Chapter 10: The Newborn Infant Flashcards
You are a trainee intern in birthing suite and have just attended a male infant at birth that required resuscitation including intubation. You assign an Apgar score of 1 at one minute. At five minutes, he was gasping with slow irregular breathing - the endotracheal tube was still in situ. His heart rate was 120/min, and he was grimacing and had some flexion of extremities. He was centrally pink but had blue peripheries.
Which of the following options is the most likely 5 minute Apgar score?
Five or six
Seven or eight
Nine or ten
Three or four
One or two
5-6
HR = 2 ( >100bpm), Resp. =1 tone = 1 flexion ) 1 (Grimace) and Colour 1
You are a trainee intern in birthing suite and have just attended a male infant at birth. The baby needed intubation and oxygen. You are asked to determine the Apgar scores. At one minute, the heart rate was t80/minute and he was intubated as there was no attempt to breathe after suctioning. He was cyanosed, loose and floppy, and had no response to stimuli.
What was the Apgar score at one minute?
One or two
Hr present = 1 but not >100
You are a trainee intern in birthing suite and have just attended an infant at birth. At five minutes his heart rate is 130/minute; he is crying, he has good tone moving his arms and legs; he has pink gums, and his feet and hands are blue.
What is his Apgar score at five minutes?
Nine or ten
Three or four
One or two
Seven or eight
Five or six
9-10.
-1 coz peripheral blue
You are a trainee intern in birthing suite with a midwife attending a rapid, unexpected birth. The mother had a spontaneous labour at term, with a one hour first stage/ She ruptured her membranes with thick meconium in the liquor during the second stage. The mother is bleeding profusely and being managed by the midwife who has called for help. You are handed the baby which is floppy, unresponsive, pale and not breathing. You take the baby to the Resuscitaire.
Which of the following should be your FIRST action when resuscitating the baby?
Listen to the heart to determine the heart rate
Administer naloxone IM
Stimulate the baby by slapping it
Take cord blood for Hb
Dry the baby
Suction the nose, mouth and pharynx
Bag mask ventilation
Dry the baby
You are a trainee intern in a postnatal ward with Susan, a 24 year old para 1 NZ European woman who has just been advised that her baby has required admission to the neonatal intensive care because of suspected infection. The baby is 24 hours old. Susan had had a normal pregnancy, and ruptured her membranes at 40 weeks. She went into spontaneous labour 24 hours after rupturing her membranes. The infant has not fed well since delivery, and had become more sleepy with laboured breathing. Susan asks you what tests will be done?
Which of the following test is LEAST likely to be performed on the baby?
Blood cultures
Blood count
Axillary swabs
Chest X-ray
Bladder catheter
Bladder catheter
She had prolonged ruptured membranes - likely lung/blood/brain
You are a trainee intern in birthing suite with a midwife attending a rapid, unexpected birth. The mother had a spontaneous labour at term, with a one hour first stage/ She ruptured her membranes with thick meconium in the liquor during the second stage. The mother is bleeding profusely and being managed by the midwife who has called for help. You are handed the baby which is floppy, unresponsive, pale and not breathing.
You dry and wrap the baby in a towel, and take it to the Resuscitaire.
What of the following management principles will be the most important in your resuscitation?
Effective ventilation
Effective administration of medications and fluids
Effective stimulation
Effective cardiac compression
Effective nasopharyngeal suction
Maintenance of body temperature
Effective ventilation
You are a trainee intern called in to assist a midwife at the imminent delivery of a term baby. The midwife advises you that the mother has been in labour for four hours and when the membranes ruptured spontaneously an hour ago, the liquor was clear. You note that the continuous CTG in the last 20 minutes has been abnormal with complex variable decelerations. For the last five minutes there has been a fetal bradycardia with the fetal heart sitting at 60 beats per minute. When you arrive, the head is crowning. The baby is born with the next contraction, just as you finish checking the Resuscitaire. You are handed the baby who has a weak cry, is blue, floppy and making some movements. The midwife is looking after the mother who is bleeding. While awaiting further assistance, you are required to resuscitate the baby.
When commencing neonatal resuscitation, what is your FIRST action?
Intubate and ventilate
Suction of larynx and trachea
Dry the baby
Check the heart rate
Give oxygen by mask or Neopuff
Insert an oropharyngeal airway
Dry the baby
Stimulus for breathing and avoid heat loss
You are a trainee intern in an antenatal ward with Sarah, a 35 year old nulliparous Samoan woman admitted from antenatal clinic at 35/40 because of intrauterine growth restriction. An ultrasound shows an estimated fetal weight of 1700 gram (<5th centile), oligohydramnios and abnormal umbilical artery Dopplers. A CTG is normal. Delivery by caesarean section is planned for this afternoon.
Sarah is worried about her baby and asks what the neonatal complications of IUGR are.
Of the following options, which neonatal complication of IUGR is this infant at MOST risk of?
Hypoglycaemia
Feeding intolerance
Infection
Hypoxia
Hypothermia
Hypoglycaemia
