Care of the Newborn Term Infant

Question 1

What is a normal birth weight?

Answer 1

2.5-4kg

Question 2

What does the apgar score measure?

Answer 2

HR; RR; responsiveness; tone; colour

Question 3

What is a normal apgar score?

Answer 3

> =8

Question 4

What is important immediately after birth for the establishment of breastfeeding?

Answer 4

skin-to-skin contact

Question 5

What is haemorrhagic disease of the newborn?

Answer 5

tendency to bleed esp. in CNS and GI due to vit K deficiency

Question 6

How is haemorrhagic disease of the newborn prevented?

Answer 6

all newborns are offered an IM vitamin K injection after birth

Question 7

What is the difference between IM and oral vit K?

Answer 7

oral is not as effective esp. if baby is breast fed

Question 8

How many wet nappies should a baby with adequate intake have per day?

Answer 8

4-6

Question 9

Why should babies at risk for breastfeeding jaundice be fed more frequently?

Answer 9

dehydration is less likely and excretion of bilirubin is more rapid due to increased stooling

Question 10

What screeening tests are carried out at birth?

Answer 10

neonatal exam; universal hearing screening; hip screening; CF: haemoglobinopathies; thyroid function; metabolic disease

Question 11

What is the most common acquired GI emergency in newborns?

Answer 11

necrotising enterocolitis

Question 12

What is seen on xray with necrotising enterocolitis?

Answer 12

dilated bowel loops; pneumatosis intestinalis; portal venous gas and feww intraperitoneal air

Question 13

Who gets necrotising enterocolitis?

Answer 13

preterm infants

Question 14

What causes necrotising entercolotiis?

Answer 14

immature and fragile bowel

Question 15

What is looked for on head part of hte neonatal exam?

Answer 15

OFC; overlapping sutures; fontanelles; ventouse/forceps marks; moulding; cephalhaematoma; caput sucedaneum

Question 16

What is cephalhaematoma?

Answer 16

sub-aponeurotic discrete swelling that cdoesn’t cross suture lines but can lead to extensive bleeding; anaemia and other problems

Question 17

What should be looked for in the eyes in a neonatal exam?

Answer 17

size; red reflex; conjunctival haemorrhage; squints; iris abnormality

Question 18

What would an absent red reflex in neonatal exam suggest?

Answer 18

congenital cataracts

Question 19

What should be looked at in neonatal exam of ears?

Answer 19

position; EAM; tags/pits; folding

Question 20

What can ear tags be associated with?

Answer 20

renal abnormalities

Question 21

What should be looked for in the mouth of the neonatal exam?

Answer 21

shape; philtrum; tongue tie; palate; neonatal teeth; epsteins pearls; sucking/rooting reflex

Question 22

What could a very smooth philtrum indicate in a newborn?

Answer 22

fetal alcohol syndrome

Question 23

Why do neonatal teeth tend to be removed?

Answer 23

cause problems with breastfeeding and aspiration risk

Question 24

What are Epstein’s pearls?

Answer 24

cysts found in the gums or roof of a neonates mouth

Question 25

What is looked for in the face of a neonate?

Answer 25

facial palsy; dysmorphism

Question 26

Why do infants grunt when in respiratory distress?

Answer 26

expiring thorugh closed/partially closed vocal cords to elevate pulmonary pressure and increase lung volume

Question 27

How long are neonates obligate nasal breathers?

Answer 27

thrid to sixth week of life

Question 28

What are signs of respiratory distress in the newborn?

Answer 28

nasal flaring; grunting; tachypnoea; in-drawing;

Question 29

What is examined during hte CVS part of the neonatal exam?

Answer 29

colour/sats; pulses-femoral; apex; thrills/heaves; HS

Question 30

What is looked for in the abdo part of the neonatal exam?

Answer 30

moves with respiration; distension; hernia; bile-stained vomiting; passage of meconium; anus

Question 31

What is looked for the in GU part of hte neonatal exam?

Answer 31

normal passage of urine; genitalia; undescended tests; hypospadius

Question 32

What is examined during the MSK part of the neonatal exam?

Answer 32

movemetn and posture; limbs and digits; spine; hip exam

Question 33

What is looked for in the neuro part of hte neonatal exam?

Answer 33

alert, responsive?; cry; tone; posture; movement; primitive reflexes

Question 34

What is ATNR?

Answer 34

asymmetric tonic neck reflex- activated by turning head, ipsilaterally limbs extend whilst contralterally will bend

Question 35

Waht is the first reflex to develop in utero and to be integrated?

Answer 35

moro reflex

Question 36

What is the function of the Moro reflex?

Answer 36

fight or flight response

Question 37

What happens when the moro reflex is activated?

Answer 37

extension and abduction of the arms; and open hands; abduct legs and sharp inspiration then limbs are drawn back into the body