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Lifecycles > Infancy & Early Childhood - Test 2 > Flashcards

Infancy & Early Childhood - Test 2 Flashcards

1
Q

What is the APGAR score?

A

Appearance (skin color)

Pulse

Grimace (response to catheter in nostril)

Activity

Respiratory

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2
Q

When is the APGAR score measured (When in the baby’s life)? What is a normal APGAR score?

A

first minute of life and 5th minute of life

less than 7 is abnormal

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3
Q

What are normal newborn vitals (respirations, HR, temp, blood pressure)?

A

Respirations: 30-60 breaths per minute

Heart Rate: 100-160 bpm

Temperature: 96-99.5 F

Blood pressure: 60-80/40-50 mmHg

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4
Q

When a baby is born, we give it three post-parturition medications. What are they?

A

erythromycin eye ointment

Intramuscular vitamin K

Hepatitis B immunization

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5
Q

Is it good for the mother and baby to initiate skin-to-skin after birth?

A

yes

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6
Q

How do you assess intake in a breastfeeding infant? (8 points)

A

Frequency of latch (normal every 1-3 hours)

Duration of latch (10-30 minutes)

Infant feeding cues (rooting [moving head], wake up, chews on hands)

Behavior at breast (stays latched, active/audible swallowing)

Quality of latch (opens mouth wide to latch)

Feeling of breast milk emptying

Observe mother breast feed

Daily weights, urine, and stool output

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7
Q

Is weight loss normal after birth? Why?

A

yes

babies lose water weight

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8
Q

How much weight can newborns lose? When do they start to regain their weight?

A

newborns can lose up to 10% of their weight

babies begin to regain weight in 3 days and should regain their birth weight around 2 weeks

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9
Q

What is the expected urine output for the 5 days of life?

A

1 = 1 diaper

2 = 2 diapers

3 = 3 diapers

4 = 4 diapers

5+ = 5+ diapers

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10
Q

Is it normal for a baby to not produce any urine during the first day of life?

A

NO!!!!

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11
Q

Name the type of stool

black and tarry. Passes in first 3 days of life

A

meconium

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12
Q

Name the type of stool

Dark green and sticky. Begins at day 4

A

transitional stool

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13
Q

Name the type of stool

green-yellow-brownish. Liquid but not watery

A

normal infant stool

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14
Q

is it normal for a baby to not pass stool within the 1st 24 hours of life?

A

NO!!!

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15
Q

If a baby doesn’t pass stool within the first hour, what are some of the possible causes?

A

no butthole (imperforate anus)

hirschprung’s, meconium plug, meconium ileus, neurointestinal disorders

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16
Q

If a baby has pale stools, what could be a cause?

A

no bile –> biliary obstruction or atresia

17
Q

If a baby has blood in stool, what could be a cause?

A

anal fissure, swallowed maternal blood, milk protein intolerance

18
Q

should babies sleep in a flat crib, on their own, and on their back?

A

yeah

19
Q

What are some signs of respiratory distress?

A

cyanosis

tachypnea

nasal flaring

grunting

subcostal retractions

20
Q

What is the differential for a cyanotic baby?

A

depends on whether the baby is presenting with respiratory distress!!!

21
Q

A pre-maturely born (cannicular stage; 16-25 weeks) baby becomes cyanotic. You observe nasal flaring, subcostal retractions, grunting, and tachypnea. Because you want the baby to become exposed to radiation, you order a CXR to diagnose this baby. What does this baby have and explain the pathophysiology?

A

This baby has NRDS

premature babies lack sufficient surfactant, which is produced by type II pneumocytes. Surfactant deficiency causing decreased lung compliance and atelectasis. Blood being shunted through areas of atelectasis leads to hypoxia

22
Q

How do you treat a pre-mature baby with NRDS? What would you do if a baby might be born pre-maturely?

A

exogenous surfactant

steroids to increase surfactant production before birth

23
Q

A term baby is born today. After delivery, you notice this baby is becoming cyanotic. The baby is showing signs of respiratory distress. You run some tests and realize that the baby has increased pulmonary vascular resistance. You decide to order a CXR. What’s going on with this baby? Explain the pathophysiology

A

Meconium aspration syndrome

The baby aspirated meconium (shit). Aspirated meconium causes obstruction and inflammation of the lung. The inflammation causes increased pulmonary vascular resistance

24
Q

A baby is cyanotic. This little shit was born at term, and doesn’t have poop around his mouth. You decide to do a pulse ox on his right and left hands. His right hand has a higher O2 saturation compared to his left. What does this baby have? how do you treat this guy?

A

Persistent Pulmonary Hypertension (PPHN)

Failure of pulmonary vascular resistance to decrease due to maladaptation after birth or maldevelopment of system

respiratory support

25
Q

A baby was born to a mother who did not recieve prenatal care. The mother tested positive for GBS. The baby is now cyanotic and is showing signs of repsiratory distress. CXR shows this. What does this baby have?

A

pneumonia

26
Q

A baby is cyanotic and is showing signs of respiratory distress. You exhausted your differentials. You take an CXR and you see this. What does the baby have?

A

Transient tachypnea of the newborn (TTN)

diagnosis of exclusion

usually resolves within 24-72 hours

NOTICE THE FISSURE IN THE RIGHT LOBE

27
Q

A baby is diagnosed with a respiratory illness. According to this CXR, what does the baby have?

A

pneumothorax

28
Q

A baby is jaundiced. What are some potential causes?

A

Hemolytic disease (ABO and Rh), fetal delivery trauma, and increased interohepatic circulation (slow bowel reabsorbs the junk) are pretty high on the DDx

29
Q

When evaluating jaundice, what labs are helpful?

A

total serum bilirubin

ABO or Rh disease (coombs test)

30
Q

Do all babies need phototherapy for jaundice? How do you know?

A

no. It depends on the nomogram

31
Q

What does human breast milk contain?

A

protein

fats (medium-chain and long-chain polyunsaturated fatty acids; LCPUFA have docosahexaenoic acid (DHA) which is important for brain and eye development)

biological components (antibodies, etc)

32
Q

What are the height equations for a male and female?

A

male = [father height + (mother height + 4)]/2

female = [(father height - 4) + mother height]/2

33
Q

What is the differential for failure to thrive?

A
34
Q

Are adverse childhood experiences associated with a higher risk of disease and early morality?

A

yes

35
Q

If you are born prematurely, are you at higher risk for disease?

A

yeah

36
Q

When is autism screened?

A

around 2 years old

37
Q

What can a 6 month do in terms of developmental milestones?

A

palmer reflex disappears

can sit up

can roll over

can transfer objects between hands

can rake grasp

can babble

can respond to name

stranger anxety

38
Q

What can a 1 year old do in terms of developmental milestones?

A

can stand

starts walking

point

throw ball

babinski reflexes disappear

two-pincher grasp

perform simple commands

can say mama and dada

39
Q

What is the screening tool for ASD?

A

CHAT

Lifecycles (19 decks)

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