Newborn Adaptations Flashcards
This deck looks at circulatory system, GI system, renal system
What is the plantar grasp ? When does it typically disappear?
A newborn reflex that occurs when a finger is placed under toes, toes will curl
Disappears at 9-10 mo
What is cutis marmorata (moltling) a result from? (What is the physological response?)
Results from NB undeveloped nerve and blood vessel systems.
When the skin cools, the blood vessels near the surface contract and dilate alternately. The red color is produced when the vessels expand and the pale part is produced when the vessels shrink.
What indicates a properly functioning GI tract in a newborn?
Progressive changes in stool patterns
What is conduction heat loss? what can be done to help prevent/reduce this?
is the loss of heat from the body surface to cooler surfaces in direct contact. The scales used for weighing the newborn should have a protective cover to minimize conductive heat loss.
What is Thrush (Candida Albicans)? How is it treated?
White fungal patches that adhere to mucous membranes of the mouth (cheeks, lips) caused by exposure to Candida albicans
Treated with anti[-fungal drops4
Should treat mother too (nipples)
Risk factors for hydrocele?
Babies born prematurely are at a higher risk for developing hydrocele.
What is “capput succedaneum”? How long does it take to displace/resolve? What does it cross?
Localized edema on the scalp often after a prolonged labour or use of vacuum extraction.
Dissipates in about 3-4 days.
Crosses suture lines
How is Jandice categorized as either physological or pathological?
Traditionally, newborn jaundice has been categorized as either physiological or pathological (nonphysiological), depending primarily on the time it appears and on serum bilirubin levels.
What is the optimal state of arousal?(what is it also known as?)
The optimal state of arousal is the quiet alert state. During this state newborns smile, vocalize, move in synchrony with speech, watch their parents’ faces, and respond to people talking to them
What can failure to pass meconium indicate?
Failure to pass meconium can indicate bowel obstruction related to conditions such as malrotation, small or large bowel atresia, an inborn error of metabolism (e.g., cystic fibrosis), or a congenital disorder (e.g., Hirschsprung disease or an imperforate anus).
Charcteristics of transitional stools?
Appear by third day after initiation of feeding
Greenish brown to yellowish brown
Thin and less sticky than meconium
May contain some milk curds
Physiological jaundice charcteristics and treatment?
Physiological or nonpathological jaundice occurs in approximately 60% of newborns born at term and 80% of preterm infants. It appears after 24 hours of age and usually resolves without treatment.
Treatment for Ankyloglossia?
Can be surgically incised if causing feeding issues
What is tonic neck? When does it typically disappear?
A newborn reflex that occurs when the infant is in a supine position, with head turned to one side, the arm and leg extend on the side to which the head is turned; the opposite arm and leg flex (“fencing” position).
Disappears 6-7 mo
What is a cephalohematoma? How is it different than a capput succedaneum?
A collection of blood beneath the periosteum of the skull.
-Different than a capput succedaneum because it does NOT cross the seture lines
WWhat gender is developmental dysplasia of the hip (DDH) more common in?
More common in females, left hip and firstborns
Can Epispadias occur with girls? or does it only occur in males?
Can also happen in girls where urethral opening is located elsewhere and there are other abnormalities of the genitalia
How many mL is excreted via the renal system within the first few days?
Excretes 15-60 ml/kg (first few days)
What is not routinely measured in a healthy newborn?
Unless there is a specific indication, BP is not routinely measured in the healthy newborn.
What structure carrys blood from the Patent, carrying of blood from hypogastric arteries to placenta?
Umbilical areteries
What is Lanugo? When does it disaperar?
Soft, downy hair on the body, particularly on the face, shoulders and back.
Disappears over the first few weeks of life.
What is Erytheum toxicum (Newborn Rash)? When is it common? What is the treatment?
Very common in 1st week.
Small white or yellow papules or vesicles on the skin.
No clinical significance. No treatment
What are expected/normal physical examiniation for newborn breasts?
Breasts may be enlarged, in both boys and girls, and may secrete milk (Galactorrhea).
