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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
if mom is hep B +
give HBIG and hepatitis B vaccine within 12 hours of birth
26
neonatal abstinence syndrome (NAS)
neonatal substance withdrawal high pitched shrill cry, inconsolable tremors, convulsions fever tachypnea irritability poor feeding constant sucking increased muscle tone
27
treating NAS
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
28
alcohol use
no alcohol is safe can lead to.. cranial facial anomalies microcephaly FASD
29
cocaine baby
no withdrawal symptoms risk for emergency placental abruption has neurotoxic effects
30
Finnegan Neonatal Abstinence Syndrome scale
Q3 hours
31
hypoglycemia
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
32
risk factors for hypoglycemia
mom w GDM or diabetes preterm late term
33
treating hypoglycemia
early breastfeeding formula supplementation dextrose gel buccally
34
macrosomia infant
LGA , 4000g+, 90th percentile risk factors: GDM, postmature infant (after 42wks), maternal obesity, genetics
35
complications of macrosomic infant
birth trauma shoulder .. respiratory distress hypoglycemia (body expects sugar from mom so metabolically uses energy without actually having it)
36
sepsis neonatorum
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
37
APGAR
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
38
A in APGAR
Activity flaccid=0 some flexion=1 well flexed/active=2
39
P in APGAR
Pulse less than 50= 0 less than 100= 1 100+=2
40
G in APGAR
Grimace/reflex irritability none= 0 moans and wiggles=1 crying=1
41
2nd A in APGAR
Appearance whole body blue=0 acrocyanosis= 1 whole body pink=2
42
R in APGAR
Respiration none=0 slow weak cry=1 strong cry=2
43
expected temp
97.8 - 99.6 36.5 - 37.5
44
expected pulse
100-160 bpm
45
expected respirations
30-60 apnea less than 15 sec is ok
46
expected blood pressure
65-90 / 45-65
47
MAP
should be near the weeks of gestation diastolic + 1/3(systolic-diastolic)
48
New Ballard Scale
determines if pre or fully mature neuromuscular assessment physical maturity assessment
49
square window
flex wrist towards arm 0 degree=good 90 degree=premature
50
types of heat loss
conduction convection evaporation radiation
51
conduction
heat loss through direct contact with a cooler surface
52
convection
heat loss through cooler air
53
evaporation
heat loss when surface liquid is turned into vapor
54
radiation
heat loss from proximity (keep away from cold window)
55
normal weight range
2500-4000g 5 lbs 8 oz- 8lbs 13oz
56
normal length
44-55 cm 18-22 inches
57
normal head circumference
13-15 inches at birth, head circumference is 2-3cm larger than chest
58
normal chest circumference
12-13 inches chest and head do not equal out until 12 mo
59
1st period of reactivity
up to 30 min after birth pulse 160-180 will hear fine crackles
60
btw 1st and 2nd periods of reactivity
60-100 min of decreased responsiveness, decreased motor activity, or sleeping
61
2nd period of reactivity
2-8 hrs after birth tachycardia tachypnea increased muscle tone improved skin color meconium passes (need to poop within 24hrs)
62
signs of respiratory distress
nasal flaring intercostal or subcostal retractions circumoral cyanosis central cyanosis grunting
63
blood volume
84mL/kg can reach 100mL/kg if delay cord clamping
64
delay cord clamping
waiting until there is no pulse in the cord increases blood volume gives 6 mo of iron stores instead of 4 mo
65
murmurs
OK in first couple hours NEVER ok when accompanying unstable vitals or symptoms
66
aligohydramnios
low amniotic fluid a sign of renal issues places at risk for birth trauma
67
infant urination
should pee within 24 hrs rectal temp stimulation put feet in warm water will be a rust color
68
wet diaper expectations
1 wet diaper in 24hrs 2 wet diapers in 2nd 24hrs day 4= 6 wet diapers/day
69
early signs of hunger
rooting sucking/smacking lips crying is a LATE sign
70
normal blood glucose
40-45, LOVE 50
71
hypoglycemia
below 40 must intervene oral glucose gel swaddle feed baby
72
risk factors for hypoglycemia
premature infants high stress (hypothermia) GDM LGA babies SGA babies
73
LGA
90th+ percentile BS checks for 12 hrs
74
SGA
10th or less percentile BS checks for 20 hrs
75
babies born to GDM
BS checks for 12 hrs baby is used to producing insulin in utero, pancreas will continue to do so outside
76
preterm
born before completion of 37weeks
77
late preterm
34 weeks - 36 weeks 6days
78
early term
37 weeks - 38 weeks 6 days
79
full term
39 weeks - 40 weeks 6 days
80
late term
41 weeks 0 days - 6 days
81
postterm
42 weeks and beyond
82
pathologic jaundice
within 24 hours NOT normal
83
physiologic jaundice
bilirubin increases then plateus at 96 hrs normal
84
breast milk jaundice
lack of effective breastfeeding direct bilirubin is stable encourage breastfeeding
85
phototherapy
breaks up bilirubin bilirubin excreted in pee and poop ensure eye protection
86
pseudomenses
small amount of blood excreted in female neonates caused by extra estrogen from mom
87
epispadis
urethral opening at upper edge of penis stop circ
88
hypospadias
urethal opening of penis is at lower edge stop circ
89
hydrocele
extra fluid in testicles will resolve in 24 hrs
90
swollen breast tissue
caused by hyperestrogenism
91
ambiguous genitalia
appear as one gender but are another
92
oligodactyly
missing a digit
93
polydactyly
more than 10 digits
94
syndactyly
webbed or fused digits
95
estimated date of confinement
due date
96
gravita
how many times a patient has been pregnant
97
para
#1 - term deliveries #2 - preterm deliveries #3 - abortions #4 - # of living children
98
vision
can track by 3 mo
99
hearing
screen around 24 hrs amniotic fluid will come out
100
expected hemoglobin
14-24
101
expected PLT
150,000-300,000
102
expected WBC
9,000-30,000
103
expected RBC
4.8-7.1
104
bilirubin at 24 hrs
2-6
105
bilirubin at 48 hrs
6-7
106
bilirubin at 3-5 days
4-6
107
hypocalcemia
below 7.8 in term below 7 in preterm risk factors: GDM moms, critically ill babies signs: jitters, irritable, periods of apnea
108
moro reflex
startle reflex "drop" patient, they will symmetrically extend and abduct the arms
109
plantar reflex
place finger at base of toes, will curl toes downward
110
babinski reflex
stroke outer edge of foot moving up towards toes, toes will fan upward and out
111
stepping reflex
hold the newborn upright with feet touching flat surface, the newborn will make stepping motions
112
palmar grasp
place a finger in the palm, the newborn's fingers will curl
113
rooting reflex
stroke the cheek and the newborn will turn head toward the side that is touched
114
fungal infections
thrush (in mouth) diaper dermatitis/candidiasis
115
bacterial infections
e coli staph aureus chlamydia
116
perinatal hypoxia
baby is deprived of oxygen during labor (cord around neck, not enough perfusion to placenta)
117
ESC
eat sleep console
118

Women and Neonatal Health (7 decks)

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