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Y4 Neonatology > Healthy term infant > Flashcards

Healthy term infant Flashcards

1
Q

Define what a term baby is

A
  • This is a baby born after 37+0 wks & < 41+6 wks
  • Considered pre-term if before this and post-term if after this
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2
Q

What is the normal weight range of a newborn ?

A
  • 2.5 - 4kg
  • Considered LGA if >4 and SGA if < 2.5
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3
Q

What happens to the weight of a baby during the 3rd trimester ?

A

Its weight dramatically increases:

  • Average male at 28 weeks = 1150g, 3.5% fat
  • Average male at term = 3550g, 15% fat
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4
Q

Transplacental transfer of what occurs during the 3rd trimester ?

A

Iron, vitamins, calcium, phosphate & antibodies

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5
Q

When the baby is born light, tough and temp all help stimulate what?

A

The change from fetal to newborn circulation

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6
Q

Why should you be wary of hypoxia when carrying out the initial assessment of a baby ?

A

Because labour is a hypoxic environment

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7
Q

What is used to assess a newborn baby?

A

APGAR score

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8
Q

When is the APGAR score used and what does it objectively measure ?

A

Used at min 1&5 following birth as an objective measurement of perinatal adaptation

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9
Q

What do you assess when carrying out the APGAR score and what is a normal score ?

A

Scored out of 10, with ≥ 8 being normal

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10
Q

After initial assessment of the baby using APGAR score, you want to wrap the baby up to keep them warm & feed them (establish breastfeeding) & establish attachment.

List the important things to be done following APGAR score assessment

A
  • Ensure skin to skin contact - important for emotional development
  • Prophylactic IM Vit K given - to prevent haemorrhagic disease of the newborn (caused by Vit K deficiency)
  • Mother will have been screened during pregnancy for Heb B, HIV, Syphilis & Hep C - so will know if extra precautions, vaccinations or prophylactic treatment is needed
  • Monitor baby with newborn early warning chart (essentially NEWS chart for a newborn)
  • Snuggle bundle
  • BCG only given if risk of TB exposure
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11
Q

What vaccinations may mothers get given ?

A

Pertussis & influenza (should already be vaccinated in the UK)

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12
Q

What will babies born to mothers with Hep B recieve at birth ?

A

Hep B vaccination

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13
Q

What does the 6-in-1 vaccination consist of ?

A

diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B vaccinations

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14
Q

Routine vaccination protocol - what is the first potential vaccination someone will recieve and when ?

A

BCG at birth - if risk factors e.g. recent travel or e.g. TB in the family in the past 6 months

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15
Q

Routine vaccination protocol what is the first (sometimes second if BCG) vaccinations someone will recieve and when ?

A

Done at 2 months:

  1. 6-1 vaccine
  2. Oral rotavirus vaccine
  3. Men B
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16
Q

Routine vaccination protocol what is the second vaccinations someone will recieve and when ?

A

Done at 3 months:

  1. 6-1 vaccine
  2. Oral rotavirus vaccine
  3. PCV
17
Q

Routine vaccination protocol what is the third vaccinations someone will recieve and when ?

A

Done at 4 months:

  1. 6-1 vaccine
  2. Men B
18
Q

Routine vaccination protocol what is the forth vaccinations someone will recieve and when ?

A

Done at 12-13 months:

  1. Hib/Men C
  2. MMR
  3. PCV
  4. Men B
19
Q

Routine vaccination protocol what is the fifth vaccinations someone will recieve and when ?

A

Done annually between ages 2-8:

  1. Flu vaccine
20
Q

Routine vaccination protocol what is the sixth vaccinations someone will recieve and when ?

A

Done at 3-4 years:

  1. ‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio)
  2. MMR
21
Q

Routine vaccination protocol what is the seventh vaccinations someone will recieve and when ?

A

Done at 12-13 years old:

  1. HPV vaccination
22
Q

Routine vaccination protocol what is the 8th vaccinations someone will recieve and when ?

A

Done between ages 13-18:

  1. ‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)
  2. Men ACWY
23
Q

What screening tests should a newborn undergo?

A
  1. Have a universal hearing screening before discharge
  2. Hip screening - clinical (burlow & ortalani) +/- USS
  3. Newborn head to toe exammination when born and a formal one around 24hrs
  4. At about 5 days they have a blood heel spot test to screen for a number of diseases
24
Q

What is screened for on the blood heel spot test ?

A
  • Cystic fibrosis
  • Congenital hypothyroidism
  • Sickle cell disease
  • 6 metabolic conditions; Phenylketonuria, Medium-chain acetyl CoA dehydrogenase deficiency (MCADD), Maple syrup urine disease (MSUD), Isovaleric acidaemia (IVA), G;utaric aciduria type 1 (GA1), Homocytinuria (HCU)
25
Q

What are the main components of the newborn exammination which are assessed?

A
  • Head
  • Eyes
  • Ears
  • Mouth
  • Face
  • Resp
  • Cardio
  • Abdo
  • Genitourinary
  • MSK
  • Neuro
  • Skin
26
Q

What is checked when assessing the head during the newborn exammination?

A
  1. OFC
  2. Fontanelles (ant & post) & sutures - if bulging its a sign of increased ICP), sunken may be a sign of dehydration
  3. Checking for signs of trauma e.g. cephalohaematoma
27
Q

What is checked when assessing the eyes during the newborn exammination?

A
  1. Red reflexes (absent in cataracts & retinoblastoma)
  2. For squints
  3. Iris abnormalities
  4. Conjunctiva
  5. Size of pupils
28
Q

What is checked when assessing the ears during the newborn exammination?

A
  1. Shape, position
  2. Tags/pits
  3. External auditory canal
29
Q

What is checked when assessing the mouth during the newborn exammination?

A
  1. Check palate intact - by sticking finger in and feeling roof of mouth
  2. Sucking/rooting reflex (when finger in mouth)
  3. Teeth
  4. Tongue
  5. Philitrum
  6. For cleft palates
30
Q

What is checked when assessing the face during the newborn exammination?

A
  1. Any signs of facial nerve palsy (impaired at birth)
  2. Dysphorphism - signs of congenital disease
31
Q

What is checked when assessing the Resp system during the newborn exammination?

A
  1. Resp exam
32
Q

What is checked when assessing the cardiovascular system during the newborn exammination?

A
  1. Cardio exam
  2. For pulses simply checking the femoral are both intact
33
Q

What is checked when assessing the abdomen during the newborn exammination?

A
  1. Check for hernias - umbilical most common in infants
  2. Check if meconium has past (should in the first 24hrs)
  3. Abdo distension
  4. Abdo exam
34
Q

What is checked when assessing the genitourinary system during the newborn exammination?

A
  1. Normal passage of urine
  2. Normal genitalia
  3. Descended testes
  4. Hypospadius
35
Q

What is checked when assessing the neuro system during the newborn exammination?

A
  1. Alert, responsiveness
  2. Cry
  3. Tone, movement
  4. Posture
  5. Primitive reflexes; sucking & rooting (already done), monros, ATNR, stepping, grasp
36
Q

What is checked when assessing the MSK system during the newborn exammination?

A
  1. Movement & posture
  2. Spine exam (this is when you pick baby up and use fingers to check the spine seen in pic)
  3. Limbs & digits
  4. Hip exam (barlow & ortalani)
37
Q

What is checked when assessing the skin during the newborn exammination?

A

Check for any deformities

Y4 Neonatology (10 decks)

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