newborn

Question 1

Preparation & positioning

Answer 1

• timing (1-2 hr after being to fed not to drowsy or hungry)
• warm & comfy
• approach (eye contact. warm hands & stethoscope, smooth movement, soft voice
• clean
• PPE
• encourage parent presence

Question 2

Sequence

Answer 2

• least distressing to more invasive
• may need to reorder
• its great if they sleep @ first
• moro last

Question 3

APGAR

Answer 3

1 & 5 mins

• immediate response to extrauterine life
• breathing, hr, muscle tone, reflex colour
• hi score = less intervention

Question 4

Warm & comfy environment

Answer 4

1) overhead radiant warm
2) supine on a padded examination table or parent/ gaurdiance chest
3) good lighting is important

Question 5

what is best to do while they sleep

Answer 5

listen to heart, lung, abdominal sounds

Question 6

what vitals do you take

Answer 6

pulse, resp & temp

Question 7

Normal variations:

Answer 7

• Full min assess of pulse & resp. (b/c irregularities)
• Bp could be taken but not as accurate especially while crying
• it would be 85/55
• pulse speeds up & slows down with respirators
• apical pulse = forth intercostal mid clavical
• 120-160bmp (slower @ sleep, faster @ cry)

Question 8

how to take temp & when will it stabilize

Answer 8

-Axillary for screening

36-37.5 degress will stabilize 24hr after birth

Question 9

average weight , head & length

Answer 9

3400g, 50cm, heard circumference 35cm.

Up to 10% lost in few days

Question 10

General survey

Answer 10

• Body symmetry
• spontaneous position
• flexion
• movment
• skin color
• deformities
• facial features
• alerness
• strong cry

Question 11

Normal findings

Answer 11

• Lanugo
• Cyanosis of hand & feet
• sort, protuberant abdomen
• skin color variations according to genetic & racial heritage
• moulding will return to normal in a few days
• palpable sutures (diamond anterior, triangle posterior)
• reflexes (Sucking, rooting, grasping, yawn, cough, sneeze,hickup,blink, startle)
• sporadic by symmetrical movement
• ability to fixate on object 20-25cm from face
• crying
• quiet but alert for first hour
• could sleep continuously for 2-3 days

Question 12

What is hyperbillirubinemia

Answer 12

excessive bilirubin accumulates in blood b/c infant immature liver cannot balance the destruction of RBC with the use or excretion of byproducts, can be toxic
-phototherapy

Question 13

what kind of screening

Answer 13

• blood tests to see inborn errors in metabolism (rare but serious)
• cystic fibrosis & hemophilia

Question 14

Sequence

Answer 14

1) chest & heart
2) abdomen
3) face & head
4) eyes
5) nose
6) mouth & throat
7) neck
8) upper extremities - lower
9) genetalia
10) neruomuscular
11) spine & rectum
12) moro & otoscope

Question 15

primary task of newborn

Answer 15

stabilize organ systems

Question 16

in the first few hours after being born should be done

Answer 16

• height & weight
• head circ
• temp puse rr
• gen appearance
• body function
• sensory capacity
• reflex & response

Question 17

AVERAGESSS

Answer 17

Weight: 3400
Lenght: 50 
head: 35 
Pulse: 120-160
BP: 85/55
Temp: 36-37.5
RR: 30-60

Question 18

1st month gain

Answer 18

+200-450g weekly
0.5-2.5cm weekly length
2cm weekly head

Question 19

cyanosis should be gone by

Answer 19

24 hr

Question 20

hyperbillirubinea balance can be further upset by

Answer 20

• premature
• not enough milk
• excessive production
• disease
• liver disturbance

Question 21

what is inborn errors or metabolism

Answer 21

term for absence or deficiency

can detect Phenylketonuria, hypothermic, galactosemia (to prevent disability)

Question 22

circumcision

Answer 22

not recomenented
risk: hemorrhage, infection, adhesion, mental stenosis
benefit: prevent cancer, prevent UTI, body image
check freq: swell, ooze, bleed, can’t void