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Pediatrics > Newborn Exam > Flashcards

Newborn Exam Flashcards

1
Q

Key Questions for Prenatal Interview

A 
Social circumstances
Health of mother & father
Genetic history
Alcohol & smoking history
Pregnancy history
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2
Q

What to Discuss at Prenatal Interview

A 
Breast feeding vs. bottle feeding
Car seat usage
SIDS
Exposure to cigarette smoke
Crib safety
Work plans/child care plans
Social support
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3
Q

When do Pediatric or Neonatal Providers Attend a Birth?

A 
C-sections
Multiple births
Premature births
Fetal distress noted
High risk pregnancy
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4
Q

Immediately After Delivery One Must:

A

Clear airway secretions
Dry baby
Cover baby
APGAR scores

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5
Q

What is APGAR for?

A

Time honored method in evaluating the newborn infant at time of delivery

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6
Q

What Does APGAR Stand for?

A 
Activity
Pulse
Grimace
Appearance
Respirations
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7
Q

Newborn Prophylaxis

A 
Erythromycin drops
Administration of vitamin K1
Hep. B vaccination
Umbilical cord care
Monitor for hyperbilirubinemia & hypoglycemia
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8
Q

Routine Screening for Infants

A 
Hearing loss
PKU
Congenital hypothyroidism
Galactosemia
Hemoglobinopathies
Congenitally acquired infections
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9
Q

Common Sense in Newborn Exam

A

Startles/stops with noise; can hear
Blinks with bright lights; can see
Urinates; urethra patent
Defecates; anus patent
Gross neuro exam; crying, moving, fussing, etc.
Jitteriness; low sugar, seizure, infection
Nasal flaring; respiratory distress

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10
Q

Measurement of an Infant

A

Weight- grams or pounds
Length- cm or in
Head circumference- cm or in
Chest circumference- cm or in

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11
Q

Etiologies of Small Gestational Age Infants

A 
Congenital infections
Chromosomal defects
Cell toxins
Maternal malnutrition
Multiple gestations
Pre-eclampsia: asymmetric
Placental abnormalities
Maternal use of tobacco
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12
Q

Etiologies of Large Gestational Age Infants

A 
Maternal diabetes
Hydrops fetalis
Genetic predisposition
Male fetus
Post-date gestation
Multiparity
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13
Q

Newborn Skin Exam

A

Inspect the skin for color, lesions, and rashes

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14
Q

Define Cutis Marmorata

A

Mottled appearance that will disappear over time

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15
Q

Define Vernix Caseosa

A

White to yell waxy covering in newborns, most abundant in the creases and flexor surfaces

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16
Q

Define Lanugo

A

Downy hair covering the body, more common with prematurity

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17
Q

Define Erythema Toxicum

A

Benign rash characterized by fleeting erythematous papillose and pustules filled with eosinophils

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18
Q

Define Nevus Flammeus/Vascular Nevi/Salmon patches

A

Usually benign flat red markings on upper eyelids, in the area above the nose sometimes extending to the forehead, and/or on the back of the neck

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19
Q

Define Port-Wine Stain

A

Permanent discolorations of the skin

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20
Q

Define Sebaceous Gland Hyperplasia

A

Small yellow papillose that are often seen over the nose and cheek; disappear spontaneously

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21
Q

Define Milia

A

Similar to sebaceous gland hyperplasia but white papillose and smaller

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22
Q

Define Acne Neonatorum

A

Acne appearance likely from maternal hormonal influence,

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23
Q

Define Mongolian Spots

A

Bluish black macular lesions usually over lumbrosacral area

Native American, Black, or Asian infants

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24
Q

Define Strawberry or Capillary Hemangiomas

A

Perhaps worrisome

Grow for 3-7 months, stabilize, then involute at about 1 year

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25
Q

Define Cavernous Hemangioma

A

Collection of larger blood vessels, usually much larger than strawberry hemangioma and bluish in color

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26
Q

Define Jaundice

A

Yellow staining of the body tissues and fluids due to hyperbilirubinemia

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27
Q

Types of Skin Issues

A 
Cutis Marmorata
Vernix caseosa
Lanugo
Erythema toxic
Nevus flammeus/vascular nevi/salmon patches
Port-win stain
Sebaceous gland hyperplasia
Milia
Acne neonatorum
Mongolian spots
Strawberry or capillary hemangiomas
Jaundice
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28
Q

Newborn Head Exam

A 
Head circumference
Palpate fontanelles
Check for molding & forceps marks
Hydrocephalus
Caput succedaneum
Cephalohematoma
Craniosynostosis
Craniotabes
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29
Q

When does the anterior fontanelle close?

A

18-24 months

30
Q

When does the posterior fontanelle close?

