CNM Varney's Review Book Part F Flashcards
Newborn examination; Sick newborn; Primary care of newborn
What is the minimum age for which the New Ballard Scale is accurate?
20 weeks
What is the margin of error for the NBS?
2 weeks
How do you do the popliteal angle test for neuromuscular maturity?
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
what is an anthropomorphic measurement of the newborn?
birthweight
teh presence of how many minor malformations is suggestive of a major underlying malformation in the nenwborn?
3
what is the most commonly used criteria for the evaluation of the neurological status of the newborn?
Moro reflex
startle reflex. usually disappears by 3-4 months
persistence of the entire Moro reflex beyond what age following a term birth is considered abnormal?
4 months
What is the relationship of vernix to GA?
it decreases with GA
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
Mottling
When does the anterior fontanelle close?
approx 12-18 months
what are normal findings on examination of a newborn’s eyes?
red eye reflex
doll’s eye response
blink response
what is the normal range for head circumference for the average full-term newborn?
32-38 cm
a positive result on the Ortolani or Barlow maneuvers signals to what neonatal abnormality?
congenital hip dysplasia
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?
40 wks
What mechanism is responsible for transient tachypnea of the newborn?
inadequate absorption of liquid from the lungs after birth
what is the most common sign of neurological compromise in the newborn period?
seizure activity
a newborn is born with eviscerated abdominal organs that are covered by a membranous sac. What is this called?
omphalocele
gastroschisis
looks similar to omphalocele, but instead of sticking out abdominal wall, it sticks out belly button and is NOT covered by membrane
in addition to a STAT call to peds, what is the midwifery mgmt of a diaphragmatic hernia dx at birth?
immediate endotracheal intubation and artificial ventilation
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?
diaphragmatic hernia
Midwifery mgmt of esophageal atresia includes positioning of the newborn in which position?
prone
Newonatal absitnence syndrome is associated with which drug exposure of the fetus in utero?
heroin
neonatal abstinence syndrome
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
the infant of a diabetic mother is at increased risk for:
early jaundice
tremors
polycythemia
prognosis for newborn suffering for Erb-Duchenne paralysis
majority of these cases of paralysis disappear in 3-6 months
Breech delivery in which traction was applied to neck could result in …?
brachial plexus injury
What is the mgmt step to take when you suspect that a newborn has a congenital viral or bacterial infection?
order that the cord blood be saved for testing or culture
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?
coordinating/ensuring adequate respiratory support efforts
what is the most common type of sz activity in the newborn?
subtle
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?
IUGR (is what the book says, but I think it’s
postmaturity syndrome)
10 days old, lethargic, not feeding well. skin has slight grayish color, HR 178 bpm, respirations 70 bpm. What do you suspect?
congenital heart dz
Waht is the rate of complications from circumcision of the male newborn?
1%
Waht is the best method for cleaning the penis of the newborn while a circumcision is healing?
using lukewarm water only
At what age do formula-fed infants need to start receiving iron supplementation?
6 months
or is that for bf infants only?
what mineral other than iron needs to be supplemented in bf infant?
flouride
per 2002 varney’s
for a normal term newborn what is the caloric requirement for formula?
20 cal/oz
24 if preemie
approx how much breastmilk/formula shoud a term infant receive at each feeding during the first two weeks of life?
30-60 ml
Over the course of the first year of life, how big should baby be in relation to birthweight?
weight should quadruple in first year
What is a reason for physiologic rather than pathologic jaundice?
decreased life span of red blood cells
What vaccine for infants and children should not be given prior to 12 months of age?
MMR
in what waking behavioral state of the newborn as defined by brazelton does the newborn learn best?
alert
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?
monilial diaper rash
what is the best tx for monilial diaper rash?
topcal nystatin or miconozole
pityriasis rosea
common skin problem seen ages 10-35 yr
problem if pregnant woman gets it
starts with herald patch, rarely spreads to face
