Factors related to sucking ability in healthy newborns.

OBJECTIVE: To identify maternal, infant, and environmental factors related to newborn sucking ability. DESIGN: Prospective, descriptive, exploratory study using a convenience sample. SETTING: Normal newborn nursery in an urban tertiary-care medical center. PARTICIPANTS: Two hundred three healthy newborns admitted to the normal newborn nursery after delivery. The newborns were between 30 minutes and 11 hours of age, and between 34 and 42 weeks gestation. MAIN OUTCOME MEASURES: This study examined 15 variables related to newborn sucking ability: infant state, age, gestational age, Apgar scores, birth weight, labor medications, type of delivery, elapsed time since last feeding, infant sex, perinatal complications, infant vital signs, birth resuscitation, clothing, room temperature, and length of labor. Sucking ability was measured by the Neonatal Oral Motor Assessment Scale (NOMAS). RESULTS: The variables of gestational age, weight, and state were positively correlated with sucking ability (NOMAS scores). Newborn's age postdelivery and minutes to the quiet alert state were inversely correlated with sucking ability. CONCLUSIONS: Newborn weight and gestational age are related to sucking ability. Younger newborns had better sucking ability than did older newborns.

A study of mothers' postpartum teaching priorities.

This descriptive study investigated the teaching priorities of mothers during the early puerperium. Subjects (N = 117) were English-speaking women who had normal vaginal deliveries and healthy newborns. A questionnaire consisting of 16 maternal and 23 infant care teaching topics was administered during the 3-day postpartum hospital stay. Respondents rated each topic's teaching priority on a 4-point, Very Important to Not Very Important, scale. Results were analyzed with percentages in relation to all mothers, maternal age groups (teens, twenties, thirties), and parity groups (primiparas, multiparas). The maternal care topic of highest priority for all age and parity groups was "Postpartum Complications." The infant care topic of highest priority for all age and parity groups was "Infant Illnesses." The results suggest that these teaching topics are of most concern to mothers during the early postpartum period. The mothers' priorities assigned to other teaching topics varied by age and parity groups.

Neonatal jaundice in the home: assessment with a noninvasive device.

Hyperbilirubinemia continues to be the major reason for hospital readmissions of neonates. This is particularly true for neonates who are discharged before the 72-hour physiological jaundice occurs. A small descriptive study reveals that use of a noninvasive bilirubinometer can be of assistance in screening for elevated bilirubin levels of newborns visited at home.

Chorionic villus sampling: counseling your patient.

Chorionic villus sampling is a technique for prenatal genetic screening that has been widely publicized by the print and television media. Although not yet commonly available, women may seek additional information about the procedure from nurse practitioners. This article discusses the women for whom this procedure is most appropriate, the procedure's accuracy, sampling techniques, safety records and the procedure's accessibility and cost. The NP's role in counseling and anticipatory guidance is also discussed.

What's new in pregnancy tests.

Immunologically based pregnancy tests that will diagnose pregnancy even before the menstrual period is missed are now available. Nurses who deal with female patients in the reproductive years must be aware of these newer pregnancy tests now in use. Appropriate interpretation of pregnancy tests will aid women in early pregnancy to avoid potentially harmful radiation, drugs, or treatments.

PIP: Advances in pregnancy testing now enable women to discover a pregnancy at the time of her missed menstrual period or even before. Early detection of pregnancy allows early care as well as avoidance of the potentially teratogenic effects of medications, anesthesia, or radiation. To interpret accurately a pregnancy test, the nurse needs to be familiar with commonly used tests and their sensitivity levels, as well as the patient's history. All currently popular pregnancy tests detect levels of human chorionic gonadotropin (hCG), a hormone secreted by the fertilized egg shortly after conception. Most of the current pregnancy tests fall into 1 of 4 categories of inhibitor tests: latex agglutination inhibition, hemagglutination inhibition, radioreceptor assay, and radioimmunoassay. Radioimmunoassays can quantitatively indicate abnormal levels consistent with an ectopic pregnancy, missed abortion, or hydaditiform mole. Home pregnancy tests are generally hemagglutination inhibition tube tests, but tend to be more expensive and less accurate than hemagglutination inhibition tube tests performed in the laboratory. Given the availability of pregnancy testing technology, no woman should be instructed to wait several weeks after her missed menstrual period to ascertain if she is pregnant.