Management of the Newborn Flashcards
What are the three major s/sx of hypoglycemia in the neonate?
- Poor feeding
- Poor tone
- Jitteriness
What causes macrosomia in the newborn born to DM mothers?
IGF increases tissue growth
What causes the SGA seen with DM mothers? In whom is this more common in?
Maternal renovascular insufficiency
Longstanding poorly controlled DM
What are the physical abnormalities that can occur with poorly controlled DM? (4)
- Sacral agenesis
- Femoral hypoplasia
- Heart defects
- Cleft palate
What are the metabolic disturbances common with DM babies? (3)
- Hypomagnesemia
- Hypocalcemia
- Hypoglycemia
How do you prevent hypoglycemia in the newborn? Treatment if it occurs?
- Early and frequent feeding
- Give D10 IV
What is the target BG level for newborns?
greater than 45 mg/dL
How soon should babies be fed if there is a risk for hypoglycemia?
Within 1 hour
What is chorioamnionitis?
Rupture greater than 18 hours that leads to sepsis
ROM greater than how many hours indicates a risk for chorioamnionitis?
18 hours
When should GBS be screened for?
35-37 weeks
How long should PCN treatment be done for prior to delivery?
at least 4 hours
What are the major s/sx of GBS in the neonate? (4)
- Cold
- Excessive jaundice
- Gray/pale/hypoxemia
- Decreased tone
True or false: transmission of GBS can occur before delivery
True
Most neonate present with GBS infection within what time frame?
Within 24 hours
Last onset GBS infection is defined when? Is this more commonly meningitis or pneumonia?
1 week to 3 months
Late = meningitis Early = pneumonia
True or false: increased use of IV Abx has decreased the risk for late onset GBS
False
True or false: if GBS status is unknown, then Abx are recommended
True
Mother who labor for longer than how long are at increased risk for GBS?
18 hours
What is the treatment for asymptomatic infants with possible GBS infection?
Observe for ~48 hours
What is the treatment of infants with symptomatic infants with GBS infx?
Begin lab and x-ray work up including cultures, and Begin Abx
If no source for fever is found in the neonate less than 28 days, what is the work up? (4 +, what if cough, diarrhea)
- CBC and BC
- UA + UC
- LP/CSF
- HSV PCR of CSF
- CXR if coughing
- Fecal WBC if diarrhea
What is fecal lactoferrin? When will this alway be positive?
Used to diagnose bacterial enteritis
Always positive if BF
What are the three bacterial infections that are common in the neonate?
GEL
GBS
E.coli
Listeria
