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Pediatrics > Newborn Assessment > Flashcards

Newborn Assessment Flashcards

1
Q

What are the two methods for determining gestational age in newborns?

A

1) New Ballard
2) Dubowitz Method

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2
Q

When should the New Ballard or Dubowitz method be used to ensure greatest accuracy?

A

Within 48 hours of life

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3
Q

What are the 2 components examined when using New Ballard/Dubowitz Method?

A

1) Neuromuscular maturity
2) Physical maturity

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4
Q

T/F: A higher score on the New Ballard or Dubowitz method is indicative of a higher gestational age?

A

True

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5
Q

What is the normal weight for a newborn?

A

2500-4000 grams or 5.5-8 pounds

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6
Q

What is considered a low birth weight?

A

<2500 Grams or 3.3-5.5 pounds

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7
Q

What is considered a very low birthweight?

A

1000-1500 grams or 2.2-3.3 pounds

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8
Q

What is considered an extremely low birthweight?

A

<1000 g or 2.2 pounds

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9
Q

Describe Macrocephaly

A

head circumference that is greater than 2 standard deviations above the mean for given age, gender and gestation

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10
Q

Describe microcephaly

A

head circumference that is two standard deviations below the mean for given age, gender and gestation

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11
Q

What could pale skin be indicative of in a newborn?

A
  1. Hypoxia
  2. reduced peripheral perfusion
  3. acute blood loss
  4. anemia
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12
Q

What is acrocyanosis?

A

blue discoloration of the hands and feet

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13
Q

What is acrocyanosis indicative of?

A

peripheral vasoconstriction

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14
Q

Is acrocyanosis normal in neonates?

A

Yes, it is normal and typically disappears within 72 hours after birth

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15
Q

What does skin mottling look like?

A

A spider web on the skin

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16
Q

What is can skin mottling be indicative of?

A
  1. Hypotension
  2. Anemia
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17
Q

What is the normal heart rate for a neonate?

A

100-160 bpm

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18
Q

What is normal respiratory rate for a neonate?

A

40-60 bpm

19
Q

What is a normal blood pressure for a neonate?

A

60-90/30-60 mmHg

20
Q

What is the normal MAP for a neonate?

A

gestational age + 5

21
Q

Where should heart rate be assessed on a neonate?

A
  1. Brachial artery
  2. Femoral artery
22
Q

What considerations should you make when assessing fetal heart rate?

A
  1. Sleep vs awake
  2. Premature vs mature
23
Q

What effect should stimulation have on a neonates heart rate?

A

Should increase with stimulation

24
Q

What is the correlation between gestational age and respiratory rate?

A

Lower the gestational age, the higher the respiratory rate

25
Q

When is a neonate considered tachypneic? Bradypneic?

A

Tachy > 60
Brady < 30

26
Q

When assessing a neonates respiration, how long should you do it and why?

A

Over the course of a minute because neonates can have irregular breathing patterns

27
Q

What are the components of the respiratory assessment of a neonate?

A
  1. examination of the chest
  2. evaluation of respiratory distress
  3. auscultation of the chest
  4. chest radiograph
28
Q

What findings on a chest examination of a neonate might be indicative of respiratory complications?

A
  1. Barrel chest
  2. rib deformities
  3. absence of chest muscles
  4. pectus excavatum or carinatum
29
Q

What are the clinical sighs of respiratory distress in the neonate?

A
  1. Nasal flaring
  2. Grunting
  3. Tachypnea
  4. Retractions
30
Q

Describe the Silverman Score

A

Tool used to quantify distress and lung disease

31
Q

What are the 5 areas examined during when calculating a Silverman score?

A
  1. Upper chest
  2. Lower Chest
  3. Xiphoid retractions
  4. Nares dilation
  5. Expiratory grunting
32
Q

What score on the Silverman score is indicative of severe respiratory distress?

A

7 or greater

33
Q

Describe how a score of 0 would appear clinically

A
  1. Synchronized expansion of upper and lower chest
  2. No lower chest retractions
  3. No xiphoid retractions
  4. No nare dilations
  5. No expiratory grunting
34
Q

Describe a silverman score of 5 would appear clinically

A
  1. Lag on inspiration
  2. Retractions of lower chest just visible
  3. Xiphoid retractions just visible
  4. Minimal nasal flaring
  5. Grunting audible only to stethoscope
35
Q

Describe how a silverman score of 10 clinically presents

A
  1. Seesaw between upper and lower chest
  2. Marked lower chest retractions
  3. Marked xiphoid retractions
  4. Marked nare dilation
  5. Grunting audible without stethoscope
36
Q

What should areas of focus be when performing cardiovascular assessment on a neonate?

A
  1. Cardiac murmurs
  2. peripheral pulses
  3. capillary refill time
  4. Preductal and post-ductal oxygen saturation
37
Q

What can a heart murmur be indicative of in a new born?

A

congenital heart defects

38
Q

What method is used to assess cardiac output and peripheral circulation in a neonate

A

capillary refill

39
Q

What is a normal capillary refill in a neonate?

A

fewer than 3 seconds

40
Q

What congenital disorders are neonates mandated to be screened for at birth?

A

sickle cell anemia
cystic fibrosis
hemoglobinopathies
phenylketonuria
galactosemia

41
Q

What is the moro reflex?

A

startle reflex
infant is startled, arms extend and abduct outward with palms open which is quickly followed by bringing arms inward with hands clenched

42
Q

What is the grasp reflex?

A

neonates hand closes around the finger and grasp tightens when the finger is moved within the palm

43
Q

What is the rooting reflex?

A

neonate turns head toward the stroked cheek side and begins making sucking motions

Pediatrics (10 decks)

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