Newborn Flashcards
During adjustment to extrauterine life, it is the most critical adaptation
Initiation of respiration
What are the three factors that stimulate breathing?
Chemical, Thermal, and Tactile Factors
What causes fetal lung fluid removal
compression of the chest when passing through the birth canal
It keeps the alveoli expanded
Surfactant
What are the three different ways to establish the ABC also known as Airway, breathing and circulation
Suctioning with proper positioning, Institute standard precautions and cardiopulmonary adaptation
What is the correct way to position a newborn to facilitate airway and breathing?
Side-lying or modified Trendelenburg
What is the correct order of suctioning
Mouth then nose
After initiation of respiration, this process is also critical to the newborn’s survival.
Thermoregulation
What are the principal thermogenic sources?
Heart , Liver, Brain and Brown adipose tissue
Involves the loss of heat when liquid is converted to a vapor.
Evaporation
Involves the loss of body heat to cooler objects which come in direct contact with the baby’s skin.
Conduction
Involves loss of infant’s body heat to cooler solid objects that are not directly in contact with him.
Radiation
Involves the flow of heat from the surface to the cooler surrounding air to air circulating over the body surface
Convection
What principle of heat transfer is involve when weighing a newborn
Conduction
Principle of heat transfer when a baby is inside the room
Radiation
The principle of heat transfer used in an incubator with humidification
Convection
Large body surface area results in loss of heat to the environment. TRUE OR FALSE
TRUE
Newborn’s thin layer of adipose tissue is a good insulator. TRUE or FALSE
FALSE
Newborns cannot shiver to increase the heat production. TRUE OR FALSE
TRUE
Arrange the following in order:
1. Dry the infant completely for at least 30 seconds and remove the wet cloth.
2. Wrap the newborn immediately and place it under a droplight/radiant warmer.
3. Check temperature
4. Provide warmth (Early skin to skin contact) including Newborn via Caesarian section, place cap)
2,1,4,3
It is a care that every newborn baby needs regardless of where it is born or its size.
Essential Newborn Care/ Unang Yakap
What are the 4 Core Steps of ENC
Immediate drying, skin-to-skin contact, proper cord clamping & cutting, nonseparation of newborn and mother
It prevents hypothermia
Immediate thorough drying and early skin-to-skin contact
Why is it important to wait for the cord pulsation to stop before cutting?
Prevents anemia and protects against brain hemorrhage in premature newborn
What practices should not be done to a newborn anymore?
- routine suctioning
- putting a newborn on a cold or wet surface
- removing vernix caseosa
- Foot printing
- bathing earlier than 6 hours of life
- unnecessary separation of the newborn and the mother
Who developed APGAR in 1952, which became a standard tool in assessing newborn babies?
Virginia Apgar
It is a quick, overall assessment of newborn well-being, a measure of the physical condition of a newborn infant.
APGAR
What is the meaning of APGAR?
Activity
Pulse
Grimace
Appearance
Respiration
Apgar score for a blue or pale appearance
0
Blue extremities and pink body
1
Pink all over
2
Absent pulse or heart rate
0
> 100 betas per minute
2
< 100 beats per minute
1
No response to stimulation
0
Grimace when stimulated
1
Strong cry or sneezes when stimulated
2
Limp, flaccid
0
Some flexion of extremities
1
Well flexed
2
Absent respiratory effort
0
Weak cry/ irregular, slow
1
Good/ Strong or lusty Cry
2
It is normal for a newborn to have acrocyanosis for the first 15 to 30 minutes after birth? True or false
True
Around what time does the color of the baby stabilizes after delivery?
30 minutes to 2 hours
Around 2-6 hours after delivery, what happens to the color of the baby?
Quick color changes occur with movement or crying
During the 1st period, what is the usual activity of the baby
Alert: Watching
After 30 min. to 2 hours, what is the usual activity of the baby?
Sleeping
During the 3nd period (2-6) hours, what is the usual activity of the baby?
Awakening
In terms of the ability to respond to stimuli, what happens during the 1st period after birth?
Vigorous reaction
During the sleep period or 30 min. to 2 hours after birth, what happens to the baby’s ability to respond to stimuli?
Difficult to arouse
In terms of ability to respond to stimuli, what happens during the 2nd period (2-6) hours after birth?
Becomes responsive again
During this period, there is a small amount of mucus while sleeping.
Sleep period
During this period mucus is visible in the mouth?
1st period
During this period, the mouth is full of mucus, causing gagging
2nd period
Bowel sounds can be heard after how many minutes after birth?
15
During this period there is often passage of the first meconium stain.
2nd period
< 34 weeks
premature
34 - 37 weeks
late pre term
37 - 38 weeks
early term
39 - 40 weeks
full term
41 - 42 weeks
late term
> 42 weeks
post term/ postmature
Synchronize upper chest retractions
0
lag on inspiration
1
see-saw movement
2
expiratory grunting can be observed by stethoscope only.
1
What are the parameters involved in Silverman Anderson Score?
