neonatal assess 2 Flashcards
4 parts of routine newborn care
- vit. K
- antibiotic eye ointment
- hearing screen
- newborn screen
what is K for
prevent deficent bleeding (hemoragic disease of the newborn)
what is oitnment for
erythromycin for maternal gonorrhea
when is screening done and what test
24hrs to 7 days
- PKU and hypothyroid , now 26
6 common neonatal illnesses
- sepsis
- cyanosis
- resp. distress
- GI reflux
- vomiting
- jaundice
risk for sepsis
- membrane ruptures
- GBS colonization
- mat. fever
- preemie
- male
- foul smelling
- maternal UTI in labor
Sx of sepsis
non-spec. and may be subtle
- poor feed, vomiting
- lethargy
- RSD
- grunting
- apnea
- low tone
- fever >37.8
- abdo distension
- petechiae
- cyanosis
what predicts sucess in sepsis
early diagnosis and intervention
what is central cyanosis
deoxy Hb in blood
- normal for first 5-10minute
- persisent never normal
4 causes of cyanosis
- hypovent.
- pulm disease (V/Q mismatch, diff. impairment)
- RtoL shunt
- heme disorders
signs of resp. distress
- tachypnea
- retractions
- grunting or stridor
- nasal flaring
- tachycardia
- cyanosis
2 general causes of resp. distress
immediate - lung disease/infection
beyond first days - infection and cardiac
def. RSD
def. surfactant production
- lung needs to do too much work
def. of transient tachypnea of newborn
inadequate lung fluid clearance
4 infectious causes of resp. distress
- pneumonia
- sepsis
- upper resp infections
- lower resp infeciton
6 cardiac causes of resp. distress
- congenital heart disease
- arrythmias
- incr. intravascular fluid
- high output failure
- caridomyopathy
- pneumopericardium
2 causes of cyanosis with no resp. distress
- congenital heart disease
2. idopathic pulm hypertension
5 causes of upper airway obstruction
- nasal atresia or stenosis
- micrognathia
- laryngeal/tracheal obs.
- nasal stuffiness
- masses
6 GI red flags
- abdo distension
- bile stained vomit
- GI bleeds (stool)
- absent bowel sounds
- persistent vomiting
- delayed passage of myconium
what is typical GE reflux in newborn
weak lower sphyncter
- not forceful, but high volume
- treat only if sympomatic
what is concern if vomitin (2)
- bile stained
- persistent
- pyloric stenosis
- strictures
- malformation
what is jaundice in bb
common
- from uncong. bili
what is concern with jaundice
kernicterus - bili in basal ganglia
CP and hearing loss
when to be concerned with jaundice 5
- less than 24 hours age
- rapid increae in bili
- direct hyperbilirubinemia
- premature
- sepsis
what is alloimmune hemolytic disease of newborn
Rh ABs from mom
when to treat baby with jaundice
changes with risk of baby- treat high risk at lower levels
3 treatments of jaundice in first weel
- phototherapy
- IVIG
- exchange transfusion
what to look at in jaundice beyond the first week
conj. vs. uncong
causes of uncong. (6)
breast milk jaundice hypothyroidism sepsis hemoglobinopathies, red cell defects etc. inherited enzyme defects
causes of cong.
hepatitis‐usually viral sepsis anatomic: biliary atresia, paucity of bile ducts etc. metabolic
what is breast milk jaundice
Unconjugated hyperbilirubinemia in breast fed baby beyond 7 days of age
- not known why
