Newborn Flashcards
How does a neonate switch from fetal to neonatal circulation?
Alveoli fill with air, begin gas exchange
This causes umbilical vessels to constrict
Closing of ductus venosus, ductus arteriosis, and for amen ovale
Breastfeeding should be initiated in first ___ minutes of life
30-60
What is used to assess gestational age of a newborn?
Ballard tool- assesses neuromuscular and physical maturity
When is an infant considered SGA or LGA?
90th percentile for weight
What is a normal newborn respiratory rate?
30-60, rhythmic
What should a newborn heart rate be after birth?
At least 100bpm
Once stabilizes, 120-160
Where is the PMI on a newborn?
3rd-4th intercostal space, left of midclavicular line
What causes transient neonatal heart murmurs?
Incomplete closure of ductus arteriosis or foramen ovale
What happens with neonatal glucose levels after birth?
Switches from exogenous supply of glucose to endogenous glucose
Falls over first couple hours, stabilizes at 40, rises to 50-80 by 3 hrs
What is neonatal polycythemia?
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
How is bilirubin excreted?
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
What are the two types of hyperbilirubinemia?
Physiological (immature liver can’t keep up)
Pathologic- levels rise quickly
What is kernicterus?
Dangerously high levels of bilirubin causing staining of brain and mass destruction of neurons by apoptosis and necrosis
What is respiratory distress syndrome ?
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
What does meconium aspiration syndrome cause?
Chemical and infectious pneumonitis
What is transient tachypnea of the newborn?
Fetal lung fluid not reabsorbed
Usually resolves 12-72 hours
What is a normal temperature for neonates?
97.7-99.2
What happens at 96.8-97.6 degrees?
Cold stress Non shivering thermogenesis Brown fat metabolism Uses oxygen and glucose Can lead to hypoxia and hypoglycemia
What are the four methods of heat loss?
Evaporation- wet skin
Convection- from body to air
Conduction- from body to solid surface
Radiation- heat transfer between objects not touching
What can a GBS infection cause?
Mental retardation, developmental disabilities, deafness, blindness
Early onset GBS can occur ___ while late onset GBS occurs ___. Symptoms include ___
First 24 hrs
As late as 7 days
Pneumonia, bacteremia, meningitis, resp distress, apnea, lethargy, hypotonia, pallor, hypotension, tachycardia, temperature instability
What are the neonatal reflexes?
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
How many kcals does a newborn need a day?
100-110kcals/kg/day
What is normal weight loss?
Up to 10% in first four days
What is the difference between caput succedaneum and ceohalohematoma?
Caput crosses suture lines
Why is antibiotic eye ointment given?
Reduce opthalmia neonatorum caused by gonorrhea and chlamydia
What do infants of a hepB positive mom get?
HBIG AND hepB vaccine
What complications are increased with late preterm infants (34 0/7-36 6/7)?
Respiratory distress, temperature instability, hypoglycemia, feeding difficulties, jaundice, apnea
When should late preterm babies have a follow up visit?
48-72 hours after discharge
What are withdrawal symptoms of a NAS baby?
Feeding problems, irritability, tremulousness, sweating, nasal stuffiness, diarrhea, vomiting, seizures
How long should a NAS baby be monitored in the NICU?
At least 7 days
What are the three major tasks newborns must do to transition to the extrauterine environment?
Cardiopulmonary transition
Thermoregulation
Assimilation of calories, water, electrolytes
