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T 2.5 > Newborn exam > Flashcards

Newborn exam Flashcards

1
Q

apgar score

A

appearance, pulse, grimace, activity, respiration

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2
Q

danger signs in newborn

A

pallor, cyanosis, floppiness, tachynpnoea, alar flaring, intercostal recessions, grunting, abnormal features

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3
Q

immediate observation after birth

A

apgar exam

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4
Q

detailed exam at convenient time

A

gest age, anthro, vitals, gen, systemic, neuro exams

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5
Q

approach

A

soon as possible after birth, mother + ID + present check road to health card + history, hands warm and clean, baby kept warm

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6
Q

gest age assessment

A

length of time feotus spent inutero
det majority at birth
n/term gest - 37-40 weeks
late term - 40-42
preterm - <37
post term - >42

each has different set of risk factors etc

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7
Q

neonat anthro

A

w
ofc
l

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8
Q

weight neonat

A

2.5-3.5kg
(low <2.5, high risk <1.5)
sga etc

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9
Q

ocf neomat

A

n-34cm
mciroceph - below 3rd perc for ga
macroceph - abovr 97th perc for ga

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10
Q

l neonat

A

n - 47-53cm
infantometer

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11
Q

vital signs of infant (n)

A

resp rate 35-45 bpm
hr 120-160 bpm
bp 50-55/30 to 80/50
cap refill 2-3s
temp rectal 36.5-37.5 axillary 35.6-37.3

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12
Q

general exam of neonat

A

abnormalities exam
behaviour and activity
tone colour
sick or well
injuries
position of limbs
proportions of limbs

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13
Q

systemic exam of neonat (skin)

A

colour, skin coverings (vernix caseosa- baby custard), birth marks, rashes

reassure parent of normal findings

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14
Q

milia

A

white spots ovet bridge of nose - retained sebum non path

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15
Q

telangiectasic nevia

A

red lesions back of head and neck
blanch easily

reassure parent

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16
Q

eerythema toxicum neonatorum

A

raised papules
inflit eosinophils
asympt, regress spontaneously

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17
Q

mongonlian spot

A

blue grey spot on bums
dissappear 3-5 yrs

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18
Q

transient jaundice

A

may be physiological and degress spontaneously
phototherapy

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19
Q

head observations

A

shape, symmetry, size,
fontanelles - ant up to 4x4 and post fingertip
sutures (moulding during birth)
swelling - caput succedaneum (bulging)

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20
Q

caput succedaneum

A

transient scalp oedema
swelling causes by birthing, natural and resolves

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21
Q

face observations

A

dysmorphic syndorms
eyes
ears
mouth

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22
Q

down synd

A

upward slant eyes
epicanthic folds
short broad hands
etc

40% congent heart dx

23
Q

fas

A

feot alch syndrome
small eyes
thin upper lip
smooth phillithrum

24
Q

eyes observation

A

eye discharge is abnormal (eg neonat conjucntivitis)

25
Q

ears observation

A

size shape
position related to eye - upper 3rd is above the level of outer angle of eye
pits and tags

26
Q

nose observation

A

patent nostrils
nasolabial folds when baby cries

27
Q

mouth observations

A

cleft lip or palate
shape, opening, arch, tongue normal

28
Q

epsteins pearls

A

two white spots either side of midline on palate
harmless and dissappear usually after few weeks

29
Q

neck observations

A

appearance and neck folds or webs
swellings

30
Q

chest exam

A

resp and cvs

31
Q

resp exam

A

resp rate 35-45 bpm
pattern - often irregular in sleep
shape and expansion of chest
ausc

32
Q

cvs exam

A

radio fem delay - coary of aorta
120-160 bpm
cap refill
apex beat 4 lic within mcl
s1 and s2
added sounds or mumurs

33
Q

abdom exam

A

organomeg
n palp : 2-3 cm of liver and tip of spleen + full bladder + lower poles of kid in thin infants
check umb for umb cord, vessels and sepsis in periumb

gross abn (defects)

34
Q

gent + anus observation

A

ext gen - scrotum sym, penile deformities
patent anal opening + normal location
urine output within 24 hrs
stool 1st - meconium within 36 hours

35
Q

hypospadias

A

uretheral opening on under surface

36
Q

muscskel system exam

A

clavicles, upper limb, spine, lower limbs, finger and toes, hips (cdh)

37
Q

cdh

A

congent dislocation of hips

38
Q

neurological exam

A

consciousness
tone
cranial nerves
reflexes

39
Q

loc observation

A

alert/normal/drowsy
abn - hyperactivity, high pitched cry, abn drowsiness, coma

40
Q

tone observation

A

ventral suspension- tensing limbs and neck
n vs floppy - hypotonia - froglike posture supine
hypertonia - increased resistance to extension

41
Q

cranial nerves assessment

A

appearance of face
facial movements
eye movements
pupillary response
swallowing
normal cry
vision resp to bright light and face
hearing resp to noise

42
Q

Newborn reflexes

A

primitive reflexes
deep tendon
superficial reflexes

43
Q

primitive reflexes

A

grasping reflex - 26 wks - 4 m
rooting reflex - 28 wks
moro reflex - 28 wks - 4 m
sucking and swallowing - weak in preterm
stepping reflex

44
Q

moro reflex

A

sudden supported extension movement of head in relation to spine
extention and abd of limbs
extension of fingers

followed by flexion of elbows amd fingers across chest

45
Q

sucking reflex

A

placr thumb in mouth or offer mothers breast
strong sucking response, weak in preterm

46
Q

stepping reflex

A

stimulate dorsum of foot
foot raises

47
Q

deep tendon

A

knee jerk reflex

48
Q

knee jerk reflex

A

place hand below knee, feel quadriceps tendon snd apply sharp tap
sudden kicking movement

49
Q

supericial reflex

A

plantar reflex

50
Q

plantar reflex

A

stroke lat sole and curve inwards
upward point of big toe and extention of others
adults - flexion is normal, extension abn (babinskis sign)

51
Q

conclusion

A

summarize finding
record on rthc
reflect management plan long + short term
discharge criteria

52
Q

grasp reflex

A

place finger ulnar side of palm or foot
flexion or grasping of finger

53
Q

rooting reflex

A

stroke cheek with finger or nipple
infant turns head to side and opens mouth

T 2.5 (10 decks)

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