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joy's deck for FNP > newborn > Flashcards

newborn Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

down’s syndrome

s/s and parent education

A

palpebral fissures ( upward slant eyes), macroglossia ( enlarged tongue, chronic open mouth), simian crease (transverse palmar cease), 50% change heart defects, early alzheimers, visual problems, low set ears

education:AVOID trampoline (esp

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2
Q

fetal alcohol syndrome s/s

A

microcephaly, shortened palpebral fissures (narrow eyes), flat nasal bridge, underdeveloped ears, smooth philtrum.

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3
Q

cryptochidism (undescended testes)

how to assess

A

empty scrotal sac.
infant sitting, warm to relax muscle, massage inguinal canal. Or exam after warm bath

increase risk of TESTICULAR CANCER if testes are not removed from the abdomen.
if does not descend after 1 year, surgical orchiopexy.

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4
Q

gonococcal ophthalmia neonatorum
s/s
tests
tx

A

2-4 days post birth
can cause blindness!- DON”T DELAY TX
s/s: red conjuntiva, discharge

tests: gonococcal Thayer Martin, herpes simplex culture, chlamydial PCR, gram stain of eye exudate.

hospital and tx with IV or IM ceftriaxone.

prophalaxis topical .5% erythromycin ointment ( 1cm rib be per eye)

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5
Q

chlamydial opthalmia neonatorum (Trachoma)
s/s
tests
tx

A

4-10 days after birth.

s/s: edematous eyelids, watery/purulant eyes

tests: sample of exudate and conjuntival cells
tx: systemic antibiotics, macrobid IM, tx only 80% effective and may need 2nd course. (i.e. azithromycin, erythromycin).

REPORTABLE DISEASE.

treat mom and sexual partner

** rule out chlamydial pneumonia with nasopharyngeal culture

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6
Q

chlamydial pneumonia

A

test with nasopharyngeal culture.
cough, rales, tachypnea, hyperinflation, diffused infiltrates on xray.

tx: erythromycin, DAILY follow up.

REPORTABLE DISEASE

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7
Q

SIDS

A

risk with premature/low birth weight, maternal smoking/drugs, poverty
cause unknown

only back sleeping and avoid “overheating” baby

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8
Q

weight loss >7%

A

weight loss should be regained 10-14 days. loss >7% abnormal assess for dehydration/lactation

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9
Q

when does mongolian spot fade

A

2-3 yrs

most common pigmented spots on babies

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10
Q

erythema toxicum

A

whitish/yellow pustules
erupts during the 2nd/3rd day.
resolves spontaniously 1-2 wks

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11
Q

faun tail nevus

A

hair at lumbosacral area, ultrasound of the lesion to r/o spin bifida

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12
Q

cafe au lait spots, when to rule out?

A

if >6 spots >5mm (.5cm), rule out neurofibromatosis or von recklinghausen’s disease (neuro disorder marked by sz, learning disorder).

refer to neurologist!

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13
Q

port wine stain (nevus flammeus) when to r/o?

A

on the v1 and v2 branch of trigemenal nerve
refer ophthalmologist to r/o glaucoma.
blanches to pressure, irregular size
if half of face may be sign of trigemenal nerve involvement and STURGE-WEBER syndrome (neuro disorder). tx with pulse dye laser

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14
Q

if port wine stain more than half of the face, what is the sign of

A

trigemimenal nerve/sturge weber

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15
Q

newborn vision

A

newborns are nearsighted (myopia)

normal: 30/400

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16
Q

amblyopia

A

lazy eye, correct early

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17
Q

esotropia

A

misalignment of eyes (“cross eyed”)

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18
Q

when to refer (eyes)

A

abnormal red reflex ( r/o retinoblastoma, cataract, glaucoma)
white reflex (r/o retinoblastoma)
strabismus ( r/o CN 3, 4, 6 abnormalities)
**vision 20/30 or worse in child >6yo
** > to line difference between each eye
new onset of strabismus

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19
Q

red reflex

A

to test for cataracts and retinoblastoma

red reflex showing a white colored pupil- congenital cataract

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20
Q

retinoblastoma

A

An eye cancer that begins in the back of the eye (retina), most commonly in children.

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21
Q

auditory test newborn

A

test for CN 8 (acoustic) by use of “click” stimuli

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22
Q

risk for hearing loss

“HEARS”

A

hyperbilirubinemia, ear infection, apgar score low, rubella, cmv, toxoplasmosis, seizures

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23
Q

PKU

A

phenylketonuria.
mental retardation if not treated early
inability to metabolize phenylalanine to tyrosine because of the defect if phenylalaline hydrosylase.