A

6 weeks

31
Q

Define Hydrocephalus

A

Increased volume of CSF usually due to obstruction of CSF into subarachnoid space

32
Q

Clinical Features of Hydrocephalus

A 
Macrocephaly
Irritability
Vomiting
Loss of appetite
Impaired upgaze
Impaired extra ocular movements
Hypertonia
Hyperreflexia
33
Q

Treatment of Hydrocephalis

A

Ventriculoperitoneal shunt

34
Q

Define Caput Seccedaneum

A

Boggy swelling in subcutaneous tissues which crosses the suture lines

35
Q

Define Cephalohematoma

A

Blood collected below the periosteum and confined to a single bone
Results from fracture
Birth trauma

36
Q

Define Craniosynostosis

A

Abnormal premature closure of skull sutures

Most common sagittal suture

37
Q

Define Craniotabes

A

Ping-pong ball feel of the skull

Usually benign

38
Q

Face Exam

A

Eyes
Chin
Nose
Ears

39
Q

Characteristics of Down Syndrome

A

Eyes slanting up
Sloping forehead
Low-set with small canals
Short broad hands with single palmar crease

40
Q

Eyes too large may indicate

A

Glaucoma

41
Q

Characteristics of Fetal Alcohol Syndrome

A

Eyes appear too small
Wide, flat nasal bridge
Lack groove between lip and nose
Small jaw

42
Q

Facial Asymmetry may indicate

A

Aortic valve abnormalities

Facial nerve palsy

43
Q

Newborn Eye Exam

A 
Positioning & symmetry
Trauma
Reflex eye opening
Cornea clear
Red reflex
Erythromycin ointment
Irises same color
44
Q

Newborn Nasal Exam

A

Septal deviation
Patency
Choanal atresia

45
Q

Newborn Ear Exam

A

EAC patency
Visualize TMs
Hearing

46
Q

Newborn Mouth Exam

A

Cleft palate
Teeth present
Epstein pearls

47
Q

Newborn Neck/Clavicle Exam

A

Short neck/webbing

Clavicle fractures

48
Q

Newborn Chest Exam

A 
Respiratory rate (40)
Grunting & retractions
Check nipples
Pectus carinatum
Pectus excavatum
49
Q

Newborn Cardiovascular Exam

A

Pulse: 120-180
BP: check arm/leg
Pulses: radial, femoral, and brachial pulses
Auscultate heart

50
Q

Newborn Abdominal Exam

A

Full
Protruding
Round
Inspect for masses

51
Q

Newborn with Tense Abdomen

A 
Intestinal obstruction
Imperforate anus
Hirschsprung disease
Meconium ileus
Perforated viscus
Perforated peritonitis
52
Q

Umbilical Cord Inspection

A

2 arteries

1 vein

53
Q

Newborn Female Genitalia Exam

A

Labia majora/minora
Clitoris
Possible withdrawal bleeding from vagina

54
Q

Newborn Male Genitalia Exam

A

Testes
Shape/size of penis
Foreskin
Location of urethral meatus

55
Q

Define Cryptorchidism

A

Inability to palpate testes

56
Q

Reasons for Hard Testis

A

Congenital torsion

Tumor

57
Q

Define Hypospadias

A

Condition where the urethral meatus is displaced proximally on ventral aspect of penis

58
Q

Newborn Anal Exam

A

Imperforate anus

Fistula

59
Q

Newborn Musculoskeletal Exam

A 
Count fingers/toes
Palpate long bones
Hips- Barlow's & Ortolani's
Metatarsus adductus
Internal tibial torsion
Talipes Equinovarus (Clubfoot)
Straight spine
Pilonidal sinus
60
Q

Define Clinodactyly

A

Interning of a finger

61
Q

Define Metatarsus Adductus

A

Forefoot adduction from intrauterine crowding

62
Q

Define Internal Tibial Torsion

A

In conjunction with Metatarsus adducts from intrauterine crowding

63
Q

Define Talipes Equinovarus (Clubfoot)

A

Combination of metatarsus adducts, varus deformity, & shortening of Achilles tendon

64
Q

Newborn Neuro Exam

A 
Babinski sign
Flexor tone > extensor tone
Brachial plexus palsies
Moro reflex
Grasp reflex
Plantar reflex
Stepping reflex
Rooting reflex
65
Q

Causes of a “floppy” baby

A

Insult to CNS
Congenital disorder
Sepsis

66
Q

Define Brachial Plexus Palsy

A

One of upper extremities flaccid secondary to difficult delivery with injury to brachial plexus

67
Q

Define Moro Reflex

A

“Dropping” baby down

Symmetric abduction & extension

68
Q

Define Grasp Reflex

A

Placing index finger in palm of hand will elicit grasp

69
Q

Define Plantar Reflex

A

Touching base of toes causes toes to curl downward

70
Q

Define Stepping Reflex

A

When placed in standing position, will elicit stepping reflex

71
Q

Define Rooting Reflex

A

Stroking the cheek will cause infant will turn head towards stimulus and open mouth

Pediatrics (23 decks)

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