(This is a result of high exposure to maternal estrogen in utero. This usually dissipates in a few weeks)
What is “Pseudomenstruation”? Treatment?
a vaginal discharge composed of mucus mixed with blood > may be present during the first few weeks of life>.requires no treatment
What serum level of bilirubin is classified as hyperbilirubinemia?
Although there is no consistent definition for neonatal hyperbilirubinemia, the Canadian Paediatric Society suggests that an unconjugated bilirubin greater than 340 mcmol/L in the first 28 days of life constitutes hyperbilirubinemia
How many voids is expected per day for the first 5 days after delivery? How many voids ia expected per day at 1 week of age?
1 void/day for first 5 days
At 1 wk., 6-8 voids/day
What is “molding”?what is it a result of?
Elongated shape of the skull as a result of overlapping of cranial bones during birth
What structrue allows blood to pump from the right ateria to the left atria in newborns?
Foramen ovale
How should newborn ears be?
Ears should be aligned with the outer canthi of the eyes.
What “symptpms” indicate the need to measure/take a newborns BP?
In the presence of cardiovascular symptoms such as tachycardia, murmur, abnormal pulses, poor perfusion, or abnormal precordial activity, four extremity BP and preductal and postductal oxygen saturation levels may be taken
When does a cephalohematoma typically occur? When does it disappear? What may happen as a result?
Appears on day 2 or 3 and disappears in weeks or months.
Jaundice may result.
In utero, what is the low-resistance pathway for gas exchange?
The placenta
Characteristcs of formula fed stools?
pale yellow to light brown, firmer consistency, odour more characteristic of a normal stool
What is the babinski reflex? When does it typically disapear?
Fanning and hyperextension of all the toes and dorsiflexion of the big toe, occurs when the lateral aspect of the sole is stroked from the heel upwards and across the ball of the foot.
(Positive babinski:when the big toe bends up and back to the top of the foot and the other toes fan out - This can mean that you may have an underlying nervous system or brain condition that’s causing your reflexes to react abnormally)
Disappears 2 years of age
At what biliroubin level is jaundice considered to be pathological?
Jaundice is usually considered pathological or nonphysiological if it appears within 24 hours of birth, if total serum bilirubin levels increase by more than 100 mcmcol/L in 24 hours, and if the serum bilirubin level exceeds 256 mcmol/L at any time
What is ANKYLOGLOSSIA? Who is it more common in?
*Tounge tie
A ridge of frenulum tissue attached to the underside of the tongue, causing a heart-shape at the tip of the tongue
More common in boys, genetic component
The first meconium is usally?
The first meconium passed is usually sterile, but within hours all meconium passed contains bacteria.
Characteristcs of breastfed stool?
yellow to golden, pasty, odour similar to sour milk
What are “Telangiectatic Nevi”? When are they more visable?
Superficial vascular areas (flat, pink, capillary hemangiomas)on nape of neck, eyelids, nose, upper lip, and lower occiput.
More visible when crying.
What is TALIPES EQUINOVARUS (CLUBFOOT)
linked to?
Can be linked to other conditions such as spina bifida
What is the stomach capacity of a newborn on day 1?
Stomach capacity: 30 ml (1 oz) day 1
When does a cephalohematoma occur/appear?
It appears several hours or the day after birth and may not become apparent until a caput succedaneum is absorbed.
What is meconium composed of?
Composed of amniotic fluid & its constituents,
intestinal secretions, shed mucosal cells and possibly blood.
What is Epispadias? How is it treted?
The urinary meatus is on the dorsal surface (top side) of the glans (Rare birth defect)
Tx: Treated with surgery
What connects the main pulmonary artery to the aorta?
The ductus arteriosus connects the main pulmonary artery to the aorta
What are “Mila”? How do they disappear?
Distended, small white sebaceous glands on the nose, chin, and forehead.
Disappear on their own
What is VERNIX CASEOSA? Where is it common?
A thick, white substance that protects the skin of the fetus.
Common in body creases.
Don’t wash it off – it has positive benefits for neonatal skin
At whay bilirubin levels doe sjaundice typicall occur?