Test ONLY after 48 hours, treated by following PKU free diet.

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24
Q

laboratory tests

A

PKU, TSH, sickle cell, h/h, lead

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25
Q

H/H

A

tests at 9-12 months.

newborns have Hemoglobin F/A. The have iron stores to last 6 months due to maternal RBC

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26
Q

lead screening

A

1-2 years for high risk children

27
Q

how much Vit D supplement

A

minimum of 200IU if not more

28
Q

how much calories in Breast milk or formula

A

20kcal/oz

29
Q

cow’s milk

A

avoid 1st yer

common cause of iron def anemia in babies

30
Q

when is meconium passed

A

1st 24 hours after birth

31
Q

caput succedaneum

A

diffused edema crosses midline, normal dt labor and resolved spontaniously

32
Q

cephalohematoma

A

does NOT cross midline or suture lines, r/o skull fracture

33
Q

birth weight

A

loses 7%, regains in 1-2 wks. double weight by 6 months triple by 1 year.

34
Q

when to measure head circumference

A

at each wellness visit until 3 years old

chest is 1-2cm less than head circumference

35
Q

when does baby have ALL their teeth

A

2.5 years old

36
Q

first permanent teeth

A

6 years old

37
Q

hypospadias

A

A condition in which the opening of the penis is on the underside rather than the tip.

refer

38
Q

anal wink

A

look for contraction of perianal muscle. If not present, risk of spina bifida

39
Q

when does morro reflex disappear

A

3-4 months
if NOT present, rule out spinal cord/brain lesion
if one side, r/o shoulder dystocia/fracture

40
Q

when does stepping reflex disappear

A

6 wks

41
Q

tonic neck reflex

A

(fencing reflex) neck turned on one side will cause limbs on same side to extend,opposite flex

42
Q

if moro reflex strong on infant OLDER than 6 months..

A

indicative of brain damage

43
Q

MMR

A

2 doses
given AFTER 12 months, then 4-6 years
live attenuated virus vaccine

44
Q

avoid aspirin to children less than 1 year old

A

avoid salicylates 6 wks ( reyes syndrome), no aspirin products (pep to, alka seltzer, kaopectate)

45
Q

influenza

A

do NOT give before 6 months

flu mist: age 2-49 yo healthy and non pregnant

46
Q

DTAP

A

use for 7 years or younger ( if older use, TDAP)

47
Q

age 12-15 months, which vaccines are completed

A 
hep B
hib (hemophilus type b
pcv
rv
 dtap
 mmr
varicella
ipv (inactived polio)
48
Q

ONLy vaccine at birth

A

hepatitis B

49
Q

which vaccines NOT to give before 12 months

A

varicella, MMR ( live vaccine)

50
Q

if hbsaG positive mother, what to give neonate

A

give hbig and hep b

51
Q

when to give tdap booster

A

11-12 yo. if older than 12 replace one dose of TD with trap ( once in a lifetime)

52
Q

fine motor, can feed self with spoon, drink from a cup

knows 4-6 words

A

15 months

53
Q

can walk up steps, turns pages of book, point to 4 body parts, knows 10-20 words

A

18 months

54
Q

rear facing

A

birth -2 yo

55
Q

when to put child in back seat

A

until 13 yo

56
Q

school age seat

A

booster seats, until child reaches 4 feet, 9 inches or is 8-12 yo.

57
Q

physiologic jaundice

A

5mg/dl or higher

elevation of bilirubin due to increased breakdown of fetal RBC.

58
Q

kernicterus

A

neuro disorder caused by high levels of bilirubin in infant

associated with mental retardation

59
Q

physiologic anemia of infancy

A

hemoglobin drops at losel level at 2 months

temporary decrease in erythropoietin production by kidneys, which prompts gown marrow to product more.

60
Q

infant colic rule of 3

A

last 3 hours or more during the day
under 3 months
occurs more than 3 days/week

61
Q

coarctation of the aorta

A

congenital narrowing of portion of the heart. compare radial and femoral pulses simultaneously (bp @ arms vs legs).

if abnormal order keg, echo, chest x ray

62
Q

neonates screening pulse

A

compare femoral and brachial pulse (wrist)

normal findings in older infant: systolic BP higher in legs than arms

63
Q

barlow versus ortolani

A

barlow- push both knees together at midline downwards

ortalani- abduct/adduct frog leg position

joy's deck for FNP (24 decks)

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