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Women and Neonatal Health > Newborn > Flashcards

Newborn Flashcards

1
Q

acrocyanosis

A

normal
trunk is pink but extremities are blue

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2
Q

vernix

A

normal
thick, cheesy white substance covering newborn
protects skin (less in full term babies)

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3
Q

lanugo

A

normal
fine hair
helps w thermoregulation
a premature infant has an abundant amount
fully mature infant does not have much

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4
Q

jaundice

A

abnormal always when it is within 24hrs

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5
Q

stork bites (telangiectatic nevi)

A

normal
pink discoloration of skin
dilated capillaries
go away on own (by 2nd yr)

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6
Q

milia

A

normal
little white cysts on face

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7
Q

mongolian spots

A

normal
blue purple pigmentation on lower back/buttocks
more common with darker skin tone

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8
Q

desquamation

A

peeling

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9
Q

nevus flammeus

A

normal
port wine stain
purple red discoloration of face or neck
permanent

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10
Q

erythema toxicum

A

normal
transient rash w papules
disappears in few weeks

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11
Q

molding

A

elongated fetal headshape

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12
Q

fontanels

A

should be symmetrical
soft, flat, and open
anterior- large and diamond shaped in front
posterior- triangular and small in back

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13
Q

caput succadeneum

A

expected soft tissue localized swelling crossing the suture line
resolves in 3 days

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14
Q

cephalohematoma

A

collection of blood between skull and periosteum, does NOT cross suture line
results from birth trauma
one sided
resolves on own, 2-4 weeks
at risk for jaundice r/t RBC breakdown

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15
Q

subgaleal hemorrhage

A

can cause seizures
measure head circumference each shift

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16
Q

if skin tags on ear..

A

anticipate renal ultrasound

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17
Q

epstein pearls

A

normal
small white cysts on the gums or palate

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18
Q

umbilical cord

A

2 arteries, 1 vein

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19
Q

ortalani maneuver

A

normal finding= negative
positive finding: hip abduction and clunk/crepitus

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20
Q

screening at birth

A

universal newborn screening (state mandated- metabolic screenings for PKU, CF, maple syrup disease, sickle cell)

critical congenital heart disease screening (R hand= preductal saturation, any foot= postductal saturation)

hearing screening

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21
Q

erythromycin

A

ophthalmic ointment
prophylactic abx for ophthalmia neonatorum (gonorrhea or chlamydia)

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22
Q

vitamin K

A

IM injection
vit k is synthesized in the gut, neonates have a sterile gut
vit k does not cross placenta or pass through breastmilk

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23
Q

hepatitis B

A

IM injection
birth, 1-2 mo, 6-18 mo
requires informed consent

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24
Q

IM injections in newborns

A

vastus lateralis (anterior thigh)
5/8 inch, 25 gauge

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25
Q

if mom is hep B +

A

give HBIG and hepatitis B vaccine within 12 hours of birth

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26
Q

neonatal abstinence syndrome (NAS)

A

neonatal substance withdrawal
high pitched shrill cry, inconsolable
tremors, convulsions
fever
tachypnea
irritability
poor feeding
constant sucking
increased muscle tone

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27
Q

treating NAS

A

supportive care..
skin to skin
encourage breastfeeding (NOT w marijuana)
reducing stimuli
replacing opioid with medically safe dose (buprenorphine, methadone)
anticonvulsants if seizures
increase number of feedings
seizure precautions

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28
Q

alcohol use

A

no alcohol is safe
can lead to..
cranial facial anomalies
microcephaly
FASD

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29
Q

cocaine baby

A

no withdrawal symptoms
risk for emergency placental abruption
has neurotoxic effects

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30
Q

Finnegan Neonatal Abstinence Syndrome scale

A

Q3 hours

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31
Q

hypoglycemia

A

glucose less than 40 in first 4 hrs of life
or
less than 45 in 4-24 hrs of life
poor feeding
jitteriness
weak cry
flaccid muscle tone
diaphoresis

