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CNM > CNM Varney's Review Book Part F > Flashcards

CNM Varney's Review Book Part F Flashcards

Newborn examination; Sick newborn; Primary care of newborn

1
Q

What is the minimum age for which the New Ballard Scale is accurate?

A

20 weeks

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2
Q

What is the margin of error for the NBS?

A

2 weeks

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3
Q

How do you do the popliteal angle test for neuromuscular maturity?

A

with infant supine and pelvis flat on examining suface, leg is flexed on thigh at knee and thigh is fully flexed using one hand; the leg is then extended at the knee while keeping the thigh flexed

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4
Q

what is an anthropomorphic measurement of the newborn?

A

birthweight

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5
Q

teh presence of how many minor malformations is suggestive of a major underlying malformation in the nenwborn?

A

3

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6
Q

what is the most commonly used criteria for the evaluation of the neurological status of the newborn?

A

Moro reflex

startle reflex. usually disappears by 3-4 months

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7
Q

persistence of the entire Moro reflex beyond what age following a term birth is considered abnormal?

A

4 months

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8
Q

What is the relationship of vernix to GA?

A

it decreases with GA

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9
Q 
which of the following findings upon inspection of the skin of the newborn is not an indicator of prematurity?
Absence of vernix
Abundance of lanugo
Visible veins across abdomen
Mottling
A

Mottling

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10
Q

When does the anterior fontanelle close?

A

approx 12-18 months

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11
Q

what are normal findings on examination of a newborn’s eyes?

A

red eye reflex
doll’s eye response
blink response

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12
Q

what is the normal range for head circumference for the average full-term newborn?

A

32-38 cm

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13
Q

a positive result on the Ortolani or Barlow maneuvers signals to what neonatal abnormality?

A

congenital hip dysplasia

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14
Q

Upon examining a newborn shortly after birth:
Arms fully flexed at elbows while legs are extended
You can flex wrist completely against forearm without effort
There is almost no lanugo present, the body is mostly bald
Creases are present over 2/3 of the anterior portion of the sole of the foot
There is some cracking of the skin and a few veins are visible
The ear pinna are well formed and firm, ther is instant recoil
What GA does this indicate?

A

40 wks

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15
Q

What mechanism is responsible for transient tachypnea of the newborn?

A

inadequate absorption of liquid from the lungs after birth

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16
Q

what is the most common sign of neurological compromise in the newborn period?

A

seizure activity

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17
Q

a newborn is born with eviscerated abdominal organs that are covered by a membranous sac. What is this called?

A

omphalocele

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18
Q

gastroschisis

A

looks similar to omphalocele, but instead of sticking out abdominal wall, it sticks out belly button and is NOT covered by membrane

19
Q

in addition to a STAT call to peds, what is the midwifery mgmt of a diaphragmatic hernia dx at birth?

A

immediate endotracheal intubation and artificial ventilation

20
Q

Newborn develops severe resp distress immediately after birth with decreased breath sounds in L lung field, heart sounds predominantly on the righ side of chest, and concave abdominal contour. What is suspected dx?

A

diaphragmatic hernia

21
Q

Midwifery mgmt of esophageal atresia includes positioning of the newborn in which position?

A

prone

22
Q

Newonatal absitnence syndrome is associated with which drug exposure of the fetus in utero?

A

heroin

23
Q

neonatal abstinence syndrome

A

symptoms depend on drug involved. Can begin 1-3 days after birth, or may take 5-10 days to appear. May include:
blotchy skin diarrhea
excessive crying or high-pitched crying
excessive sucking fever
hyperactive reflexes increased muscle tone
irritability poor feeding
rapid breathing seizures
sleep problems slow weight gain
stuffy nose, sneezing sweating
trembling vomiting

24
Q

the infant of a diabetic mother is at increased risk for:

A

early jaundice
tremors
polycythemia

25
Q

prognosis for newborn suffering for Erb-Duchenne paralysis

A

majority of these cases of paralysis disappear in 3-6 months

26
Q

Breech delivery in which traction was applied to neck could result in …?

A

brachial plexus injury

27
Q

What is the mgmt step to take when you suspect that a newborn has a congenital viral or bacterial infection?

A

order that the cord blood be saved for testing or culture

28
Q

What should be the top priority in the midwife’s mgmt plan for the care of a newborn who appears to have an early-onset bacterial infection?

A

coordinating/ensuring adequate respiratory support efforts

29
Q

what is the most common type of sz activity in the newborn?

A

subtle

30
Q 
A newborn under your care:
weight: 5 lb 12 oz
head circ: 28 cm
loose skin around shoulders and back
dry, peeling skin that is meconium stained
prominent eyes
what is your suspicion?
A

IUGR (is what the book says, but I think it’s

postmaturity syndrome)

31
Q

10 days old, lethargic, not feeding well. skin has slight grayish color, HR 178 bpm, respirations 70 bpm. What do you suspect?

A

congenital heart dz

32
Q

Waht is the rate of complications from circumcision of the male newborn?

A

1%

33
Q

Waht is the best method for cleaning the penis of the newborn while a circumcision is healing?

A

using lukewarm water only

34
Q

At what age do formula-fed infants need to start receiving iron supplementation?

A

6 months

or is that for bf infants only?

35
Q

what mineral other than iron needs to be supplemented in bf infant?

A

flouride

per 2002 varney’s

36
Q

for a normal term newborn what is the caloric requirement for formula?

A

20 cal/oz

24 if preemie

37
Q

approx how much breastmilk/formula shoud a term infant receive at each feeding during the first two weeks of life?

A

30-60 ml

38
Q

Over the course of the first year of life, how big should baby be in relation to birthweight?

A

weight should quadruple in first year

39
Q

What is a reason for physiologic rather than pathologic jaundice?

A

decreased life span of red blood cells

40
Q

What vaccine for infants and children should not be given prior to 12 months of age?

A

MMR

41
Q

in what waking behavioral state of the newborn as defined by brazelton does the newborn learn best?

A

alert

42
Q

6 wk infant. rash in diaper area with erythematous confluent lesions, marked skin-fold involvement, and satellite lesions on abdomen, thighs, and lower back. Infant appears to be in pain as a result. What condition do you suspect?

A

monilial diaper rash

43
Q

what is the best tx for monilial diaper rash?

A

topcal nystatin or miconozole

44
Q

pityriasis rosea

A

common skin problem seen ages 10-35 yr
problem if pregnant woman gets it
starts with herald patch, rarely spreads to face

CNM (15 decks)

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