M1: Newborn & Adolescent History Flashcards
Newborn History can be divided in three periods
Prenatal, Natal & Neonatal
The newborn period begins at birth and includes the first month of life
Neonatal period
Neonatal period
First 28 days of life
Full term baby at what week
38th week
28th week of gestation through 7th day
Perinatal
Perinatal History: 1. _________ & ________ data
Demographic & Social
Perinatal History: 2. ______________ in the mother and family (including siblings)
Past medical illnesses
Perinatal History: 3. Previous ____________ problems
Maternal reproductive
Perinatal History: 4. Events is ___________
Present Pregnancy
Perinatal History: 5. Description of __________
Labor
Perinatal History: 6. Description of __________
Delivery
Includes maternal & fetal conditions, mother’s health during pregnancy, prenatal care, radiation exposure, smoking, substances and emotional & behavioral status.
Prenatal
Includes birth history, place/manner of delivery, birth weight of infant (grams/kg), duration of pregnancy and age of gestation
Natal
Duration of pregnancy & age of gestation
In wks up to 44 weeks
Is determined by counting weeks from amenorrhea to birth
Age of Gestation
Used to accurately determine Gestational age through neuromuscular and physical assessment of a newborn fetus. For maturity rating.
Ballard score
Scope of weeks for Ballard scoring
20-44weeks
Two maturity components in Ballard score
Physical & Neuromuscular Maturity
Six criteria in Neuromuscular Maturity
Square window, Scarf sign, Heel to ear, Arm recoil, Posture & Popliteal angle “SSHAPP”
Six criteria for Physical Maturity
Breast, Plantar surface, Lanugo, Eye/Ear, Genitals & Skin “BP LEGS”
Downy hair covering a body of a newborn
Lanugo
Maximum score for Ballard
50
Minimum score for Ballard
-10
Posture with a score of 4 indicates
Full term baby
Score for preterm when talking about posture
0 & 1
Leathery, cracked & wrinked skin with a score of 5 indicates
Post term baby
In plantar surface, what score indicates a Post term. Give its characteristics.
- Creases over entire sole.
The younger the baby, the more the ear is __________.
Gelatinous
In Categorizing Newborns, classification would include
Birth weight & Gestational age
Birth weight & Gestational age is plotted in what kind of curve
Intrauterine growth curve
SGA stands for (more problems than LGA)
Small for Gestational Age
AGA stands for
Appropriate for Gestational Age
LGA stands for
Large for Gestational Age
Is a practical method of assessing newborns to help identify those requiring resuscitation and to predict survival in the neonatal period.
APGAR
APGAR stands for
Appearance, Pulse rate, Grimace, Activity & Respiration
For immediate resuscitation
1 minute
Successful resuscitation. Cannot predict neurologic outcome.
5, 10, 15 & 20 minutes
Predicts neonatal death
APGAR 0-3 at 5min
Apgar scoring: HR absent, Respiratory effort absent, Muscle tone limp, Response to catheter in nostril no response and Color is blue pale.
0
Apgar scoring: HR scores 1
Below 100
Apgar scoring: Respiratory effort of 3
Good & Crying
Apgar scoring: Muscle tone scores 1
Some flexion of extremities
Apgar scoring: Response to catheter in nostril scores 1
Grimace
Apgar scoring: Color scores 2
Completely pink
Apgar scoring: Heart rate scores 2
Over 100
Apgar scoring: Respiratory effort scores 1
Slow & Irregular
Apgar scoring: Muscle tone scores 2
Active motion
Apgar scoring: Response to catheter in nostril scores 2
Cough or Sneeze
Apgar scoring: Color scores 1
Body pink, extremities Blue
APGAR Interpretation: 3-4
Moderate Asphyxia
APGAR Interpretation: 8-10
No Asphyxia
APGAR Interpretation: 0-2
Severe Asphyxia
APGAR Interpretation: 5-7
Mild Asphyxia
Ask about first few hours of life
APGAR, wt, length, head circumference & Gestational age
Neonatal History should: Identify ___________ for prompt action.
Disabling diseases
Neonatal History should: _____________ that may be of later importance.
Anticipate conditions
Neonatal History should: Uncover __________ explaining pathology.
Causative factors
Age for Early Adolescence
11-14 y/o
Age for Middle Adolescence
15-17 y/o
Age for Late Adolescence
18-21 y/o
A growing ability to use abstract thought
Early Adolescence
Peer group remains very important for social and behavioral norms
Middle Adolescence
Dating a major activity
Middle Adolescence
Seeking increasingly more independence
Late Adolescence
Beginning of abstract cognition
Middle Adolescence
Physical growth and hormonal development
Early Adolescence
Conflicts with parents & emancipation issues become dominant themes
Middle Adolescence
Pubescence, Risk-taking behaviors & rejection of authority
Middle Adolescence
Discover self, social & academic potential accompanied by changing life goals
Late Adolescence
Feelings of omnipotence and invincibility
Middle Adolescence
Uncertain or ambivalent about career. Difficulty performing traditional academic tasks. Become more self confident.
Late Adolescence
HEEADSSS stands for
Home, Education/Employment, Eating, Activities with peers, Drugs/Alcohol/Tobacco, Sexual Identity/Sexuality, Suicide & Depression/Sleep and Safety
Maximum hours to spend in electronic gadgets or TV
2hrs
Makes question seem natural and less intrusive
Context
Number one cause of death & injury in youth
Accidents
Is an increasing threat for many American youth
Violent behavior
For high-risk youth, ask about __________ and a history of _______ including friends and family.
Criminal activity. Incarceration.
Sum up their life in one word or as in weather report. Identify a trusted adult in the family. It is important to acknowledge those parts of the adolescent’s life that are going well.
Wrapping it up