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32
Q

risk factors for hypoglycemia

A

mom w GDM or diabetes
preterm
late term

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33
Q

treating hypoglycemia

A

early breastfeeding
formula supplementation
dextrose gel buccally

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34
Q

macrosomia infant

A

LGA , 4000g+, 90th percentile
risk factors: GDM, postmature infant (after 42wks), maternal obesity, genetics

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35
Q

complications of macrosomic infant

A

birth trauma
shoulder ..
respiratory distress
hypoglycemia (body expects sugar from mom so metabolically uses energy without actually having it)

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36
Q

sepsis neonatorum

A

infection of neonate’s bloodstream
risk factors: prematurity, low birth weight, chorioamnionitis, prolonged rupture of membranes(24+)
signs: poor feeding, lethargy, periods of apnea, fever, hypothermia, pale
labs: positive blood cx, hyperglycemia, elevated CRP, elevated lactic acid
treat: IV abx, encourage breastfeeding, eye abx

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37
Q

APGAR

A

1 and 5 min after birth
assesses their adaptability to extrauterine life
0-3= severe distress
4-6= moderate distress
7-10=minimal difficulty adapting

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38
Q

A in APGAR

A

Activity
flaccid=0
some flexion=1
well flexed/active=2

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39
Q

P in APGAR

A

Pulse
less than 50= 0
less than 100= 1
100+=2

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40
Q

G in APGAR

A

Grimace/reflex irritability
none= 0
moans and wiggles=1
crying=1

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41
Q

2nd A in APGAR

A

Appearance
whole body blue=0
acrocyanosis= 1
whole body pink=2

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42
Q

R in APGAR

A

Respiration
none=0
slow weak cry=1
strong cry=2

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43
Q

expected temp

A

97.8 - 99.6
36.5 - 37.5

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44
Q

expected pulse

A

100-160 bpm

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45
Q

expected respirations

A

30-60
apnea less than 15 sec is ok

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46
Q

expected blood pressure

A

65-90 / 45-65

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47
Q

MAP

A

should be near the weeks of gestation
diastolic + 1/3(systolic-diastolic)

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48
Q

New Ballard Scale

A

determines if pre or fully mature
neuromuscular assessment
physical maturity assessment

49
Q

square window

A

flex wrist towards arm
0 degree=good
90 degree=premature

50
Q

types of heat loss

A

conduction
convection
evaporation
radiation

51
Q

conduction

A

heat loss through direct contact with a cooler surface

52
Q

convection

A

heat loss through cooler air

53
Q

evaporation

A

heat loss when surface liquid is turned into vapor

54
Q

radiation

A

heat loss from proximity
(keep away from cold window)

55
Q

normal weight range

A

2500-4000g
5 lbs 8 oz- 8lbs 13oz

56
Q

normal length

A

44-55 cm
18-22 inches

57
Q

normal head circumference

A

13-15 inches
at birth, head circumference is 2-3cm larger than chest

58
Q

normal chest circumference

A

12-13 inches
chest and head do not equal out until 12 mo

59
Q

1st period of reactivity

A

up to 30 min after birth
pulse 160-180
will hear fine crackles

60
Q

btw 1st and 2nd periods of reactivity

A

60-100 min of decreased responsiveness, decreased motor activity, or sleeping

61
Q

2nd period of reactivity

A

2-8 hrs after birth
tachycardia
tachypnea
increased muscle tone
improved skin color
meconium passes (need to poop within 24hrs)

62
Q

signs of respiratory distress

A

nasal flaring
intercostal or subcostal retractions
circumoral cyanosis
central cyanosis
grunting

63
Q

blood volume

A

84mL/kg
can reach 100mL/kg if delay cord clamping

64
Q

delay cord clamping

A

waiting until there is no pulse in the cord
increases blood volume
gives 6 mo of iron stores instead of 4 mo

65
Q

murmurs

A

OK in first couple hours
NEVER ok when accompanying unstable vitals or symptoms

66
Q

aligohydramnios

A

low amniotic fluid
a sign of renal issues
places at risk for birth trauma

67
Q

infant urination

A

should pee within 24 hrs
rectal temp stimulation
put feet in warm water
will be a rust color

