Neonate Assessment Flashcards
What are fontanelles?
The soft spot on a baby’s skull where the bones haven’t fully fused yet. They allow to skull to be flexible during birth and give the brain room to grow.
How do fontanelles look when a baby is severely dehydrated?
Sunken
poor skin turgor
What does it mean when the fontanelles are bulging?
Swelling
Inflammation
Increased ICP
What is Caput Succedaneum?
When fluid accumulates between the skin and periosteum due to trauma during delivery.
What is Choanal atresia?
A congenital disorder where the back of the nasal passage is blocked by abnormal bony or soft tissue due to failed recanalization of the nasal fossae during fetal development
What is Pierre robin sequence?
A condition parent at birth where the infant has a smaller than normal jaw, a tongue that falls back in the throat and have difficulty breathing.
How d you manage he airway of an infant with Pierre robin sequence?
Position the infant prone to maintain airway and use and oral adjunct if needed
What is periodic breathing?
Normal short pause in breathing or breathing at a slightly irregular rate
What is jaundice and why do all newborns have some degree of jaundice?
Jaundice is the yellowing of the skin and sclera that happens when there’s too much bilirubin in the blood.
Common in newborns as their liver is developing and cannot process bilirubin yet.
Could also be because they have more RBC; break down faster; release bilirubin.
What ways can jaundice be treated?
Phototherapy- special light tat breaks down bilirubin
Breastfeeding- increased nutrients and stimulating bowels
Blood transfusions- albumin protein infusion
What can happen is jaundice is left Untreated in infants?
Kernicterus
Moves from the blood to the brain cells; can result in cerebral palsy, epilepsy, motor dysfunction and or learning disorders
What is diaphragmatic hernia? Signs and symptoms associated?
An abnormal opening in the diaphragm; most common in the left side.
Signs and symptoms
-decreased breath sounds
-scaphoid abdomen (sunken)
-cyanotic
Treatment for diaphragmatic hernia?
Is positive pressure ventilation is needed use an advanced airway.
Will. Ultimately require surgical correction
DO NOT. USE A BVM( distends the intestines)
What is gastroschisis with exposed abdominal contents?
A congenital defect in which the anterior abdominal wall has. Abdominal contents freely protruding.
What is omphalocele?
A defect caused by the umbilicus
Intestines protrude through The opening and are covered by fine Membranes.
Centre of defect is the umbilical cord.
Treatment for omphalocele and gastroschisis?
-Place newborn from waist down into a sterile bag to keep the bowel clean
-Moist sterile dressings
-minimize fluid/heat loss.
-Monitor the colour of the intestines
What is myelomeningocele?
-A type of spina bifida.
-The spinal canal and the meninges may protrude through the child’s back
-In some cases the skin covers the spinal cord and meninges
-In some cases it sticks through the skin.
Management of a bay with Myelomeningocele?
-Build log cabin with 4x4 or roller gauze around the site (like an impaled object) to protect the spinal cord so no pressure is placed on it.
- hold newborn on their side or prone to avoid any pressure on the cord
What are 3 ways to test a baby’s reflexes?
Palmar grasp reflex-(push your finger into the baby’s palm; should cause them to wrap their fingers around yours.)
Moro reflex- (hold infant and pull forward until a few cm above bassinet, drop babies head gently into your hand- arms should shoot up in attempt to hold up - extend and retract)
Rooting reflex- (evaluate by stroking the infants cheek- baby shoulder seem to Abe attempting to suckle on a nipple)
History questions for the parents?
-Was the baby premature or full term?
-Any complication during the pregnancy? During delivery?
-How much is the neonate sleeping?
-Does the baby get hypoxic during feedings?
-How many wet diapers? Soiled?
-Weight gain normal? Weight loss?
-Is anyone else sick in the house or at childcare?
If your patient has a post partum hemorrhage, how are you going to get the infant to breastfeed?
Breastfeeding promotes oxytocin release, which helps contract the uterus and reduce bleeding. If the mother is unstable, prioritize hemorrhage management while still attempting to facilitate breastfeeding when possible.
With consent manually stimulate the nipple to release oxytocin
We assist with latching
