Management of the Neonate Flashcards
What are the “normal” vitals for neonates
Temp = 97.7-99.5 RR = 40-60 bpm HR = 120-160 bpm (80 if sleeping) BP = ~70/43
What co-factor should be given to a neonate d/t immaturity of their liver
Vitamin K
If there is concern a pt may have gonorrhea, what should be given to the neonate
Erythromycin
How often should feedings be given and what is the normal weight gain for a newborn
Feedings q 2-3 hrs
Gain 15-30 grams/day
How low can a neonates glucose level go
40
What is the most common cause of a pneumothorax in a neonate
Spontaneous or d/t PPV during resuscitation
Def: Acryocyanosis
Blue discoloration of perioral area, feet, and hands w/in first 24 hrs (may be seen during feeding/suckling)
Def: Central cyanosis
Bluish discoloration of tongue/mucus membranes (if persists > 10 minutes, very concerning)
What should be considered if a baby is purple/ruddy
Polycythemia
What are the names for Nevus Flammeous lesions
Salmon patches
Angles kisses
Stork bites
Which blanches, bruises or cyanosis
Bruises
What is a gray color to the baby associated w/
Severe acidosis and shock
What is the palpebral fissure angle associated w/ if it is upward or downard
Upward = Trisomy 21 Downward = Treacher-collins, FAS, DiGeorge
What is Hypertelorism (wide spacing eyes) associated w/
Trisomy 13
When should disconjugate gaze be gone
4 months
what associations are made with a small nose, low nasal bridge, and nasal obstruction
Small nose = FAS
Low nasal bridge = Achondroplasia
Nasal obstruction = Choanal Atresia (CHARGE syndrome - may cause baby to become cyanotic when not crying)
What is a micrognathia mouth associated w/
Pierre-Robin sequence
Def: Epstein Pearls
Epithelial cysts or collagen balls w/in the mouth that look like teeth and resolve on their own
What associations are made w/ excess skin at the base of the neck and along the posterolateral line
Base of neck = Trisomy 21
Posterolateral line = Turner syndrome
Palpable LNs in the __________ are NEVER normal
Supraclavicular area
Which heart sound is normally split and where is it best heard
S2
Upper left sternal border
The disappearance of a murmur in a clinically deteriorating infant is indicative of a…
Coarctation of the aorta
Tricuspid atresia
Pulmonary atresia
How should the infant be placed for the best ab exam
Supine w/ legs flexed and infant sucking
Def: Cephalohematoma
DO NOT cross suture lines
Will enlarge
Resolve in wks - months
Def: Caput Succedaneum
DO cross suture lines
Boggy area of edema/bruising
Present at birth and doesn’t enlarge
Resolves in days
Def: Subgaleal Hemorrhage
DO cross suture lines
Enlarges after birth
Has “fluid wave”
MOST DANGEROUS
What is the most common cause of an abnormal back curve in a newborn
Dysraphic state (defective fusion)
What 4 things should you look for on the back of a newborn
Tuft of hair
Dimples separate from gluteal crease
Skin tags/pits
Aplasia cutis
Def: Erbs Palsy
C4, 5, 6, 7
Arm extended and IR
Waiter’s tip position of hand
Palmer grasp
Def: Barlow/Ortolani test
Tests for developmental hip dysplasia
Barlow = dislocation
Ortolani = reduction
What 3 things are associated with developmental hip dysplasia
Female sex
CNS abnormalities
Breech presentation
By what month should cryptorchid testes resolve? If they don’t resolve, what is the next step
3 months
Need surgery consult if not descended by 9-12 months
Def: Erythema Toxicum Neonatrum
“Flea-Bite syndrome”
Benign rash that appears on 2nd/3rd day of life and spares the palms and soles
Def: Miliaria Rubra
1-2mm whitish papules most often on the face and neck/shoulders
Associated w/ overheated room
Def: Milia
White, firm papules on face and bridge of nose that resolve spontaneously after a few months
Def: Dermal Melanosis
“Slate Gray spots”
Benign lesions on lower back/buttocks that resolve over several years
*More common in AA
*Need to be documented