68
Q

wet diaper expectations

A

1 wet diaper in 24hrs
2 wet diapers in 2nd 24hrs
day 4= 6 wet diapers/day

69
Q

early signs of hunger

A

rooting
sucking/smacking lips
crying is a LATE sign

70
Q

normal blood glucose

A

40-45, LOVE 50

71
Q

hypoglycemia

A

below 40
must intervene
oral glucose gel
swaddle
feed baby

72
Q

risk factors for hypoglycemia

A

premature infants
high stress (hypothermia)
GDM
LGA babies
SGA babies

73
Q

LGA

A

90th+ percentile
BS checks for 12 hrs

74
Q

SGA

A

10th or less percentile
BS checks for 20 hrs

75
Q

babies born to GDM

A

BS checks for 12 hrs
baby is used to producing insulin in utero, pancreas will continue to do so outside

76
Q

preterm

A

born before completion of 37weeks

77
Q

late preterm

A

34 weeks - 36 weeks 6days

78
Q

early term

A

37 weeks - 38 weeks 6 days

79
Q

full term

A

39 weeks - 40 weeks 6 days

80
Q

late term

A

41 weeks 0 days - 6 days

81
Q

postterm

A

42 weeks and beyond

82
Q

pathologic jaundice

A

within 24 hours
NOT normal

83
Q

physiologic jaundice

A

bilirubin increases then plateus at 96 hrs
normal

84
Q

breast milk jaundice

A

lack of effective breastfeeding
direct bilirubin is stable
encourage breastfeeding

85
Q

phototherapy

A

breaks up bilirubin
bilirubin excreted in pee and poop
ensure eye protection

86
Q

pseudomenses

A

small amount of blood excreted in female neonates
caused by extra estrogen from mom

87
Q

epispadis

A

urethral opening at upper edge of penis
stop circ

88
Q

hypospadias

A

urethal opening of penis is at lower edge
stop circ

89
Q

hydrocele

A

extra fluid in testicles
will resolve in 24 hrs

90
Q

swollen breast tissue

A

caused by hyperestrogenism

91
Q

ambiguous genitalia

A

appear as one gender but are another

92
Q

oligodactyly

A

missing a digit

93
Q

polydactyly

A

more than 10 digits

94
Q

syndactyly

A

webbed or fused digits

95
Q

estimated date of confinement

A

due date

96
Q

gravita

A

how many times a patient has been pregnant

97
Q

para

A

1 - term deliveries

#2 - preterm deliveries
#3 - abortions
#4 - # of living children

98
Q

vision

A

can track by 3 mo

99
Q

hearing

A

screen around 24 hrs
amniotic fluid will come out

100
Q

expected hemoglobin

A

14-24

101
Q

expected PLT

A

150,000-300,000

102
Q

expected WBC

A

9,000-30,000

103
Q

expected RBC

A

4.8-7.1

104
Q

bilirubin at 24 hrs

A

2-6

105
Q

bilirubin at 48 hrs

A

6-7

106
Q

bilirubin at 3-5 days

A

4-6

107
Q

hypocalcemia

A

below 7.8 in term
below 7 in preterm
risk factors: GDM moms, critically ill babies
signs: jitters, irritable, periods of apnea

108
Q

moro reflex

A

startle reflex
“drop” patient, they will symmetrically extend and abduct the arms

109
Q

plantar reflex

A

place finger at base of toes, will curl toes downward

110
Q

babinski reflex

A

stroke outer edge of foot moving up towards toes, toes will fan upward and out

111
Q

stepping reflex

A

hold the newborn upright with feet touching flat surface, the newborn will make stepping motions

112
Q

palmar grasp

A

place a finger in the palm, the newborn’s fingers will curl

113
Q

rooting reflex

A

stroke the cheek and the newborn will turn head toward the side that is touched

114
Q

fungal infections

A

thrush (in mouth)
diaper dermatitis/candidiasis

115
Q

bacterial infections

A

e coli
staph aureus
chlamydia

116
Q

perinatal hypoxia

A

baby is deprived of oxygen during labor
(cord around neck, not enough perfusion to placenta)

117
Q

ESC

A

eat
sleep
console

118
Q
A

Women and Neonatal Health (7 decks)

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