Care of Newborn Infant

Question 1

What are the parameters for normal birthweight?

Answer 1

2.5-4 kg

Question 2

When is a baby classed as large for gestational age?

Answer 2

> 4kg

Question 3

When is a baby classed as small for gestational age?

Answer 3

<2.5kg

Question 4

What are the main neonatal changes in the 3rd trimester?

Answer 4

Increased fat reserves
Transplacental transfer (vitamins, minerals, antibodies)

Question 5

State the two main types of labour

Answer 5

Spontaneous

Induced

Question 6

State the two most common presentations of the fetus during delivery

Answer 6

Cephalic (vertex)

Breech

Question 7

Describe the foetal environment during contractions of labour, and how the foetus helps to overcome this

Answer 7

Hypoxic environment

Foetal haemoglobin helps release oxygen

Question 8

Which hormones help perinatal adaptation?

Answer 8

Cortisol

Adrenaline

Question 9

List physiological changes that occurs within the foetus after delivery

Answer 9

Alveolar expansion
Foetal to newborn circulation
Increased PaO2
Reduced pulmonary arterial pressure

Question 10

Which score is used as an objective measure of perinatal adaptation?

Answer 10

Apgar score

Question 11

Well grown term infants have great calorific intake in first 24 hours after birth. True/False?

Answer 11

False

They have little calorific intake

Question 12

What is hemorrhagic disease of the newborn?

Answer 12

A deficiency of clotting factors leading to bleeding into the lungs, GIT and the brain

Question 13

Why is vitamin K supplementation important for newborns?

Answer 13

Prevent against hemorrhagic disease of the newborn

Question 14

What is the main risk factor for haemorrhagic disease of the newborn?

Answer 14

Children who are entirely breastfed

Question 15

List infections that can be passed from mother to foetus during delivery

Answer 15

Hepatitis B
Hepatitis C
HIV
Syphilis 
TB
Group B Strep

Question 16

Which vaccination is given at birth?

Answer 16

Hepatitis B

Question 17

Which vaccination is given within the first month?

Answer 17

BCG vaccine

Question 18

List screening tests performed on the fetus at birth

Answer 18

Newborn exam
Universal hearing screening
Hip screening (clinical, USS f risk factors)
Cystic fibrosis
Heamoglobinopathies 
Metabolic disease

Question 19

How are metabolic diseases screened for in pregnancy?

Answer 19

Guthrie card

Heel prick and blood released onto 5 spots

Question 20

A newborn examination should be performed within the first ___ hours after birth

Answer 20

24 hours

Question 21

List important features to examine on the neonatal head

Answer 21

Moulding
Overlapping sutures
Head circumference
Fontanelles (bulging/sunken)
Cephalohaematoma
Ventouse/forceps marks
Caput succedoneum

Question 22

List important features to examine on the neonatal eyes

Answer 22

Red reflex (cataracts)
Size and position
Conjunctival haemorrhage
Squinting
Iris abnormality

Question 23

List important features to examine on the neonatal ears

Answer 23

Position
External auditory meatus
Tags, pits
Folding

Question 24

List important features to examine on the neonatal mouth

Answer 24

Shape and palate
Philtrum
Tongue tie
Sucking/rooting reflexes

Question 25

List important features to examine on the neonatal face

Answer 25

Facial palsy | Dysmorphism

Question 26

List important features to examine of the neonatal respiratory system

Answer 26

``` Chest shape Nasal flaring Grunting Tachypnoea In-drawing Breath sounds ```

Question 27

List important features to examine of the neonatal cardiovascular system

Answer 27

``` Colour/SATs Femoral pulses Apex Thrills/ heaves Heart sounds ```

Question 28

List important features to examine on the neonatal abdomen

Answer 28

``` Movement with respiration DIstension Hernia Umbilicus Bile-stained vomiting Passage of meconium Anus ```

Question 29

List important features to examine on the neonatal genital system

Answer 29

Normal passage of urine Undescended testes Hypospadius Normal genitalia

Question 30

What is hypospadius?

Answer 30

A congenital condition in males in which the opening of the urethra is on the underside of the penis

Question 31

List important features to examine of the neonatal MSK system

Answer 31

``` Movement Posture Limbs and digits Spine Hip exam ```

Question 32

List important features to examine of the neonatal neurological system

Answer 32

``` Alert Responsiveness Cry Tone Posture Movement ```

Question 33

List primitive reflexes that should be exhibited by the normal infant

Answer 33

``` Sucking Rooting Moro ATNR Stepping Grasp ```

Question 34

What is the rooting reflex?

Answer 34

Turn face to stimulus touching baby's mouth

Question 35

What is the moro reflex?

Answer 35

Startle reflex, when baby loses support they naturally spread and flex their arms

Question 36

What is the ATNR?

Answer 36

Fencing reflex, characteristic position of the infant's arms and head, which resembles that of a classically trained fencer