neonatal assess 2

Question 1

4 parts of routine newborn care

Answer 1

1. vit. K
2. antibiotic eye ointment
3. hearing screen
4. newborn screen

Question 2

what is K for

Answer 2

prevent deficent bleeding (hemoragic disease of the newborn)

Question 3

what is oitnment for

Answer 3

erythromycin for maternal gonorrhea

Question 4

when is screening done and what test

Answer 4

24hrs to 7 days

- PKU and hypothyroid , now 26

Question 5

6 common neonatal illnesses

Answer 5

1. sepsis
2. cyanosis
3. resp. distress
4. GI reflux
5. vomiting
6. jaundice

Question 6

risk for sepsis

Answer 6

• membrane ruptures
• GBS colonization
• mat. fever
• preemie
• male
• foul smelling
• maternal UTI in labor

Question 7

Sx of sepsis

Answer 7

non-spec. and may be subtle

• poor feed, vomiting
• lethargy
• RSD
• grunting
• apnea
• low tone
• fever >37.8
• abdo distension
• petechiae
• cyanosis

Question 8

what predicts sucess in sepsis

Answer 8

early diagnosis and intervention

Question 9

what is central cyanosis

Answer 9

deoxy Hb in blood

• normal for first 5-10minute
• persisent never normal

Question 10

4 causes of cyanosis

Answer 10

1. hypovent.
2. pulm disease (V/Q mismatch, diff. impairment)
3. RtoL shunt
4. heme disorders

Question 11

signs of resp. distress

Answer 11

1. tachypnea
2. retractions
3. grunting or stridor
4. nasal flaring
5. tachycardia
6. cyanosis

Question 12

2 general causes of resp. distress

Answer 12

immediate - lung disease/infection

beyond first days - infection and cardiac

Question 13

def. RSD

Answer 13

def. surfactant production

- lung needs to do too much work

Question 14

def. of transient tachypnea of newborn

Answer 14

inadequate lung fluid clearance

Question 15

4 infectious causes of resp. distress

Answer 15

1. pneumonia
2. sepsis
3. upper resp infections
4. lower resp infeciton

Question 16

6 cardiac causes of resp. distress

Answer 16

1. congenital heart disease
2. arrythmias
3. incr. intravascular fluid
4. high output failure
5. caridomyopathy
6. pneumopericardium

Question 17

2 causes of cyanosis with no resp. distress

Answer 17

1. congenital heart disease

2. idopathic pulm hypertension

Question 18

5 causes of upper airway obstruction

Answer 18

1. nasal atresia or stenosis
2. micrognathia
3. laryngeal/tracheal obs.
4. nasal stuffiness
5. masses

Question 19

6 GI red flags

Answer 19

1. abdo distension
2. bile stained vomit
3. GI bleeds (stool)
4. absent bowel sounds
5. persistent vomiting
6. delayed passage of myconium

Question 20

what is typical GE reflux in newborn

Answer 20

weak lower sphyncter

• not forceful, but high volume
• treat only if sympomatic

Question 21

what is concern if vomitin (2)

Answer 21

1. bile stained
2. persistent
   - pyloric stenosis
   - strictures
   - malformation

Question 22

what is jaundice in bb

Answer 22

common

- from uncong. bili

Question 23

what is concern with jaundice

Answer 23

kernicterus - bili in basal ganglia

CP and hearing loss

Question 24

when to be concerned with jaundice 5

Answer 24

1. less than 24 hours age
2. rapid increae in bili
3. direct hyperbilirubinemia
4. premature
5. sepsis

Question 25

what is alloimmune hemolytic disease of newborn

Answer 25

Rh ABs from mom

Question 26

when to treat baby with jaundice

Answer 26

changes with risk of baby- treat high risk at lower levels

Question 27

3 treatments of jaundice in first weel

Answer 27

1. phototherapy 2. IVIG 3. exchange transfusion

Question 28

what to look at in jaundice beyond the first week

Answer 28

conj. vs. uncong

Question 29

causes of uncong. (6)

Answer 29

``` breast milk jaundice hypothyroidism sepsis hemoglobinopathies, red cell defects etc. inherited enzyme defects ```

Question 30

causes of cong.

Answer 30

``` hepatitis‐usually viral sepsis anatomic: biliary atresia, paucity of bile ducts etc. metabolic ```

Question 31

what is breast milk jaundice

Answer 31

Unconjugated hyperbilirubinemia in breast fed baby beyond 7 days of age - not known why