Upper Chest Retractions
Lower Chest Retractions
Xiphoid Retractions
Nasal Flaring
Expiratory Grunting
Parameters involved to determine period of reactivity?
Color
Activity
Ability to respond to stimuli
Mucus
Bowel Sounds
What are the general measurements considered for Newborns?
Head circumference
Chest circumference
Abdominal circumference
Length
Body Weight
What is considered low birth weight regardless of AOG (Age of Gestation)?
2 500 grams
What percent of a baby’s body weight is made of water?
70 - 75 percent
What is the normal measurement of the head
34-35 cm
What is the usual chest circumference?
30 -33 cm (12-13 inches)
should be equal or < 2 cm than HC
Abdominal circumference
32 - 33 cm.
When is the ideal time to identify a baby’s gender?
After delivery
When is the right time to care for the umbilical cord/stump?
Every after-diaper change
What eye prophylaxis drugs are used to prevent conjunctivitis?
Erythromycin and Tetracycline
It facilitates the production of clotting factors?
Vitamin K
What are examples of vitamin K injection
AquaMEPHYTON and phytonadione
What is the dosage, route and site of administration for Vitamin K?
0.5 - 1.0mg IM at the thigh or vastus lateralis muscle
When is the 2nd dose of Hepatitis B Vaccination administered?
1 month
When is the 3rd dose of Hepatitis B administered
6 months
What is the common posture of Newborn?
Flexion
What does it mean when the baby is turning dark red
plethora; polycythemic
Central cyanosis
decrease 02
Gray Color
infection
Pale color/Pallor
Anemia
Yellow Color
Jaundice
It is the bluish discoloration of palms, hands and soles of feet?
Acrocyanosis
What causes Acrocyanosis?
immature peripheral circulation
exacerbated by cold temperature
Acrocyanosis is normal with the 1st how many hours?
24 hours
This type of jaundice appears after the first 24 or 48 hours and disappears by the 2nd week?
Physiologic Jaundice
This type of Jaundice appears within the 1st 24 hours which may indicate early hemolysis of RBC and underlying disease process?
Pathologic Jaundice
Clear line of demarcation between an area of redness and an area of normal coloration.
Harlequin Sign
Is greasy white substance that covers the skin until 38th week of gestation
Vernix Caseosa
Fine downy hair on shoulders, upper arms, back (-) 2 weeks
Lanugo
Peeling of skin at birth/postmaturity
Desquamation
seen at birth; red to purple color; does not blanch on pressure nor disappear
Portwine stain/nevus flammeus
Pink or red flat area of capillary dilatation, seen at upper eyelids, nose, lower, occiput bone, nape and neck
Stork bites or telangiectasia nevi
2nd most common type of capillary hemangioma. Elevated, sharply demarcated or bright or dark red, rough surface swelling
Strawberry Mark or Nevus Vascularis
Are dark blue or purple bruise-like macular spots usually located over the sacrum and buttocks.
Mongolian spot
Transient newborn rash with numerous small areas of red skin with a yellow-white papule in the center, at the nape, back, and buttocks
Erythema toxicum
Unopened sebaceous glands usually found at the tip of nose and chin of the baby?
Milia
During the newborn stage it is the largest part of the human body which accounts to a total of 1/4 body length
Head
This type of fontanelle is diamond shape
Anterior
This type of fontanelle is triangular in shape
Posterior
It is the premature closure of one or more suture lines
Craniosynostosis
Localized softening of cranial bones/skull
Craniotabes
Overlapping of sagittal and coronal suture line.
Molding
Small round glistening cysts; palate and gums.
Epstein’s Pearls
During the newborn stage, the size of the anteroposterior and lateral chest diameters are equal. True or False.
True
May be present which is a thin, watery fluid also due to maternal hormones
Witch’s milk
If the abdomen is scaphoid, what does it imply?
Diaphragmatic hernia
When should the first voiding occur?
For the first 24 hours
What is the specific gravity of urine of the newborn?
1.008 to 1.010
What is the daily urine output for the 1st and 2nd day?
30 - 60 mL
What is the daily urine output by week 1?
300ml
Extra digits
Polydactyly
Fused or webbed
syndactyly
absence of the distal part of extremity
hemimelia
A single palmar crease are signs of DOWN syndrome.
Simian Crease
A birth deformity in which the front portion of the foot is deformed and turned inward. It can be benefited greatly by surgery.
Clubfoot
It is the rapid eyelid closure when strong light is shone. Tap gently over the forehead and the eyes will blink
Blink reflex
Cheek is brushed or stroked near the corner of the mouth, a newborn turn the head on that direction. (-) by 6 weeks of life.
Rooting Reflex
When newborn lips are touched the baby makes sucking motion. (-) about 6 months
sucking reflex
A substance that is placed on the anterior portion of the tongue is extruded. (-) 4 months
Extrusion reflexes
Food that reaches the posterior portion of the tongue is automatically swallowed
Swallowing reflexes
When the newborn lies on his back, the head usually turns to one side, arm and leg on that side extend and the opposite arm and leg contract.
