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RNC-OB > Newborn > Flashcards

Newborn Flashcards

1
Q

How does a neonate switch from fetal to neonatal circulation?

A

Alveoli fill with air, begin gas exchange
This causes umbilical vessels to constrict

Closing of ductus venosus, ductus arteriosis, and for amen ovale

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2
Q

Breastfeeding should be initiated in first ___ minutes of life

A

30-60

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3
Q

What is used to assess gestational age of a newborn?

A

Ballard tool- assesses neuromuscular and physical maturity

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4
Q

When is an infant considered SGA or LGA?

A

90th percentile for weight

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5
Q

What is a normal newborn respiratory rate?

A

30-60, rhythmic

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6
Q

What should a newborn heart rate be after birth?

A

At least 100bpm

Once stabilizes, 120-160

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7
Q

Where is the PMI on a newborn?

A

3rd-4th intercostal space, left of midclavicular line

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8
Q

What causes transient neonatal heart murmurs?

A

Incomplete closure of ductus arteriosis or foramen ovale

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9
Q

What happens with neonatal glucose levels after birth?

A

Switches from exogenous supply of glucose to endogenous glucose

Falls over first couple hours, stabilizes at 40, rises to 50-80 by 3 hrs

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10
Q

What is neonatal polycythemia?

A

Fetuses produce more RBC’s than neonates.
More pronounced in IUFGR, SGA, LGA, or chronic hypoxia

Polycythemia is hct >65%

Symptoms related to high blood viscosity
Impairs capillary bed perfusion

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11
Q

How is bilirubin excreted?

A

Unconjugated bilirubin (lipid soluble) is transported to liver and converted to conjugated bilirubin (water soluble)

It is then excreted to small intestine and removed by passage of stool

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12
Q

What are the two types of hyperbilirubinemia?

A

Physiological (immature liver can’t keep up)

Pathologic- levels rise quickly

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13
Q

What is kernicterus?

A

Dangerously high levels of bilirubin causing staining of brain and mass destruction of neurons by apoptosis and necrosis

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14
Q

What is respiratory distress syndrome ?

A

Not enough surfactant to keep alveoli open

Causes atelectasis, hypoxemia, hypercapnia, acidosis, pulmonary vasoconstriction, alveolar damage, and alveolar and interstitial edema

Can give synthetic surfactant
Usually need mechanical ventilation or CPAP

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15
Q

What does meconium aspiration syndrome cause?

A

Chemical and infectious pneumonitis

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16
Q

What is transient tachypnea of the newborn?

A

Fetal lung fluid not reabsorbed

Usually resolves 12-72 hours

17
Q

What is a normal temperature for neonates?

A

97.7-99.2

18
Q

What happens at 96.8-97.6 degrees?

A 
Cold stress
Non shivering thermogenesis
Brown fat metabolism
Uses oxygen and glucose
Can lead to hypoxia and hypoglycemia
19
Q

What are the four methods of heat loss?

A

Evaporation- wet skin
Convection- from body to air
Conduction- from body to solid surface
Radiation- heat transfer between objects not touching

20
Q

What can a GBS infection cause?

A

Mental retardation, developmental disabilities, deafness, blindness

21
Q

Early onset GBS can occur ___ while late onset GBS occurs ___. Symptoms include ___

A

First 24 hrs
As late as 7 days
Pneumonia, bacteremia, meningitis, resp distress, apnea, lethargy, hypotonia, pallor, hypotension, tachycardia, temperature instability

22
Q

What are the neonatal reflexes?

A 
Extrusion- tip of tongue sticks out
Moro- lift head, let fall, extend/abduct, flex/adduct
Palmar grasp- grabs finger
Rooting and suckling
Startle- abduct/flex
23
Q

How many kcals does a newborn need a day?

A

100-110kcals/kg/day

24
Q

What is normal weight loss?

A

Up to 10% in first four days

25
Q

What is the difference between caput succedaneum and ceohalohematoma?

A

Caput crosses suture lines

26
Q

Why is antibiotic eye ointment given?

A

Reduce opthalmia neonatorum caused by gonorrhea and chlamydia

27
Q

What do infants of a hepB positive mom get?

A

HBIG AND hepB vaccine

28
Q

What complications are increased with late preterm infants (34 0/7-36 6/7)?

A

Respiratory distress, temperature instability, hypoglycemia, feeding difficulties, jaundice, apnea

29
Q

When should late preterm babies have a follow up visit?

A

48-72 hours after discharge

30
Q

What are withdrawal symptoms of a NAS baby?

A

Feeding problems, irritability, tremulousness, sweating, nasal stuffiness, diarrhea, vomiting, seizures

31
Q

How long should a NAS baby be monitored in the NICU?

A

At least 7 days

32
Q

What are the three major tasks newborns must do to transition to the extrauterine environment?

A

Cardiopulmonary transition
Thermoregulation
Assimilation of calories, water, electrolytes

RNC-OB (9 decks)

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