Neonatal Tutorial Flashcards
What investigation is required if mothers have hepatitis/ HIV to detemine risk of vertical transmission?
RNA/ viral load
What is considered a normal temp range for newborns?
36.6 - 37.5
What factors can put babies at risk for hypoglycemia?
Preterm Weight <2nd centile Infant of diabetic mother Maternal labetalol Perinatal acidosis (cord pH <7.1 + BE >12 mmol/l)
What are symptoms of hypoglycaemia in neonates?
Cyanosis Apnoea Excessive sleepiness Seizures Hypotonia High pitched cry Abnormal feeding behaviour Hypothermia (<3.5 not due to environmental factors)
How is a BG of 2.6 mmol or above treated?
Support frequent breastfeeding with no longer than 3 hrs between feeds
If formula; 10-15 ml/kg/feed 3 hourly
How is a BG of <2.6 mmol/l treated?
Buccal dextrose gel
Support breastfeeding
What can cause tachypnoea in the newborn period?
Cardiac abnormalities Abstinence syndrome Resp distress syndrome of newborn Diaphragmatic hernia Pneumonia PPHN TTPN Sepsis
How is abstinence syndrome measured?
NAS score
What is the cut off for the NAS score?
An infant with 3 consecutive scores averaging more than 8 should be commenced on treatment (and therefore admitted to SCBU)
Scoring 4 hourly
What environmental factors can minimize the effects of NAS?
Regular feeding Reduce bright lights and noise Dress in appropriate clothes Swaddle baby Containment hold
How is NAS managed?
Morphine; steady state for around 24 hours then slowly wean off
What does the NAS score take into account?
Cry Sleep (less sleep is worse) Tremor Increased muscle tone Generalized convulsion (automatic 12) Frantic first suckling Poor feeding Vomiting Loose stools Frequent yawning Sneezing Nasal stuffiness Sweating Mottling Pyrexia Resp rate >60 per/min Excoriation
