Care of the Newborn

Question 1

what weeks determine preterm, term and psot term ?

Answer 1

preterm <37 weeks

term >37 weeks

psot term >41 week

Question 2

what is teh normal weight for a newborn?

Answer 2

2.5-4kg

Question 3

which trimester is important in terms of growth of baby and building up fat reserves?

Answer 3

3rd trimester

Question 4

what is the daily weight gain of baby during the 3rd trimester

Answer 4

24g per day

Question 5

why does every baby in UK recieve IM injection of Vit K within first few mins of life?

Answer 5

prevent haemorrhagic disease

Question 6

when will a baby usually recieve the Hep B vaccination?

Answer 6

2 months

if mmum known to be Hep B +ve can be given earlier than this

Question 7

what is involved in screenign of the newborn?

Answer 7

top to toe examination

eyes/hearing

hip screening

guthrie card

Question 8

who carries out top to toe exam of the newborn?

Answer 8

immediately carried out by midwife followed by formal neonatal exam around 24hrs by different staff groups, doctors, midwifes, ANP

Question 9

why is hip screenign performed?

Answer 9

screening for DDH

barlow and ortolani

Question 10

how is DDH treated?

Answer 10

pavlok harness

Question 11

when is the guthrie card carried out?

Answer 11

day 5

Question 12

what is the guthrie card screenign for?

Answer 12

Hypothyroidism

CF

Haemoglobinopathies i.e. sickle cell

metabolic disease

PKU

Question 13

what is APGAR?

Answer 13

Appearance

Pulse

Grimace (reflex)

Activity (muscle tone)

Respiration

Question 14

what is the difference between caput and cephalhaematoma?

Answer 14

caput- generalised swelling

cephalhaematoma- underneath aponeurosis

Question 15

what are the health risks with cephalhaematoma?

Answer 15

anameia

jaundice

(actually alot of blood in it)

Question 16

what are you checking when examinign eyes in newborn?

Answer 16

red reflex

iris

Question 17

if the red reflex is not present this indicates what?

Answer 17

problem w retina → could be retinoblastoma

Question 18

an iris abnormality could be a sign of what?

Answer 18

underlying syndrome

Question 19

femoral pulse is routinely checked in examination of newborn. Absence can indicate what?

Answer 19

left outflow issue

Question 20

forceps delivery can damage which nerve?

Answer 20

facial nerve resulting in palsy

Question 21

what are signs of respiratory distress in a newborn?

Answer 21

nasal flaring

grunting

tachypnoea

in-drawing (using intercostal muscles)

Question 22

there is evidence that even after inital insult to brain cooling baby to what temperature will prevent secondary insult and ongoing neurological deficit?

Answer 22

33^oC

Question 23

hypoxia during birth can result in what condition?

Answer 23

hypoxic ischaemic encephalopathy

Question 24

what will a newborn look like if hypoxic ischaemic encephalopathy?

Answer 24

non-responsive baby

floppy

Question 25

how can hypoxic ischaemic encephalopathy be treated?

Answer 25

cool baby for 3 days before gradually warming up while supporting breathing

will need neurodevelopmental follow up as serious insult can lead to developmental disorder

Question 26

what is TTN?

Answer 26

Transient Tachypnoea of the Newborn

Question 27

what causes TTN?

Answer 27

retained fluid in the lungs

usually resolves within 24-72hrs (support until then)

Question 28

which malformity can occur allowing air into tummy and the baby to ‘bubble’ due to build up of secretions?

Answer 28

Tracheo-oesophageal fistula

opening between trachea and oesophagus allows air into tummy

Question 29

how is diaphragmatic hernia managed?

Answer 29

surgery to remove intestines/stomach from chest cavity and back into abdomen then repair hole in diaphragm

Question 30

what are the 4 defects in tetralogy of fallot?

Answer 30

pulmonary stenosis

right ventricular hypertrophy

overriding aorta

ventricular septal defect

Question 31

what is potters syndrome?

Answer 31

kidneys don’t develop so can’t produce amniotic fluid- results in oligohydramnios

Question 32

do babys usually sruvive potters syndrome?

Answer 32

lungs can’t develop and baby can’t move about so born with contractures and will be very sick- many die if not stillborn

Question 33

how does daibetes/gestational diabetes in mum affect baby once they are born?

Answer 33

stop receiving high glucose from mum but still have high insulin levels so blood glucose drops dramatically when born

Question 34

how do we manage preterm birth?

Answer 34

keep baby warm- heater, plastic bags

parenteral nutrition, seperate syringe for fat

Question 35

what is one of the biggest causes of death in preterm infants?

Answer 35

infection from lines

Question 36

what is the cause of early and late onset neonatal sepsis?

Answer 36

early onset- bacteria acquired before or during delivery

late onset- after delivery

Question 37

what bacteria are responsible for early onsest sepsis?

Answer 37

group B strep

Gram -ve

Question 38

what bacteria are responsible for late onset sepsis?

Answer 38

coag -ve staph

gram -ve

S. aureus

Question 39

late onset spesis: baby that gets ‘grumbly’ unwell over 24-48hrs is likely to be caused by which bacteria?

Answer 39

coag -ve staph

treat w vancomycin

Question 40

late onset spesis: if baby becomes acutely unwell likely to be caused by which bacteria?

Answer 40

gram -ve

i.e. E.coli

Question 41

when treating neonatal sepsis are older or newer antibiotics used?

Answer 41

olderp gentamicin, flucloxacillin

try to stay away from newer broad spectrum anitbiotics