flexion, feet, knees 34 weeks - thighs, hips flexed 36 weeks - upper limbs flexed normal flexion indicates good muscle tone |
| New born neurological assessment abnormal movements | tremors, jitters, convulsions, hyper-irritability, asymmetry of movement |
| Newborn neurological assessment alertness | quiet sleep, semi-awake, alert and cooperative, fussing and uncooperative, crying, new borns sleep 16-17 hours of the dayy |
| Measuring physical growth | length, height, head circumference, surface area, skin fold thickness, bone age |
| Assessing growth | average birth weight is 3.3kg average length is 50 cm average head circumference is 35 cm |
| Growth patterns and differences | appropriate for gestational age larger than gestational age smaller than gestational age - below 2500gm low birth weight - below 2500gm extremely low birth weight - below 1000gm |
| Patterns of sleep | REM sleep decreases with age usually pattern gains 4-6 weeks should sleep more at night by 4 months of age |
| Types of sleep | quiet - may suck, not REM active - may smile and fuss awake - drowsy, quiet alert, active alert, crying alert periods -can imitate movements and emotions |
| Brain growth | Human brain at birth only 25% adult size develops neurones, dendrites, axon terminals |
| Birth to 6 months | physical growth - doubles weight by 5-6 months, teeth may begin Fine motor ability - grasp objects, mouthing objects Gross motor - develops head control, standing supports much of own weight by 6 months sensory - alert to high pitched noises, turns head to look at voices |
| 6 - 12 months | physical - growth slower, triples by 1 year fine motor ability - bangs objects, may hold pencil gross motor - crawls, sits alone sensory - recognises own name, understand words such as no |
| Bonding after birth | forming a connection is best between mother and baby encourage involvement |
| Attachment | strong emotional bond infants develop attachment behaviour tendency of young to stay close |
| Infant communication | birth to 2 months - coos, babbles 3-6 months - laughs, cries 6- 9 months - talking, increasing vowel sounds 9-12 months - understand no, says dada mama |
| crying 3 types | rhythmic - steady pulsating- hunger, unhappy mad - shrill, turbulent - anger, frustration pain - long scream followed by silence |
| Types of play | solitary - infancy parallel - toddlerhood associative - pre-schooler dramatic - pre -schooler cooperative - school age child |
| Play during infancy | plays alone uses senses to grasp, touch, taste, manipulate |
| Toddlerhood | rate of growth slows in second year displays independence and negativism pride in new accomplishments |
| Growth 1-3 years | physical - anterior fontanel closes fine - throws ball, self dress gross - walks, runs, jumps sensory - can focus well |
| Teeth eruption | regular sequence, varying timing, genetically determined |
| Toddler communication 1-3 years | verbal and non-verbal imitates words, increasingly enjoys tallking, vocab of 1000 words in 3 year old, enjoys contact with others |
| Communicating with a toddler | avoid telling toddlers about things too far in advance, allow to cry, use simple technology, comfort toddler |
| play during toddlerhood | parallel play - social, play alongside others |
| Effects of hospitalisation - four idenfied categories | seperation, pain and injury, immobility ad loss of control, change in routine reacts depends on: age, preparation, previous illness, support, health professionals |
| seperation anxiety | protest - cries, screams despair - sad, lonely detachment - denail - interested and plays, responds to parents as strangers |
| Seperation anxiety protest phase - infants | cries, scresm, attempts to escape |
| Seperation anxiety - protest phase - toddler | agitated, resist caregiver,s increasing age, regression |
| seperation anxiety despair and detachment | despair- occurs long term, withdrawn detachment - appears happy, interacts with strangers |
| Pain and bodily injury | cognitive development - pre-operational concept of illness - external to child, cannot relate cause play is important in this to help them deal and express feelings and emotions |
| Immobility and loss of control | altered routines and restrictions, decreased opportunities, help them release hospital is not a punishment |
| What can nurses do? | family-centred care talk, honesty of pain, play is important, communication and language important, talk to level of child's understanding |
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