Care of the Newborn Term Infant Flashcards
what period of gestation is considered “term”?
37-40
normal weight is between..
2.5-4kg
why are preterm babies skinny?
less time in 3rd trimester so less time to make fat
when considering delivery method in a baby what should be taken into account?
why did they do this?
was there a problem with mum, baby or both
fetal Hb gives off O2 easily in an acidotic/alkalotic environment
acidotic
how do babies preserve their brains from harm when in an acidotic environment
through production of ketones
what happens to the alveoli to enable newborn circulation?
alveolar expansion
pulmonary pressure increases/decreases after birth
decreases (pulm resistance is VERY high in utero)
name the 5 components of the apgar score; what is the max score that can be given for each?
HR RR responsiveness tone colour
a normal apgar score is >_
8
why should a baby be kept warm after birth?
increases chances of perinatal adaptation
prevents acidosis
prevents hypothermia and hypoglycaemia
what is haemorrhagic disease of the newborn?
internal bleeding disorder after birth; can present as GI, pulm, CNS bleed
what minimises the risk of haemorrhagic disease of the newborn
IM vitamin K in first few mins of birth
what should be given to babies with a hep B +ve mum?
hep B vaccine straight after birth (usually get it at 2 months with vaccination programme)
screening tests at birth?
newborn examination universal hearing screening hip screening - clinical and USS CF haemoglobinopathies metabolic diseases
name the metabolic diseases screened for at birth
PKU MCADD (acetylcoA dehydrogenase deficiency) maple syrup urine disease isovaleric acidaemia glutaric aciduria type 1 homocystinuria
when is newborn exam carried out?
24hrs after birth
what is examined in the head on newborn exam?
occipito-frontal circumference overlapping sutures forceps marks/ventouse moulding cephalhaematoma capu succedaneum
what is examined in the eyes in the newborn?
size red reflex conjunctival haemorrhage squints iris abnormality
what is examined in the ears in the newborn?
position external auditory canal tags/pits folding check FH
what is examined in the mouth in the newborn?
shape philtrum tongue tie palate neonatal teeth ebstein's pearls sucking/rooting reflex
what is examined in the face in the newborn?
facial palsy
dysmorphism
how is the resp system checked in the newborn?
chest shape nasal flaring grunting tachypnoea in-drawing breath sounds
how is the CVS examined in the newborn?
femoral pulses!! colour/saturation apex thrills/heaves heart sounds
how is the GI system examined in the newborn?
moves with resp distension hernia umbilicus bile stained vomiting passage of meconium- if delayed, bad! check anus
GU exam of newborn?
passing urine?
normal genitalia
undescended testes
hypospadius
MSK exam of newborn?
movement and posture
limbs and digits
spine
hip exam
neuro exam of the newborn?
AVPU cry tome posture movement primitive reflexes
name the primitive reflexes
sucking rooting moro ATNR stepping grasp
what is the ATNR reflex?
turning of the baby’s head causes the arm to extend out
