Newborn Flashcards
A normal newborn respiratory rate is how many breaths per min?
30-60 breaths per minute
Absence of _____ causes the closure of the ductus venous.
Placental circulation
Increased pressure in the _____ causes the functional closure of the foramen ovale.
left atrium
Blood glucose in the neonate is lowest _____ hours after delivery and stabilizes at _____ hours.
1-5 hours and 3-4 hours
By 4-24hours of age, blood glucose levels should remain greater than or equal to _____ mg/dL.
45
Which maternal immunoglobulin crosses the placenta to provide passive immunity to baby to viruses that the mother has encountered?
IgG
What does the mnemonic APGAR stand for?
Activity, Pulse, Grimace, Appearance, Respirations
During the first 60 seconds of life also termed _____, the following five initial resuscitation steps are taken: ________.
“The Golden Minute”; provide warmth, position airway, clear secretions, dry infant, provide tactile stimulation
You should initiate resuscitation medications when HR is ____ after 45-60sec of coordinated chest compressions and PPV.
<60bpm
After the Golden Minute, if there are no respirations or HR is _____, initiate PPV within 30-60sec and monitor O2.
<100
If HR is less than ____ after 30sec of effective PPV then you should _____ and continue PPV as well as initiate chest compressions.
60bpm; intubate
After 30sec of effective PPV, if HR is _____, continue PPV without chest compressions.
60bpm
With meconium stained fluid- if baby is not vigorous with depressed respirations, tone, or HR <100 then you should: initiate PPV or suction with ET tube?
initiate PPV, suctioning with ET tube is no longer recommended for meconium stained fluid due to lack of evidence
Murmur in a newborn a few hours after birth is a normal finding and is due to what?
incomplete closure of the ductus arteriosus
Which form of jaundice occurs in 50% of newborns, peaks at 3-4 days, total billi peaks at <13, is NOT visible in the first 24hours, is primarily unconjugated/indirect, and is temporary.
Physiologic
A newborn with NAS should be asymptomatic for how many hours before discharge?
48-72 hours
Which form of jaundice is visible in the first 24hours, rises quickly to total bill >13, is primarily conjugated, and persists after 1 week?
Pathologic
What are the criteria for early neonatal discharge?
uncomplicated vaginal delivery, full term, normal exam, thermal homeostasis, ability to feed, normal labs(if done)
What is the normal weight for a term newborn infant?
2501-4000g
Infants typically lose ____ - ____ of birth weight in first 3 days of life.
10%-15%
Infants should regain back to birth weight by ____ to ____ days of life.
10-14 days
The _____ reflex is when the newborn grasps an object or finger placed in the palm and typically disappears by ___ months of age.
Palmar grasp; 2 months
The ____ is elicited by ration of the head to one side and the newborn will extend arm on the side to which the head is rotated and will flex the opposite arm. This disappears by ___ months of age.
Tonic neck response; 7 months
The ____ reflex is known as the
“startle” response, elicited by jarring motions or loud noises and typically disappears by ___ months of age.
Moro; 6 months
The ____ reflex is elicited by placing infants soles of feet in contact with a flat surface or table edge and typically disappears by ___ weeks of age.
Placing and stepping or “walking”; 4 weeks
Newborn metabolic screening is generally done after ___ hours of age but is preferred at ___-___ hours of age.
24 hours; 48-72hours
What presents as purulent discharge, swelling, and tenderness adjacent to thinner cnthus of the eye that is treated by gentle pressure in a circular motion with a warm and moist cotton ball?
Dacryocystitis
Diaper dermatitis is most commonly caused by the microorganism ____ ____.
Candida albicans
Zinc oxide, 1% topical hydrocortisone, and Nystatin can be used to treat severe cases of _____.
Diaper dermatitis
Thrush is most common around the second week of life and is medically treated with what?
Oral Nystatin four times a day for 1 week
What is the most common pathogen in neonatal infections?
GBS
What are early signs of neonatal infection?
Lethargy, refusal to feed, vomiting, temperature instability
Early onset GBS develops within the first ____ hours of life and is likely or rarely fatal?
24 hours
Likely fatal
Late onset GBS develops after the ____ week of life and is likely or rarely fatal?
2nd week
Rarely fatal
Diffuse papular rash on trunk and pharynx, respiratory distress, cyanosis and sepsis are all signs of which infection in a neonate?
Listeria
Signs of microencephaly, cerebral calcifications, hepato-splenomegaly and jaundice are all signs of which viral infection in a neonate?
Toxoplasmosis
Which plexus injury accounts for 90% of all plexus injuries and involves C5-C7 (occasionally C4) with the shoulder and arm being affected?
Erb’s palsy
Which plexus injury accounts for 8-9% of all plexus injuries, involves C5-T1 and affects the upper arm, lower arm and hand?
Total palsy
Which plexus injury involves C8-T1 and affects the lower arm and hand?
Klumpke paralysis
Destruction of RBC’s, resulting in hyper-bilirubinemia and jaundice is what disease in an infant?
Hemolytic disease
Encephalopathy caused by deposition of bilirubin in brain cells causing lethargy, diminished reflexes, hypotonia and seizures is which condition?
Kernicterus
Absent or incomplete closure of one or more vertebral arches with a dimple or hair tuft over site is which CNS anomaly?
Spina bifida occulta
Extrusion of meninges and CSF through defect in vertebral column is which CNS anomaly?
Meningocele
A myelomeningocele is a meningocele with extrusion of what?
Spinal cord
Abnormal accumulation of CSF in ventricles of the brain is which CNS anomaly?
Hydrocephalus
Respiratory distress and a scaphoid abdomen that is apparent at birth could by which respiratory anamoly?
Diagphragmatic hernia
Highest prevalence of SIDS occurs between months ___ and ___.
2 and 4
What are the high risk zones for jaundice at 24, 36 and 48 hours?
24 >8
36 >11
48 >13
Limpness, low blood pressure and cyanosis are symptom clusters for which neonatal condition?
Meconium aspiration
Cyanosis, tachypnea, grunting/flaring and resolution in 24 hours is c/w which neonatal condition?
TTN
pH normal or low, pCO2 high, bicarb normal is which acid base imbalance?
Respiratory acidosis
low pH, co2 normal, bicarb low is which acid base imbalance?
Metabolic acidosis
Increased oxygenation of circulating blood causes constriction and closure of what?
Ductus arterioisis
Normal pH in an umbilical arterial cord gas is?
7.26 +/- 0.7
Normal PCO2 in an umbilical arterial cord gas is?
53 +/- 10
Normal Bicarb (HCO3) in an umbilical arterial cord gas is?
22.0 +/- 3.6
Normal base deficit in an umbilical arterial cord gas is?
4 +/- 3
Low pH, high PCO2 and low bicarb is which acid base imabalnce?
Mixed acidemia
