Evaluation Of The Neonate And Infant Flashcards by Lauren F

What gets a score of 2 for Respiration

Vigorous cry

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What are primitive reflexes?

Reflexes that disappear by certain ages

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What are abnormal findings with baby’s respiration/breathing patterns?

Nasal flaring
Grunting
Retractions
Audible wheezing/stridor

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Do babies breathe through nose or mouth

Obligate nose breathers

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Is erythema toxicum bad?

No, no one knows what causes it and it goes away within 1 week

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What is meconium staining?

Meconium causes a greenish color on skin, umbilical cord, mucosa, amniotic fluid, placenta

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What does jaundice in first 24 hours suggest?

Hemolytic disease

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What is the most common life shortening autosomal recessive disease in Caucasian’s?

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What is the heel stick for?

Checking for metabolic and genetic disorders based on state requirements

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At the one minute APGAR check: arms and legs were flexed, HR was 110, some flexion of extremities to reflex irritability, body is pink, and there is a slow, irregular cry. What is the APGAR score?

1, 2, 2, 1, 1

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How many arteries and veins are in umbilical cord

2 arteries 1 vein

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What gets a score of 1 for Appearance

Body pink, extremities blue

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What are the total bilirubin levels in physiologic jaundice?

Over 20mg/dL

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Acoustic blink reflex (snapping in ear) tests which cranial nerve

CN VIII

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Five minute APGAR score 6 or less indicates?

High risk for CNS/organ dysfunction. Intervention required

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When is the heel stick done to check for disorders

1st at 24-48hrs

2nd at first doctors visit/5-10 days

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5 components of APGAR score

Activity
Pulse
Grimace
Appearance
Respiration

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How can we know the anus is is patent and working

The baby passes meconium (usually by 48 hrs)

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Preemie age

Birth prior to 37 wks

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Is nystagmus immediately after birth normal?

Yes it’s common

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What could cause a cephalohematoma (bleeding between periosteum and skull)?

Trauma from birth. Forceps/vacuum use

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How often should breastfed babies be fed?

Every 2-3 hours for 10-15min per breast

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What might central cyanosis indicate?

Cyanotic congenital heart disease

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How do you tell the difference between acrocyanosis and central cyanosis?

Mucous membranes will be pink with acrocyanosis, and blue in central cyanosis

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What gestational age is considered full term

37-42 weeks

When does Moro reflex go away

5-6 months

Top 4 diagnoses to come out of newborn screening?

Hearing loss Congenital hypothyroidism Cystic fibrosis Sickle Cell

What is rooting reflex

Stroke skin at corner of mouth and baby turns head to suck

APGAR score range

0-10

What might a large posterior fontanelle indicate

Congenital hypothyroidism

How should babies be lying down for sleep

On their backs “back to bed”

What is meconium ileus?

Meconium is thick and hard to pass which causes an obstruction

What is plantar grasp

Touch base of toes and toes curl

What are fontanelles?

The intersections of major sutures “soft spots”

How big is the anterior fontanelle at birth?

4-6cm

When is jaundice considered pathological?

When it starts in first 24 hours or after 2 weeks

What is the most important diagnostic test for CF?

Sweat chloride testing

What does it mean if nystagmus persists for awhile?

May indicate poor vision or CNS disease

Galeazzi, Ortolani, and Barlow tests all screen for what?

Hip dysplasia

What does miliaria rubra look like

Red bumps/vesicles

What is the asymmetric tonic neck reflex

Turn head to Left and the Left arm/leg extend and Right arm/leg flex (and vice versa)

When does palmar grasp go away

4-6 months

What is leukocoria

White pupillary reflex

Pulse below 100bpm gives what score for Pulse?

What is physiologic jaundice?

Jaundice noticed AFTER 24 hours

What does prophylactic erythromycin ointment prevent? (Eye goop)

Gonococcal opthalmia (STD)

What are we looking for in the baby’s opthalmoscopic exam

Bilateral Red light reflex

Rooting/sucking reflex tests which cranial nerve

CN V

What is positive support reflex

Hold baby till his feet touch a flat surface and he’ll kind of stand up

What is the Barlow test

Holding one leg and ADDUCT the other one feeling for clunk/movement of hip joint dislocation

What gestational age is considered late-preterm?

