Care of Newborn Infant Flashcards
What are the parameters for normal birthweight?
2.5-4 kg
When is a baby classed as large for gestational age?
> 4kg
When is a baby classed as small for gestational age?
<2.5kg
What are the main neonatal changes in the 3rd trimester?
Increased fat reserves Transplacental transfer (vitamins, minerals, antibodies)
State the two main types of labour
Spontaneous
Induced
State the two most common presentations of the fetus during delivery
Cephalic (vertex)
Breech
Describe the foetal environment during contractions of labour, and how the foetus helps to overcome this
Hypoxic environment
Foetal haemoglobin helps release oxygen
Which hormones help perinatal adaptation?
Cortisol
Adrenaline
List physiological changes that occurs within the foetus after delivery
Alveolar expansion
Foetal to newborn circulation
Increased PaO2
Reduced pulmonary arterial pressure
Which score is used as an objective measure of perinatal adaptation?
Apgar score
Well grown term infants have great calorific intake in first 24 hours after birth. True/False?
False
They have little calorific intake
What is hemorrhagic disease of the newborn?
A deficiency of clotting factors leading to bleeding into the lungs, GIT and the brain
Why is vitamin K supplementation important for newborns?
Prevent against hemorrhagic disease of the newborn
What is the main risk factor for haemorrhagic disease of the newborn?
Children who are entirely breastfed
List infections that can be passed from mother to foetus during delivery
Hepatitis B Hepatitis C HIV Syphilis TB Group B Strep
Which vaccination is given at birth?
Hepatitis B
Which vaccination is given within the first month?
BCG vaccine
List screening tests performed on the fetus at birth
Newborn exam Universal hearing screening Hip screening (clinical, USS f risk factors) Cystic fibrosis Heamoglobinopathies Metabolic disease
How are metabolic diseases screened for in pregnancy?
Guthrie card
Heel prick and blood released onto 5 spots
A newborn examination should be performed within the first ___ hours after birth
24 hours
List important features to examine on the neonatal head
Moulding Overlapping sutures Head circumference Fontanelles (bulging/sunken) Cephalohaematoma Ventouse/forceps marks Caput succedoneum
List important features to examine on the neonatal eyes
Red reflex (cataracts) Size and position Conjunctival haemorrhage Squinting Iris abnormality
List important features to examine on the neonatal ears
Position
External auditory meatus
Tags, pits
Folding
List important features to examine on the neonatal mouth
Shape and palate
Philtrum
Tongue tie
Sucking/rooting reflexes
List important features to examine on the neonatal face
Facial palsy
Dysmorphism
List important features to examine of the neonatal respiratory system
Chest shape Nasal flaring Grunting Tachypnoea In-drawing Breath sounds
List important features to examine of the neonatal cardiovascular system
Colour/SATs Femoral pulses Apex Thrills/ heaves Heart sounds
List important features to examine on the neonatal abdomen
Movement with respiration DIstension Hernia Umbilicus Bile-stained vomiting Passage of meconium Anus
List important features to examine on the neonatal genital system
Normal passage of urine
Undescended testes
Hypospadius
Normal genitalia
What is hypospadius?
A congenital condition in males in which the opening of the urethra is on the underside of the penis
List important features to examine of the neonatal MSK system
Movement Posture Limbs and digits Spine Hip exam
List important features to examine of the neonatal neurological system
Alert Responsiveness Cry Tone Posture Movement
List primitive reflexes that should be exhibited by the normal infant
Sucking Rooting Moro ATNR Stepping Grasp
What is the rooting reflex?
Turn face to stimulus touching baby’s mouth
What is the moro reflex?
Startle reflex, when baby loses support they naturally spread and flex their arms
What is the ATNR?
Fencing reflex, characteristic position of the infant’s arms and head, which resembles that of a classically trained fencer