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PCM IV Final DF > management and exam of the healthy neonate > Flashcards

management and exam of the healthy neonate Flashcards

1
Q

90% of apgar scores are between

A

7-10 and require no further assistance

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2
Q

normal respiratory rate

A

40-60 if above then troublesome

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3
Q

feeding and early weight loss of neonate

A

early and often no more than 3 hours apart bc can’t keep BG up on their own

up to 10% weight loss is acceptable in most situations
weight usually regained within 2 weeks

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4
Q

what is the best way to do an initial assessment of the baby

A

wactch it and listen to it

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5
Q

what kind of breathing does baby do

A

diaphragmatic see saw respirations

if baby looks okay then probably normal

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6
Q

what would be an abnormal respiratory finding

A

retractions or singing

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7
Q

what color is good of baby and which are the worst

A

pink = good

blue
mottling/pallor
and grayish hue

  • these 3 bad
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8
Q

acrocyanosis

A

blue discolor of perioral area, feet and hands

normal within first 24 hours

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9
Q

central cyanosis

when abnormal

A

blue tongue/mucus membranes

if persists after the first 10 mintues of life then this is abnormal

think cardiac or pulmonary disease

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10
Q

does cyanosis or bruises blanch

A

cyanosis, turns white when pushed on

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11
Q

jaundice in the first _____ is of concern

A

24 hours

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12
Q

what does grayish hue/color mean

A

severe acidosis
poor outcome
seen in infections and cardiac disease

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13
Q

what does a high pitched cry mean

A

cns head trauma and or substance withdrawal

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14
Q

finding a white red reflex means what

A

tumor, trauma, rop, need urgent referral

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15
Q

red reflex in darker skinned infants

A

may be more pearly gray, vessels still present

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16
Q

disconjugate gaze should be gone by why

A

age 4 months

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17
Q

what do you look for in ears

A

if they are low set

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18
Q

choanal atresia mnemonic

when can they become cyanotic?

A

CHARGE

coloboma, heart defect, atresia choanne, retarded growth/development, genital abnormalities, ear abnormalities

may be cyanotic when not crying

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19
Q

micrognathia is part of

A

pierre-robin sequence

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20
Q

natal/neonatal teeth signifigance

A

if they are loose then they need to come out

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21
Q

what is an epstein peral

A

epithelial cysts, collagen in the mouth

22
Q

excess skin at the base of the neck is common in

A

down syndrome

23
Q

normal hr in newbork

A

100-160

24
Q

checking pulses

A

check femoral and branchial simultaneously to see if they are equal

25
Q

what does absence of murmur during ausculataion mean?

A

nothing, still can have pathological structural problems

26
Q

babies and murmors

A

most have murmurs which is usually innocent

if loud murmur then further investigation

27
Q

scaphoid abdomen seen with

A

diaphragmatic hernia

28
Q

full upper abdomen with a flattened lower abdomen means

A

proximal obstruction or atretic lesion

29
Q

which is covered gastroschisis or omphalocele?

A

gastroschisis

oh shit that is not covered (omphalocele)

30
Q

extreme distension of the abdomen at birth or shortly after think what?

____ abdomen = bad

A

pathology, taut

meconium ileus
ascites
volvulus
bowel sounds not there is bad

31
Q

when palpating baby abdomen what position do you want them in?

A

legs flexed

32
Q

umbilical vessels and abnormality

A

usually 2 arteries and 1 vein
single artery is normal varient but if also have any other abnormal (not really sure bc she didn’t say in lecture) is of concern

33
Q

cephalohematoma

what is it
where does it spread
how long till goes away?
what can mask it?

A

subperiosteal blood
do not cross suture lines
weeks to months for resolution

can be hidden under caput succedaneum

34
Q

caput succedaneum

what is it
location
resolution

A

boggy area of edema or bruising that crosses suture lines, gone in days, present at birth

35
Q

what is the least common but most dangerous extracranial injury

lots of blood loss
enlarges after birth
crosses suture lines
fluid wave

can cover entire scalp and extend in to the neck

A

subgaleal hemorrhage

36
Q

dimples separate from the gluteal crease

think what
and do what

A 
spinal dysraphism (tethered cord)
US by 3 months
37
Q

extremity important fact

what test done

A

re examine the hips before discharge bc can pick up new abnormality that was not seen before

barlow and ortolani test

38
Q

genitalia emergency

A

if ambiguous genitalia then endocrinologic emergency

CAH

39
Q

femal with mucous (ocassionally bloody) discharge

A

common and a parental concern

40
Q

labial mass or mass in the groin maybe

A

a hernia

consider ectopic gonad

41
Q

hymenal tags are rare or common

A

common

42
Q

the average penis is about ____

A

2.5 cm, (hung AF)

43
Q

epispadias

what and location

A

dorsal meatal opening

44
Q

hypospadias

what and location

A

ventral meatal opening

45
Q

2% of newborn males are cryptorchid and what usually happens

A

most resolve by 3 months

if not down by 9-12 months then surgeon eval

46
Q

absence (imperforate) anus is often associated with what

A

VATER

verterbral defects, VSD
anal atresia
T-E fistual/esophageal atresia
Radial dysplasia

47
Q

what is vernix

A

white cheesy stuff that babies have all over, appears 35 weeks and gone by 41 usually

48
Q

flea bite syndrome

A

benign rash of newborn

patches or pustules that move around = normal

49
Q

1-2 mm white firm papules on face and bridge of nose

what happens

A

milia

go away on own

50
Q

benign
dermal melanosis
look like bruises
mainly on dark skin individuals?

what must you always do with these?

A

slate gray spots

document them

PCM IV Final DF (6 decks)

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