Neonatal - newborn parameters, routine newborn care, neonatal resuscitation, newborn exam

Question 1

Normal newborn parameters at 28w, 32w, 37w, 40w

Answer 1

Question 2

Define gestational age terms

Answer 2

Question 3

Define birthweight terms

Answer 3

Question 4

Define birth size terms

Answer 4

Question 5

Imdications for level 1 and level 2 intensive care

Answer 5

Question 6

Indications for special care and normal care

Answer 6

Question 7

Routine delivery suite care for newborn

Answer 7

Early skin-to-skin contact
- For early breastfeeding experience
- Keep warm for cardiopulmonary stabilization

Delayed cord clamping for 30-60s until pulsation stops
- Less iron deficiency anemia
- Less IVH if premature

Record delivery time + APGAR score at 1,5, 10, 15min

Keep warm: plastic wrap or incubator care

Newborn examination

Monitoring: Continuous SpO2, rectal temperature, BW, length and head circumference, nursing observations Q15min

Cord care
Routine orders
Feeding practices
Sleeping advice

Question 8

Cord care advice

Answer 8

Question 9

Routine orders - injections and investigations after birth

Answer 9

Question 10

Feeding and sleeping advice for newborn

Answer 10

Question 11

Contraindications against breastfeeding

Answer 11

Question 12

APGAR score

Metrics
Scoring

Answer 12

Question 13

Ventilation corrective steps

Answer 13

Question 14

Neonatal resuscitation algorithm

Answer 14

Question 15

Newborn infant physical exam

Included examinations

Answer 15

Performed <72h after birth
- Assess baby’s ability in adapting to extra-uterine
life (esp cardiopulmonary status)
- Look for major congenital anomalies (esp those requiring urgent treatment)
- Identify at risk babies that need postnatal monitoring and investigation
- Mother’s competence in child care

General exam
Head, neck and face exam
Skeletal system exam
Cardio-respiratory exam
Abdominal exam
Neurological exam
Hip exam

Question 16

Newborn infant exam

General exam features

Answer 16

Question 17

Newborn infant exam

Head, neck and skeletal exam features

Answer 17

Question 18

Newborn infant exam

Cardio-respiratory exam features

Answer 18

Question 19

Newborn infant exam

Abdominal exam features

Answer 19

Question 20

Newborn infant exam

Neurological exam features
Hip exam

Answer 20

Question 21

List benign dermatological conditions in newborn that resolves spontaneously

Answer 21

• Peripheral cyanosis of hands and feet (1st day)
• Epstein pearls: small white pearls along midline of palate
• Epulis (cysts of gums)
• Ranula (cysts at floor of mouth)
• Capillary haemangioma/ Stork bites: pink macules on upper eyelids, midforehead and nape of neck fade over 1 year
• Erythema toxicum: rash at day 2-3, white pinpoint maules with eythematous base
• Milia: White papuleson nose and cheeks from pulosebaceous follicles
• Congenital dermal melanocytosis/ Mongolian blue spots: macular discoloration at base of spine and buttocks; fade over few years
• Caput succedaneum and cephalohaematoma

Female genital:
- White vaginal discharge or small withdrawal bleeding
- Breast enlargement +/- milk discharge

Question 22

Examples of common significant abnormalities on routine newborn examination

Answer 22

• Port-wine stain (naevus flammeus): capillary vascular malformation +/- intracranial vascular anomalies (Sturge-Weber syndrome); bone hypertrophy (Klippel-Trenaunay syndriome)
• Strawberry naevus (infantile haemangioma): increase in size until 3-15 months and regress; may interfere with vision or airway
• Natal teeth with front low incisors (removed due to aspiration)
• Extra-digits
• Heart murmur
• Midline spine or skull abnormalities
• Palpable/ large murmur due to outlfow tract obstruction
• Talipes equinovarus