Jaundice, the visible yellowish colour of the skin and sclera, is likely to appear when bilirubin levels exceed 85 to 102 mcmol/L (Blackburn, 2018). Jaundice is generally noticeable first in the head, especially in the sclera and mucous membranes, and progresses gradually to the thorax, abdomen, and extremities. The degree of jaundice is determined by serum total bilirubin measurements.
Post delevry what happens/occurs with the foramen ovale?
Post delivery, functionally closed at birth; constant apposition gradually leading to fusion and permanent closure within a few months or years in most persons due to increased pressure in left atrium and decreased pressure in right atrium, causing closure of valve over foramen.
Colonization of (blank) is established within the first week of birth?
Bacterial colonization of the gut is established within the first week of birth
Characteristics of the anterior fontanelle?How long do they remain open for?
Diamond-shaped “soft spot”.
Remains open up to 18 months to allow the brain to grow.
What is “Hydrocele”?
A collection of fluid surrounding the testes in the scrotum
*Normally, this sac closes itself and the body absorbs the fluid inside during the baby’s first year. However, this doesn’t happen for babies with a hydrocele.
Symptoms of developmental dysplasia of the hip (DDH)?
Signs of DDH are asymmetrical gluteal and thigh skinfolds, uneven knee levels, a positive Ortolani test, and a positive Barlow test.
The hips are inspected for symmetry.
Gluteal and thigh skin folds should be equal and symmetrical, and legs should be of equal length.
During which state do newborns smile, vocalize,& move in synchrony with speech?
The quiet alert state
How is ALIPES EQUINOVARUS (CLUBFOOT) treated?
Treated with casting, splinting or surgery; and physiotherapy
When do “Mongolian spots” appear? When do they generally fade?
Appear at birth or within first few weeks
Fade gradually over months or years
Charcteristcis of a cephalohematoma?
This soft, fluctuating, irreducible fullness does not pulsate or bulge when the newborn cries.
What are 3 common charatceristics of the newborns GI system?
1.) Bowel sounds are usually heard after birth
2.) Mucus membrane of the mouth is moist and pink
3.) Hard & soft palates are intact
Occasionally born with 1 or more teeth
What is evaporation heat loss? What can be done to help prevent/ reduce this?
is the loss of heat that occurs when a liquid is converted to a vapour. In the newborn, heat loss by evaporation occurs as a result of vaporization of moisture from the skin. This heat loss is intensified by failing to completely dry the newborn directly after birth or with bathing.
The less mature the newborn, the more severe the evaporative heat loss. Evaporative heat loss, as a component of insensible water loss, is the most significant cause of heat loss in the first few days of life.
What are lower set ears chacrteristics of?
Lower set ears are characteristic of many syndromes and internal organ abnormalities involving the renal system.
When the first meconium is passed, what shoul dbe noted?
1.) Time
2.) Colour
3.) Character of the newborns fiest stool
What is cutis marmorata (moltling)? What is a response to?
Lacy patterns of blood vessels under the skin
Normal physiological response to cold temperature.
Characteristics of meconium?When is it usually passed?
Greenish black, tarry consistency; usually passed within 12 to 24 hours of birth; almost all do so by 48 hours
Risk factors for Hypospadias?
(The urethral opening is on the underside (ventral aspect) of the penis at any place along the shaft)
Risk factors: Mothers >35, obesity, fertility or hormone treatments
The fetal system has high (blank) pulmonary resistance and low (bank) systemic vascular resistance
The fetal system has
high pulmonary vascular resistance (PVR) and
low aortic systemic vascular resistance (SVR)
Charcteristics of normal urine for a newborn?
Pale straw coloured
When do Telangiectatic Nevi” fade?
Fades in first and second years of life
What is “Hypospadias”? How is it treated?
The urethral opening is on the underside (ventral aspect) of the penis at any place along the shaft
Tx:Surgery – baby should not be circumcised as foreskin might be needed for repair
What is a torticolis? What does it result in?
