Care of the Newborn Flashcards
when is a baby term?
>37 weeks
when is a baby post term?
>41 wks
what size, in kg is SGA and LGA?
SGA <2.5kg LGA >4kg
what does APGAR stand for? what is normal?
Appearance
Pulse
Grimace (reflexes)
Activity
Respiratory Effort
≥8 normal
what screening is offered?
hearing
congenital dysplasia of the hip
CF
haemoglobinopathies
metabolic diseases
normal temp range for newborns?
36.5-37.2
signs of hypoglycaemia?
sleepy
poor tone
poor feeding
convulsions
cyanosis
when is jaundice pathological?
if presenting within first 24hrs of life
in babies, what type of jaundice is occuring?
prehepatic
how is bilirubin produced and cleared usually?
haemoglobin is produced when RBC lyse
converted to bilirubin
bilirubin attaches to albumin
conjugated in liver
signs of respiratory distress
nasal flare
head bop
abdominal breathing
sternal recession
intercostal recession
when does jaundice become prolonged?
term - 14 days
pre term - 21 days
what are features of biliary atresia? what is the Tx?
pale stools
dark urine
sick baby
Tx -> surgery
what is ductus arteriosis a connection between?
pulmonary artery and aorta
symptoms of PDA?
fatigue
sweating
high RR
disinterest in feeding
poor weight gain
what is a complication of jaundice? why?
kernicterus
high levels of bilirubin cross BBB and damage CNS
physiology of breast feeding?
suckling causes rise in PRL
breasts increase milk production
oxytocin acts on SM in breast to ejaculate milk
health benefits of breast feeding for baby?
decreased D and V
decreased ear infections
decreased chance of constipation
decreased risk of obesity
decreased risk of eczema
health benefits of breast feeding for mum?
decreased risk of breast and ovarian cancer
saves money
helps bonding
what is necrotising enterocolitis?
widespread necrosis in small and large intestine
features of necrotising enterocolitis?
premature
lethargic
bloody stool
temperature
decreased HR
SOB
what is the cause of a ICH in premature infants?
bleeding into germinal matrix
Ix and Tx for ICH in premature infants?
Ix - US
Tx - steroids
features of VSD?
harsh pan systolic murmur
what happens in pulmonary atresia?
blockage between RV and PA
in transposition of the great arteries, describe the anatomical change?
aorta exits RV, pulmonary artery exits LV
what happens in persistent pulmonary hypertension?
patent foramen ovale and ductus arteriosus
features of coarctation of the aorta?
radiofemoral delay
4 features of the tetralogy of fallot?
VSD
pulmonary stenosis
hypertrophy of RV
over riding aorta
when does surfactant production start and stop?
3rd trimester labour
(28-birth)
what causes foramen ovale to close
baby cries
pulmonary resistance decreases
systemic resistance increases
prostaglandins decrease
foramen ovale closes
when is anaemia ‘normal’? why?
8-10 wks adult made slower than fetal Hb
what does foramen ovale connect?
RA to LA
what does ductus arteriousis connect? what does it turn into?
pulmonary bifurcation to descending aorta
ligamentum arteriosus
what does ductus venosus connect? what does it turn into?
umbilical vein to inferior vena cava
ligamentum teres
