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G Child Health > 6-8 week check > Flashcards

6-8 week check Flashcards

1
Q

When are newborn and infant physical exminations (NIPE) done?

A

At <72 hours after birth and at 6-8 weeks

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2
Q

What are the three tests that make up neonatal screening immediately after birth?

A

Neonatal and infant physical examination, automated otoacoustic emmissions AOAE test and the heel prick test

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3
Q

When is the heel prick test done and how is it done?

A

It is done at 5-8 by community midwives
four drops of blood collected on a card
Test for 9 rare diseases

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4
Q

What are the conditions screened for in the heel prick test?

A

Sickle cell disease (most common)
Cycstic fibrosis
Congenital hypothyroidism
6 Inherited metabolic conditions

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5
Q

What are the four screening components of NIPE?

A

Eyes
Heart
Hips
Testicles

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6
Q

What are some common causes of cataracts?

A

Congential infection such as rubella or toxoplasma

Earlier surgery is done the better

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7
Q

What sign will be seen on fundoscopy to show congenital cataracts?

A

Absent red reflex

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8
Q

What are the risk factors for congenital heart disease?

A

-A first degree relative with CHD
-Maternal conditions, e.g. T1DM, SLE
-Medication during pregnancy, e.g. Antipsychotics
-Conditions such as Down’s or
Marfan’s syndrome

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9
Q

How is the heart examined at the neonatal examination?

A

 Look at the baby’s colour
 Normal respiratory rate is 40-60 breaths per minute
 Look for use of the accessory muscles
 Check for brachio-femoral delay
 Feel the position of the apex and for thrills and
heaves
 Check capillary refill time
 Listen for murmurs in the aortic, pulmonary, tricuspid
and mitral areas, plus between the scapulae for coarctation
of the aorta

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10
Q

What are the risk factors for hip problems in childbirth?

A

First degree family history
Breech delivery <36 weeks
Multiple births

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11
Q

What are barlows and ortalanis tests?

A

Barlows test is done by adducting and lightly pressing the hi, positive if it causes a posterior dislocation.
Ortalanis test is to confirm this and to reposition it and is done by abducting the hip and pulling it out

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12
Q

What is the rooting reflex?

A

When cheek rubbed will turn head to suck the stimulus, is a food reflex

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13
Q

What is the rooting reflex?

A

When cheek rubbed will turn head to suck the stimulus, is a food reflex gone by about 3 months of age as they can control head and no longer need it

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14
Q

What is the grasping reflex?

A

Develops in hands around 4-7 months, plantar grasp is 9-12 months

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15
Q

What is the moro reflex?

A

Startle reflex, when you drop them then they move their arms out - lose it around 3-5 months

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16
Q

What is the standing and stepping reflex?

A

When placed in standing position they should bear some weight even at birth, do some stepping if they are tipped forward - lose by 2 months

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17
Q

What is Cryptorchidism and what increases the chance of having it? What action is taken?

A

Undecended testicles, risk increased with first degree relative, low birth weight or pre-term delivery
Refer if both undecended, if only one wait until 4-5 months and see if it decends

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18
Q

What are the four areas that development are split into?

A

Speech and language
Gross and fine motor
Visual
Social and emotional

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19
Q

What are the important 3 month milestones?

A

Motor - lifts head above midline when lying down, lifts and shakes toys
Hearing and speech - squeals, coos and turns to sound
Visual - watches faces and follows objects
Social - smiling usually begins around 6 weeks

20
Q

What are the 7 month milestones?

A

Motor - rolling back to front and front to back, sitting intially with support and then without, transfers objects from hand to hand, uses raking grasp
Hearing and speech - babbling, responds to name and no
Visual - can track objects, develops full colour vision
Social - enjoys social play - peek a boo

21
Q

What are the 12 month milestones?

A

Gross motor - sitting position without help, crawling, walking a few steps unaided
FIne motor - using pincer grip, can bang two objects together
Speech and language - says mama, dada, can follow simple commands
Social and emotional - has seperation anxiety, finds hidden objects

22
Q

What are the three things that are measured for growth in a baby?

A

Weight, head circumference and length

23
Q

When is a babys weight normally measured?