Tonic-neck reflex
When the side of the sole of the foot is stroked in a inverted J, fanning of the toes will result.
babinski reflex
Place an object in the palm of infant’s hand and the infant will grasp the object.
Plamar grasp reflex
make an abrupt loud noise or by jarring the bassinet causes abduction of both arms and
curling of the fingers. Hold the infant in semi-sitting position, allow head and trunk to fall backward with support. (-) 4-5 mos.
Moro reflex
when an object touches the sole of a newborn’s foot at the base of the toes, the toes grasp in thesame manner as the finger do.
Plantar Reflex
newborn lies on prone position and is touched along the paravertebral area by probing finger, newborn flexes his trunk and swings the pelvis toward the touch. Usually apparent by 5-6 days.
trunk incurvation reflex
- if one leg of the newborn lying supine is extended and the sole of that foot is being rubbed, infant raises the other leg and extends it as if trying to push away the hand irritating the first leg.
crossed extension reflex
Newborn who is held in a vertical position with their feet touching a hard surface will take few alternating step or simulate walking. - Normally present for 3 to 4 weeks.
Stepping/walking reflex
Steps up when dorsum of foot is stimulated (-) 4 - 6 months
Placing Reflex
When prone, the newborn should demonstrate some muscle tone. A test of spinal cord integrity.
Landau Reflex
A simple procedure to find out congenital metabolic disorder in newborn
Newborn Screening
When is the newborn screening test ideally done
48th hour OR at least 24 hours
How many disorders can be detected by NBST
28 disorders
Results from lack/absence of thyroid hormone, low thyroid activity at birth
Congenital Hypothyroidism
Is a temporary deficiency of thyroid hormone that recovers in the first few days of life.
Transient CH
Is a persistent deficiency of thyroid hormone requiring lifelong replacement therapy.
Permanent CH
It is due to defects in the production of adrenal gland hormones
Congenital Adrenal Hyperplasia
Is a metabolic disorder in which the body cannot properly use an amino acid called phenylalanine
Phenylketonuria
Is a condition in which the body is unable to process galactose
Galactosemia
The body lacs enzyme called G6PD
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
is a genetic disease which there is a defeciency of an enzyme that converts amino acid homcysteine into cystathinonine.
Homocystinuria
What are the 6 common metabolic diseases?
- Congenital heart Diease
- Congenital Adrenal Hyperplasia
- Phenylketonuria
- Galactosemia
- G6PD deficiency
- Homocystinuria
In babies this very important genetic disorder becomes sickly shaped after they give up oxygen to the tissues. The sickly shape cells can become stuck in blood vessels causing pain and organ damage.
Sickle Cell disease
Is an inherited error involving the metabolism of the branch chain amino acids (Leucine, isoleucine and valine) that results in mental retardation and sometimes death.
Maple Syrup Urine Disease
Deficiency of the essential vitan B biotin.
Biotinidase Deficiency
- this is a genetic disorder in which there is deficiency
of an enzyme needed to convert fat to energy.
Medium chain acyl-CoA dehydrogenase
deficiency (MCAD)
- Is inherited disorder caused by absenceof a cell protein manufactured by the body
Cystic Fibrosis
-Absence of this protein causes the production of thick mucus and fluids that result in chronic respiratory and digestive problem and poor growth.
Cystic Fibrosis Transmembrane
Conductance Regulator(CFTR).
When should bathing be done for newborn
Before feeding and when temperature stabilizes
Where should you start when cleaning a newborn
From clean to dirty areas
What are the four feeding cues?
Rooting Reflex
Sucking Reflex
Extrusion Reflex
Swallowing Reflex
What are the 3 steps to execute burping technique
- shoulder hold
- sitting position
- laying prone across the lap
This type of feeding position permits eye contact, provides a sense of warmth and closeness, and provide security which is ideal for feeding.
Cradle Hold
What position is Ideal for feeding
Cross-Cradle Hold
Ideal for Burping
Upright Hold
Permits eye contact, ideal for shampooing, carrying or breastfeeding
Football hold
How many times should a mother breastfeed in a day
8-12 times a day
Sticky, greenish-black, odorless, sterile stool
Meconium
Greenish, loose, and often contains mucus which usually appears from 3 to 10 day
Transitional
Usually occur by the 4th day of life which can be voided about 2-6 times a day
Milky stool
What type of feeding method is given to a baby with a sweet odor, golden yellow or yellow-brown, and pasty, soft loose consistency stool passed about 2-3 times a day?
Breasfeed
Foul odor, pale yellow to light brown and formed/firmer in consistency usually passed 1-2 times a day?
Bottlefeed
What should be the proper sleeping position of newborns?
Supine not prone
Apart from Hepa B it is a vaccine given anytime after birth
Bacile Calmette-Guerin (BCG) vaccine
What are the different ways of infant stimulation?
- Prefers human face
- black and white objects
- human voice
- tactile stimulation
- concept of reciprocity
