child health Flashcards
preterm
a birth that occurs before 37 completed weeks of gestation
term
a birth between 37 weeks and 42 weeks of gestation
post-term
a birth that occurs after 42 weeks of gestation
normal weight for a baby
2.5-4kg
what happens in the 3rd trimester
- Daily weight gain of 24g during 3rd trimester
- Approx. 7g of fat per day in last 4 weeks
- Transplacental transfer - iron, vitamins, calcium, phosphate and antibodies
what vitamin should be given at birth
Vitamin K given in the newborn period given to prevent haemorrhagic disease of the newborn - clotting (vitamin K dependent)
list some complications of a pre-term pregnancy
- hypothermia
- Neonatal sepsis
- Respiratory distress syndrome
- Retinopathy of prematurity - usually 6-8 weeks after delivery
a higher apgar score is worse for babys
false - high score is good
give respiratory complications of the newborn
Transient tachypnoea of the newborn (TTN) - fluid in the lungs does not clear away
Pneumothorax
Congenital respiratory disease
- Tracheo-oesophageal fistula
- Diaphragmatic hernia
give cardiac complications of the newborn
Hydrops foetalis - rhesus disease, chromosomal
persistent pulmonary hypertension of the newborn (PPHN)
Congenital heart disease
give initial management of a sick newborn
- Stabilise temperature - 36.5-37.4℃
- Airway and breathing - gentle support (e.g. open airway), consider oxygen as needed
- Circulation - fluids, inotropes
- Metabolic homeostasis - glucose management, correction of acid-base balance
- Antibiotics
give causative organisms of early onset sepsis of the newborn
gram negative group B streptococcus
give causative organisms of LATE onset sepsis of the newborn (after birth)
- Gram negatives
- Staph. aureus
- Coagulase negative staphylococci
management of neonatal sepsis
- Prevention - hand washing, vigilance, infection screening
- Antibiotics
- Supportive measures
which type of jaundice can be Both physiological and pathological
unconjucated
conjugated is always pathological
define prolonged jaundice
over 14 days in a term baby or 21 days in a preterm baby
give investigations for early jaundice
FBC/SBR/DCT, investigate underlying cause
give investigations for prolonged jaundice
FBC/LFTs/SBR/TFTs, further investigation if required
give management for early and prolonged jaundice
early
- Phototherapy
- Adequate hydration
- Resolve underlying cause
prolonged
- Resolve underlying cause
outline NRDS
Affects 75% of infants born before 29 weeks - born before the lungs start producing adequate surfactant
pathophysiology of NRDS
- Inadequate surfactant leads to high surface tension within alveoli
- This leads to atelectasis (lung collapse)
- This leads to inadequate gaseous exchange
clinical presentation of NRDS
- Respiratory distress - tachypoea, grunting, intercostal recessions, nasal flaring, cyanosis
- Worsens over minutes to hours til 2-4 days then gradual improvement
management for NRDS
- Maternal steroid
- Surfactant replacement
- Ventilation (non-invasive preferred over invasive)
define neonatal abstinence syndrome
Refers to the withdrawal symptoms that happens in neonates of mothers that used substances in pregnancy