Chapter 3 - Newborn Assessments Flashcards
Thalidomide
- sedative prescribed for morning sickness
- babies were born with deformities in limbs
- Refused in canada
- PROOF - not enough research, fetus brain is more sensitive
Nicotine
- constricts blood vessels - decreases flow of O2 and nutrients to fetus
- increased risks of miscarriages and fetus/baby impacts
- impaired cognitive skills
- adolescents impaired memory
- could be chronic
Fetal Alchohol Syndrome
- slow growth, heart problems, off facial features
- “fetal alchol effect” - impact without physical growth
- mainly north americans (indigenous too)
Diagnosis
- difficult - requires specialists and parents accuracy, expensive, no biomarkers
How much alcohol
- Data done through self reports - unknown data
Genetics - individual predispositions
Apgar scale
7-10 is normal, 4-6 abnormal, 0-3 low
Heart rate - absent (0) - slow less than 100BM (1) - fast 100-140BPM (2)
Respiratory effort - no breathing for more than 1 min (0) - irregular and slow (1) - good breathing with normal crying (2)
Muscle tone - limp and flaccid (0) - weak, inactive but some flexion of extremities (1) - strong, active motion (2)
Body colour - blue and pale (0) - body pink but extremities blue (1) - entire body pink (2)
Reflex irritability - no response (0) - grimace (1) - coughing, sneezing, and crying (2)
Apgar limitations
- expression of physiological condition at one point in time
- maternal sedation may impact newborn
- scoring is subjective
- partially depends on gestational age (when concieved)
- not perfect - meant to be quick
Reflexes
Rooting - any sensations around mouth begins to suck
Moro - sudden stimulus they throw arms up and palms upward (balance and audition working)
Grasping - hands grasp when touched
Babinski - moves up and spreading of toes when touched along foot
Stepping - legs move autamatically when feet feel solid surface
Imitation
- neonatal imitation - newborns can imitate adults
Are they actually imitating:
- failed to replicate studies
- likely a reflex - no social intention
- parent bonding
Crying and Strategies
- newborns cry 2-3 hrs a day
- BASIC CRY - softly then more intense (hunger, fatigue, disconfort)
- MAD CRY - more intense
- PAIN CRY - sudden, long shriek, long pause, grasp, crying
Strategies:
- 0-3 months - attend to baby, sooth, help
- 3+ check for signs of discomfort, let them cry to learn to self soothe
- DYNAMIC INTERACTION - balance learning to self-regulate emotions and care-givers comfort levels
Shaken baby syndrome
- abusive head trauma by rough shaking
- effort to stop crying baby
- damage done in 5 seconds
Preterm and LBW infants
- low birth weight < 2500 g
- Very-low birth weight < 1600g
- extremely low < 900 g
- Preterm newborns < 37 weeks gestation
- Small for gestational age newborns < 10th percentile **highest for risks
In Canada
- LBW increasing
- adolescents higher chance of LBW because body not mature
-poverty risk factor
Kangaroo Care
- method of care for preterm infants
- infant held skin-to-skin against mother’s breast, under clothes
- babies have regular heart rate, better sleep, more lactation
- reduced stress after massages/tactile sensation
Preterm babies and memory
- hippocampus development and memory is effected in preterm children
- hippocampul volume smaller in preterm compared to control
- VLBW young adults had worse memory and smaller hippocampus
- unkown correlation with preterm and LBW
