Healthy, Sick and Preterm Infant Flashcards
What is the normal weight for a term infant?
2.5-4kg
What is assessed in the Apgar score?
Heart rate Respiratory rate Responsiveness Tone Colour
What is considered a normal Apgar score?
8 or above
What occurs in haemorrhagic disease of the newborn?
The infant is vitamin K deficient leading to haemorrhage
What screening tests are carried out on a newborn?
Hearing screening Hip screening CF Haemoglobinopathies Metabolic disease (PKU etc.)
In a newborn examination, what is being looked at in the head?
Circumference Overlapping sutures Fontanelles Forceps marks Moulding
In a newborn examination, what is being looked at in the eyes?
Size
Red reflex
Haemorrhage
Squints
In a newborn examination, what is being looked at in the ears?
Position
External auditory canal
Tags/pits
Folding
In a newborn examination, what is being looked at in the mouth?
Shape Philtrum Tongue tie Palate Teeth Sucking/rooting reflex
In a newborn examination, what aspects of the respiratory system are being looked at?
Chest shape
Nasal flaring
Grunting
Tachypnoea
In a newborn examination, what aspects of the cardiovascular system are being looked at?
O2 sats Femoral pulse Apex beat Thrills/heaves Heart sounds
In a newborn examination, what aspects of the abdominal system are being looked at?
Distention Herniation Umbilicus Bile-stained vomiting Passage of meconium Anus
In a newborn examination, what aspects of the genitourinary system are being looked at?
Normal urine passage
Normal genitalia
Undescended testes
Hypospadias
In a newborn examination, what aspects of the musculoskeletal system are being looked at?
Movement and posture
Limbs and digits
Spine
Hip examination
In a newborn examination, what aspects of the neurological system are being looked at?
Alertness Crying Tone Posture Movement Primitive reflexes
Give some primitive reflexes that may be elicited in a newborn
Suckling/Rooting Moro ATNR Stepping Grasp
What is the normal respiratory and heart rate of a newborn?
RR = 40-60 HR = 120-140
Give some common sites of infection in a newborn
Bloodstream (sepsis)
CNS (meningitis)
Respiratory (pneumonia)
GU (UTI)
Which bacteria commonly infect newborns?
Group B strep E. coli Listeria Staph aureus Staph epidermidis
Which viruses commonly infect newborns?
CMV
Parvovirus
Herpes viruses
Enteroviruses
What occurs in hypoxic ischaemic encephalopathy?
Multi-organ damage due to tissue hypoxia
What pregnancy/birth related respiratory problems can occur in newborns?
Transient tachypnoea of the newborn
Pneumothorax
What pregnancy/birth-related cardiac problems can occur in newborns?
Heart failure
PPHN
Give examples of congenital heart disease
Tetralogy of Fallot
Transposition of great arteries
Aortic coarctation
TAPVD
Give examples of congenital respiratory disease
Tracheo-oesophageal fistula
Diaphragmatic hernia
What initial management is made for sick newborns?
Temperature Airway and breathing Circulation Metabolic homeostasis Antibiotics
Give some risk factors for preterm birth
Previous preterm delivery Abnormally shaped uterus Multiple pregnancy IVF Drug use Poor nutrition
All preterm infants must be kept warm immediately. True/false?
True
Why do preterm infants struggle to control their temperature?
Low basal metabolic rate
Minimal muscular activity
Low SC fat insulation
Why are preterm infants at increased risk of nutritional compromise?
Limited nutrient reserves
Immature gut/metabolic pathways
Increased nutrient demands
Which organisms tend to cause early onset neonatal sepsis?
Group B strep
Gram negatives
Which organisms tend to cause late onset neonatal sepsis?
Coagulase negative staph
Gram negatives
Staph aurues
How can neonatal sepsis be avoided?
Hand washing
Infection screening
Judicious use of antibiotics
Give some respiratory complications of prematurity
Respiratory distress syndrome
Apnoea of prematurity
Bronchopulmonary dysplasia
What is the primary pathology occurring in respiratory distress syndrome?
Surfactant deficiency
Give some clinical features of RDS
Tachypnoea Grunting Intercostal recessions Nasal flaring Cyanosis
How is RDS managed?
Maternal steroid
Surfactant
Ventilation
What cardiovascular abnormality can occur in prematurity?
Patent ductus arteriosus
What neurovascular abnormality can occur in prematurity?
Intraventricular haemorrhage
What occurs in necrotising enterocolitis?
The intestine becomes inflamed and starts to necrose leading to a perforation
