2hour old male w/ RDS

Question 1

Ddx for tachypnea in a newborn

Answer 1

RDS
TTN
Pneumothorax
Meconium aspiration
Hypoglycemia
Hypothermia
Cardiac abnormalities
Neonatal Sepsis
Congenital Diaphragmatic Hernia

Question 2

risk factors for neonatal sepsis

Answer 2

maternal colonization with GBS
PROM
Delivery <37 weeks
Maternal fever or chorioamnionitis

Question 3

Premature birth is a risk factor for which conditions presenting w/ tachypnea

Answer 3

RDS, pneumothorax, sepsis/pneumonia

Question 4

Maternal diabetes is a risk factor which conditions presenting w/ tachypnea

Answer 4

TTN, RDS

Question 5

Delivery by c-section risk factor for which condition presenting w/ tachypnea

Answer 5

TTN

Question 6

CXR distinguishes transient tachypnea of the newborn versus respiratory distress syndrome in that it shows…

Answer 6

TTN: wet looking lungs, no consolidation, no air bronchograms

RDS: diffuse reticulogranular appearance (ground glass appearance) and air bronchograms

Diaphragmatic hernia: develops on the left side, air-filled loops of bowel in the left side of the chest, displace the heart mediastinum to the contralateral side.

Question 7

when does tachypnea preclude oral feeding?

Answer 7

RR of >80/minute will have difficulty with oral and NG feedings, would need some IVF support.

Question 8

what is a target glucose screen value prior to feeds

Answer 8

> 45mg/dL

Question 9

risk factors for congenital dysplasia of the hip

Answer 9

breech position, female, family hx

Question 10

When do you screen for developmental dysplasia of the hip

Answer 10

serial clinical exams up to 12mos

Females born in breech

optional for boys born in breech
optional for girls w/ family hx

Question 11

Newborn hospital discharge instructions for feeding

Answer 11

feed on demand q2-4hours, 10-15mins on each side

Question 12

Newborn hospital discharge instructions for Jaundice

Answer 12

measure tbili before discharge, contact physician if jaundice appears

Question 13

Newborn hospital discharge instructions for vitamin d

Answer 13

daily vitamin d drops if breastfed

Question 14

Newborn hospital discharge instructions for sleeping

Answer 14

bassinet for sleeping (no sharing sleeping space)

Question 15

newborn with tachypnea–>blood glucose levels requiring intervention at <4 hours of life

Answer 15

<25mg/dL w/out sxs or <40 mg/dL w/ sxs