34-36 weeks

What is the term for undescended testicles

Cryptorchidism

What can cause cloudiness of cornea

Cataracts

What causes miliaria rubra

Obstructed sweat glands

What is omphalitis?

Infection of the umbilical stump

what gets a score of 0 for appearance

Baby is blue and pale

What is “heat rash”

Miliaria rubra

What does ABO or Rh incompatibility have to do with jaundice?

No idea but it does

What is it called when bilirubin accumulates in the brain

Kernicterus

Infant age

29 days to 12 months

What is erythema toxicum

Red patches with central vesicles that appear on day 2-3 of life

What gestational age is considered preterm?

<34 weeks

What is torticollis?

Injury to sternocleidomastoid

What supplement do breastfed babies require?

Vitamin D 400 IU/day

What does the Nerborns and Mother’s Health Protection Act say?

Insurance is required to cover up to 48 hours for vaginal deliveries and 4 days for c-sections

What might a bulging fontanelle indicate?

Hydrocephalus/infection causing increased ICP

What is acrocyanosis

Blue extremities with pink mucous membranes that commonly appears shortly after birth and goes away in 1-2 days

What gets a score of 2 for Grimace

Active motions-sneeze, cough, pull away | to reflex irritability

When does the posterior fontanelle close

2 months

What is Ortolani test

Holding leg and ABDUCTING hip feeling for clunk of femoral head entering acetabulum

Is paradoxical breathing normal for a baby

Yes they are “belly breathers”

Abnormalities of any primitive reflexes suggests what

Neurological disease

What is galeazzi test

Place feet together and note any difference in knee heights

One minute APGAR score less than 4 requires?

Immediate resuscitation

What is positional plagiocephaly

Flat spot from laying on back of head

When does positivesupport refelx go away

6 months

What are milia?

Developing sebaceous glands on nose, chin, forehead. Look like whiteheads

What could cause leukocoria?

Retinoblastoma

How does breastfeeding protect baby from infections?

IgA antibodies

What is a normal Heart rate for infant?

120-160bpm

How big is the posterior fontanelle at birth/

1-2cm

What is Moro reflex

Pretend to drop baby and look for baby to startle and extend limbs

How often is baby assessed during transitional period

Every 30 min

When does the anterior fontanelle close for 90% of infants

7-19 months

When are APGAR scores taken

1 and 5 minutes

What is the problem with congenital hairy nevus

Significant malignant potential

What gestational age is considered post term?

>42 weeks

What does the Ballard Scoring System estimate?

Gestational age to within 2 weeks

What is a normal respiratory rate for infant?

30-60 breaths/min

How do we test for Critical Congenital Heart Disease?

Pulse oximetry

When does the asymmetric Tone reflex go away

2-3 months

What is the palmar grasp

Press finger on baby’s palm and he will grasp your finger

Five minute APGAR score of 7 or higher indicates?

Normal, proceed to more thorough examination

What could torticollis cause?

Plagiocephaly(flat spot on head)

Does crypotorchidism ever solve itself

Yes in 2/3 cases both testes descend by 1 year

80-90% of newborns with meconium ileum have___?

Cystic fibrosis

When does rooting reflex go away

3-4 months

Why is it important to do a hearing screen before baby is discharged>?

Early intervention improves speech development

What is the recommended source of nutrition for infants up to 6 months old

Breastfeeding

What are Epstein pearls

small white benign cysts on roof of mouth (at junction of hard and soft palate)

Is central cyanosis a big deal?

Yes its an emergency

Is acrocyanosis a big deal?

What is choanal atresia

One side of nose is blocked

What might a depressed anterior fontanelle indicate?

Dehydration

What is the transitional period

First 4-6 hours outside the womb

What is spina bifida occulta?

Abnormalities within 1cm of midline in baby’s buttcrack? Might allow stool to come in contact with spinal canal

Neonate age

Birth to 28 days

When does plantar grasp go away

6-8 months

What is a normal APGAR score?

7-10

What is hypospadias?

Urethra located in wrong location on penis

Arms and legs flexed gives what score for Activity

What are important skin colors to note on infant?

Jaundice, cyanosis, and meconium staining

Do we need to treat a cephalohematoma

No, resolves spontaneously within 3 weeks