4.2.3 Care of the Newborn I

Question 1

What is used to assess gestational age?

Answer 1

Ballard assessment

Question 2

SGA and LGA risks on physical exam?

Answer 2

Question 3

Considerations in history for care of newborn during transition period

Answer 3

Question 4

What is the APGAR Scoring System chart?

Answer 4

Question 5

How does baby know it is born?

Answer 5

Extra blood in circulation -> catecholamines released

Question 6

Describe the initial urine?

Answer 6

Cloudy scant amounts with uric acid cystals (brick dust in diaper)

Question 7

What is the organ of heat generation?

Answer 7

Brown fat (tons of Mito)

Question 8

What measurements are taken at birth?

Answer 8

Weight, length, head circumference

Question 9

What are the different changes during transition?

Answer 9

Question 10

How do you distinguish tremors from seizures?

Answer 10

Tremors will stop when the limb is grabbed, but seizures will continue to shake. Tremors are normal

Question 11

What happens to the mass to surface area ratio?

Answer 11

Decreases

Question 12

What helps eliminate fluid from lungs?

Answer 12

Catecholamines

Question 13

What are some causes of LGA (large for gestational age)?

Answer 13

Maternal diabeetus, maternal obesity

Question 14

What occurs to glucose metabolism before and after birth?

Answer 14

Question 15

What is transition?

Answer 15

Process of physiologic change in the newborn infant that begins in utero as the child prepares for transition from intrauterine placental support to extrauterine self-maintenance

Question 16

What are the three fetal shunts?

Answer 16

Ductus venosus, foramen ovale, ductus ateriosus (all must close for normal circulation

Question 17

Changes necessary for breathing in newborn?

Answer 17

Question 18

What is determined by the APGAR score?

Answer 18

Need for resuscitation

Question 19

What are some respiratory problems which exacerbate transition?

Answer 19

Question 20

What are routine meds for newborns?

Answer 20

Erythromycin eye ointment (gonorrhea and chlamydia)

Aquamephyton (vit K)

First Hep B vaccine

HBIG if mother is Hep B surface Ag positive (95% effective w/ vaccine)

Question 21

What three heat regulatory measures?

Answer 21

Generation, conservation, loss

Question 22

What are the five area graded in APGAR?

Answer 22

Acitivity, pulse (taken by grabbing umbilicus), grimace, appearance, respiration

Question 23

What is used to assess the newborn?

Answer 23

APGAR Score

Question 24

What are some of the different mechanisms of heat loss?

Answer 24

Conduction, convection, radiation, and evaporation

Question 25

When do the shunts typically close?

Answer 25

Question 26

What are some of the newborn reflexes?

Answer 26

Question 27

What some symptoms of improper glucose transition?

Answer 27

Question 28

Should a mom breastfeed if sick?

Answer 28

Yes, she is passing along enough Ig to keep them healthy

Question 29

What is transient tachypnea of the newborn? When is it most often seen?

Answer 29

After C-section

Question 30

What is the initial glucose level in newborns?

Answer 30

40-45 normal

Question 31

Symptoms of breathing problems?

Answer 31

Tachypnea, grunting, flaring, retractions, cyanosis

Question 32

When is an APGAR score taken?

Answer 32

1, 2, 5, and 10 minutes after birth

Question 33

What are some causes of SGA (small for gestational age)?

Answer 33

Fetal factors: genetic, infection, metabolic disorders

Maternal factors: smoking and drug use

Placental factors: insufficiency from HTN, drugs