A

In the first week, at 6-8 week check, at 12 and 16 weeks and at 12 month immunisations

24
Q

When should the preterm growth chart be used and for how long?

A

Before 37 weeks the preterm chart should be used. You continue on this chart until 42 weeks then change to the normal chart at 2 weeks

25
Q

When should a child be assessed due to a change in weight?

A

If there is a sustained drop of 2 centiles

26
Q

What is the difference between gestational age and foetal age?

A

Gestational age is since the last period so is 2 weeks older than foetal age. Gestational age is always used.

27
Q

What is gestaional correction for premature babies and how is this done?

A

If a baby is premature then you plot on the premature growth chart for up to 42 weeks. Then you move to the normal chart and place the points at the babies actual age with arrows leading back as many weeks as the baby is premature. This means that the first arrow will be at 2 weeks.

28
Q

How does weight change after birth?

A

Some degree of weight loss is normal, should regain this by 2 weeks. if lose more than 10% or gain back slowly then need monitoring

29
Q

What are the main types of vaccine?

A

Live attenuated vaccine e.g. MMR
Inactivated vaccine e.g. hep B
Toxoid vaccines- specific toxin antigens e.g. tetanus

30
Q

What immunisations are given at two months?

A

6 in 1 - Diptheria, tetanus, pertusissis, polio, haemophilus influenzae B and hep B
Pneumococcal
rotavirus
meningococcal type B

31
Q

What is given in immunisations at 3 months?

A

6 in 1 - DTaP/IPV/Hib/Hep B

Rotavirus

32
Q

What immunisations are given at 4 months?

A

DTaP/IPV/Hib/Hep B (6 in 1)
Pneumococcal
Meningococcal group B

33
Q

12 months

A 
Haemophilus influenzae type B
meningitis C
MMR
Pneumococcal
meningitis group B
34
Q

What are the side effects of vaccinations?

A

Pain, swelling, and reddening at the site of injection are most common
and systemic effects, should they occur, are
usually limited to mild fever.

35
Q

What are the absolute contraindications to vaccination?

A

Anaphylactic shock

36
Q

How is rotavirus vaccine given?

A

Orally

37
Q

What are the risk factors for sudden infant death syndrome?

A 
 Prematurity
 Low birth weight
 Maternal smoking during pregnancy
 Parental smoking after birth
 Male gender
 Babies sleeping in a prone position (face
down)
 Co-sleeping (especially if the parent has
drunk alcohol or taken drugs)
38
Q

What are the two different classifications of breast milk?

A

Colostrum is produced in the first week of the babys life and is much higher in protein and much lower in fat than mature milk
Mature milk is produced after a week

39
Q

Which hormones prepare the breasts for lactation during pregnancy?

A

Oestrogen, progesterone and human placental lactogen

40
Q

How is lactation stimulated?

A

Sucking on the nipple causes release of prolactin to be released from the anterior pituitary gland

41
Q

Why is night feeding important for maintaining milk supply?

A

Prolactin levels are high at night

42
Q

How is milk ejection stimulated?

A

Release of oxytocin from the posterior pituitary causes the let down reflex

43
Q

What are the recommendations for how long to breast feed?

A

The recommendations are to breast feed exclusively up to 6 months then supplementally until 2 years

44
Q

What does human breast milk contain to protect a baby from infection?

A

It contains IgA which protect the gut from bacteria, lactoferrin (deprives baceria of iron), peroxidases and lysozymes (antibacterial action)

45
Q

What are some of the advantages of breastfeeding?

A 
Reduction in gastrointestinal infections
Reduction in respiratory infections
Reduction in otitis media
Reduction in necrotising enterocolitis
Reduction in allergic disease and coeliac
46
Q

What are the advantages of breast feeding for the mother?

A

Lower rates of pre menopausal breast and ovarian cancer
Helps contract the uterus and accelerate involution (shrinking)
Promotes weight loss
Economic advantage
Contraception

47
Q

What are some situations when breastfeeding may be difficult?

A

Cleft lip
Prematurity, neither mother nor baby ready
Maternal ill health
Disorder of metabolism in baby

G Child Health (4 decks)

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