Care of the Normal Newborn

Question 1

symmetric vs asymmetric SFA

Symmetric: heigh, weight and head circumferences are about equally affected. Concerning because might be a __ problem/__/__ problem.

Asymmetric: weight is most affected, with a relative sparing of growth of the brain, cranium and long bones. Usually a __ issue.

Answer 1

SGA: small for gestational age infants. Birthweight in <10th percentile

Symmetric: heigh, weight and head circumferences are about equally affected. Concerning because might be a systemic problem/malnutrition/ischemia problem.

Asymmetric: weight is most affected, with a relative sparing of growth of the brain, cranium and long bones. Usually a placental issue.

Question 2

what maternal conditions constitutes a High Risk Delivery?

Answer 2

Maternal conditions: AMA or very young maternal age, maternal diabetes or HTN, maternal substance use disorder,previous history of stillbirth, fetal loss or early neonatal death

Question 3

what fetal conditions constitutes a high risk delivery?

Answer 3

Fetal conditions: prematurity, post dates, congenital anomalies, IUGR, or multiple gestations

Question 4

what antepartum complications constitutes a high risk delivery?

Answer 4

Antepartum complications: placental anomalies (placenta previa, placental abruption, presence of oligohydramnios), or polyhydramnios

Question 5

what delivery complications constitutes a high risk delivery?

Answer 5

Delivery complication: transverse lie or breech presentation, chorioamnionitis, foul smelling/mec-stained AD, antenatal asphyxia, maternal administration of a narcotic within 4 hours of birth, instrumentative delivery, C section delivery.

Question 6

Factors to consider if resuscitaiton is needed

Answer 6

• was the baby born after a full term gestation?
• is the amniotic fluid clear of meconium and evidence of infection?
• is the baby breathing or crying?
• dose the baby have a good muscle tone?
• IF YES TO ALL –> Do not separate from mother
• if NO TO ANY –> resuscitation is needed

Question 7

outline three initial resuscitation steps

Answer 7

• warming
  dry: multiple blankets ready
• stimulation: if the baby requires suction or gently rub back

Question 8

thoeretical risks of delayed cord clamping (cord for 30 seconds)

Answer 8

Risks: theoretical concerns; hyperbilirubinemia, polycythemia, respiratory distress.

Question 9

treatment for hemorrahgiv disesase of the newborn:

Can cause death

Early or late (3-8 weeks of age)

Need ___ ___ injection and ___ eye drops

Answer 9

Need vitamin K injection and erythromycin eye drops

Question 10

Outline the criteria in APGAR scoring

Answer 10

color, heart rate, resp, reflex, muscle tone

Question 11

3 factors that can point to a higher risk for neonatal asphyxia

Answer 11

• APGAR Score <5 at 5 minutes and 10 minutes
• Fetal umbilical artery pH <7 or base deficit (BE) >12mmol/L OR both
• Brain injury seen on MRI consistent with acute hypoxia-ischemia
• If you see these scores, you do an MRI to look for ischemic events

Presence of multi-organ failure consistent with HIE

Question 12

Common signs of neonatal/birth asphyxia

Answer 12

cyanosis, bradycardia, poor muscle tone, meconium stained amniotic fluid, baby experiencing seizures.

These BABIES NEED RESUSCITATION

Question 13

Risk factors of sepsis

Answer 13

maternal fever, ROM over 18 hours, delivery <37 WGA, chorioamnionitis, maternal GBS colonization.

Question 14

brachial-femoral delay which may indicate __ ___.

Answer 14

brachial-femoral delay which may indicate aortic coarctation.

Question 15

4 risks of developmental dysplasia

Answer 15

first born, female, family history, breech presentation.

4 Risks

Question 16

babies with higher risk for hypothermia

Answer 16

preterm ,LBW, SGA, required resusc, acutely ill, decreased activity level

Question 17

discharge checklist for caregivers and for newborn

Answer 17