Neonatology Flashcards
Essential Newborn Care
Immediate Drying
Uninterrupted skin to skin contact
Delayed cord clamping after 1-3 mins
Non separation of mother and baby
Heat energy to cooler surrounding air
CONVECTION
Heat to colder materials touching the infant
CONDUCTION
Transfer of heat to nearby cooler objects
RADIATION
Looses from skin and lungs (respiration)
EVAPORATION
Low Birth Weight
< 2500 g
Very Low Birth Weight
< 1500 grams
Extremely Low Birth Weight
< 1000 grams
Known as INTRA-UTERINE GROWTH RETARDATION (IUGR)
BW < 3rd percentile for calculated gestational age
Small of Gestational Age (SGA)
Associated with POOR maternal nutrition or with late onset or exacerbation of maternal vascular disease
WEIGHT affected > length
HEAD continues to grow
fetus affected in LATE gestation
Postnatal catch up growth is good
ASYMMETRIC IUGR
Associated with GENETIC and METABOLIC conditions
Associated with diseases that seriously affect fetal cell number
weight, height, HC equally affected
fetus affected early in gestation < 18 weeks
SYMMETRIC IUGR
Birth weight >90th percentile for gestational age
at risk for HYPOGLYCEMIA and POLYCYTHEMIA
Large for Gestational Age
Large for gestational age babies are at increased risk for
hyperbilirubinemia birth injuries RDS congenital cardiac defects lumbosacral agenesis
APGAR SCORING SYSTEM!!
assesses neonates in need of resuscitation
Activity Pulse Grimace Appearance Respiration
SEVERELY DEPRESSED - 0-3
MODERATELY DEPRESSED - 4-6
EXCELLENT CONDITION - 7-10
Disorders associated with LARGE ANTERIOR FONTANEL
hypothyroidism achondroplasia hydrocephaly IUGR prematurity osteogenesis imperfecta Congenital rubella syndrome Trisomies 13, 18 and 21 hypophosphatasia Kenny syndrome
The target temperature for newborn
36.5 -37.5
The reason why room temperature should be set at 25-28 C
Convection
Hypothermia may cause
Acidosis
Hypoglycemia
Hypoxemia
At point of contact
Can EXTEND across sutures
Maximal size and firmness at birth
Resolves in 48-72 hr
Caput Succedaneum
Usually over PARIETAL bones
Does NOT CROSS sutures
Distinct margins;initially firm more fluctuant after 48 hr
may cause JAUNDICE
Cephalhematoma
Beneath epicranial aponeurosis
May extend to orbits, nape of neck
Firm to fluctuant; ill defined borders
May have crepitus or fluid waves
May be MASSIVE especially if there is an associated coagulopathy
SUBGALEAL HEMORRHAGE
Estimated birth anthropometrics (Lt, Wt, HC)
Lt: 50 cm
Wt; 3.5 kg
HC: 33-35 cm
SGA
BW <3rd percentile for calculated gestational age
LGA
BW >90th percentile for calculated gestational age