Tightness of the sternocleidomastoid muscle
Results in the newborn’s head tilting to one side
What is convection heat loss/how does it occur? What can be done to help decrese this?
is the flow of heat from the body surface to cooler ambient air. Because of heat loss by convection, the ambient temperature in the newborn care area should range between 22° and 26°C and newborns in open bassinets are wrapped to protect them from the cold. A cap may be worn to decrease heat loss from the newborn’s head.
What is the palmar grasp ? When does it typically disappear?
Newborn reflex that occurs when a finger is placed in the newborn’s palm. The newborn’s fingers curl around the examiner’s finger
Disappears 2-3 mo
What is the netural thermal environment?
The neutral thermal environment is the ideal environmental temperature that allows the newborn to maintain a normal body temperature to minimize oxygen and glucose consumption
What is Developmental Dysplasia of the Hip (DDH)? How is it treated?
Condition where socket of hip joint does not form properly – too shallow so that ball of hip is loose and can come out
Treated with Pavlik harness-
What is sucking? When does it typically disappear?
A common newborn reflex that occurs when an object placed in the newborn’s mouth or anything touches the lips will elicit this reflex.
Disappears after 3 months
What is the “stepping” reflex? When does it typically disapear?
When held upright with one foot touching a flat surface, the newborn puts one foot in front of the other and “walks”
Disappears at 2 months
What structure carrys blood from the Patent, carrying of blood from placenta to ductus venosus and liver?
Umbilical Vein
What causes capput succedaneum?
(it is localized edema on the scalp often after a prolonged labour or use of vacuum extraction)
The slower venous return causes an increase in tissue fluids within the skin of the scalp, and an edematous swelling develops.
How many voids is expected at 1 day of age?
1 day of age a minimum of 1 void is expected
What connects the umblical vein to the inferior vena cava?
The ductus venosus connects the umbilical vein to the inferior vena cava
What is moro? When does it typically disappear?
A newborn reflext thats elicited when the newborn is startled or lifted slightly above the crib and then suddenly lowered. The newborn’s arms straighten, hands move outward (fingers fan out), thumb and forefinger form a “C” and knees flex.
Slowly the arms return to the chest
Disappears 5-6 mo
What is rooting? When does it typically disappear?
COmmon newborn reflex thats elicited when the side of the newborn’s mouth or cheek is touched. The newborn turns toward that side and opens the lips
Disappears 3-4 months
What is radiation heat loss? What can be done to prevent this?
is the loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity. To prevent this type of loss, cribs and examining tables are placed away from outside windows and care providers need to avoid exposing the newborn to direct air drafts.
What are “Mongolian Spots”? What ethinicities do they more commonly occur in?
Bluish black areas of pigmentation commonly noted on the back and buttocks.
Occurs more frequently in ethnicities from Asia, Africa, Indigenous North America
Risk factors for Jaundice?
Among the factors that increase the risk of hyperbilirubinemia, prematurity is the most significant one. Prematurity affects liver and brain metabolism and albumin binding sites, placing preterm and late preterm newborns at greater risk for hyperbilirubinemia. Newborns of Asian and Indigenous backgrounds have higher bilirubin levels. Breastfeeding newborns are at greater risk of hyperbilirubinemia.
What is ALIPES EQUINOVARUS (CLUBFOOT)? what may it be due to?
A painless malposition of the feet – can be turned in.
May be due to intrauterine positioning, environmental or genetic factors
What is thermoregulation? Within what kind of range do newborns attaempt to stabilize their temaptures?
Thermoregulation is the maintenance of balance between heat loss and heat production. Newborns attempt to stabilize their core body temperatures within a narrow range.
When is a cephalohematoma usually the largest?
A cephalohematoma is usually largest on the second or third day, by which time the bleeding stops.
What is the “galant” reflex? When does it typically disapear?
This reflex is observed when the infant, while prone and stroked along the spine, causes the pelvis to turn to the stimulated side
disappears at 1 month
What is “Leukorrhea”? What is it caused vy?
can also occur – whitish discharge from vagina – caused by mother’s estrogen in newborn
If the systolic is more than (blank mmHg) in the (blank extremities) further (blank) may be needed
. If the systolic pressure is more than 10mm Hg higher in the upper extremities than in the lower extremities, further diagnostic testing may be needed.
