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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
Define Cavernous Hemangioma
Collection of larger blood vessels, usually much larger than strawberry hemangioma and bluish in color
26
Define Jaundice
Yellow staining of the body tissues and fluids due to hyperbilirubinemia
27
Types of Skin Issues
``` 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 ```
28
Newborn Head Exam
``` Head circumference Palpate fontanelles Check for molding & forceps marks Hydrocephalus Caput succedaneum Cephalohematoma Craniosynostosis Craniotabes ```
29
When does the anterior fontanelle close?
18-24 months
30
When does the posterior fontanelle close?
6 weeks
31
Define Hydrocephalus
Increased volume of CSF usually due to obstruction of CSF into subarachnoid space
32
Clinical Features of Hydrocephalus
``` Macrocephaly Irritability Vomiting Loss of appetite Impaired upgaze Impaired extra ocular movements Hypertonia Hyperreflexia ```
33
Treatment of Hydrocephalis
Ventriculoperitoneal shunt
34
Define Caput Seccedaneum
Boggy swelling in subcutaneous tissues which crosses the suture lines
35
Define Cephalohematoma
Blood collected below the periosteum and confined to a single bone Results from fracture Birth trauma
36
Define Craniosynostosis
Abnormal premature closure of skull sutures | Most common sagittal suture
37
Define Craniotabes
Ping-pong ball feel of the skull | Usually benign
38
Face Exam
Eyes Chin Nose Ears
39
Characteristics of Down Syndrome
Eyes slanting up Sloping forehead Low-set with small canals Short broad hands with single palmar crease
40
Eyes too large may indicate
Glaucoma
41
Characteristics of Fetal Alcohol Syndrome
Eyes appear too small Wide, flat nasal bridge Lack groove between lip and nose Small jaw
42
Facial Asymmetry may indicate
Aortic valve abnormalities | Facial nerve palsy
43
Newborn Eye Exam
``` Positioning & symmetry Trauma Reflex eye opening Cornea clear Red reflex Erythromycin ointment Irises same color ```
44
Newborn Nasal Exam
Septal deviation Patency Choanal atresia
45
Newborn Ear Exam
EAC patency Visualize TMs Hearing
46
Newborn Mouth Exam
Cleft palate Teeth present Epstein pearls
47
Newborn Neck/Clavicle Exam
Short neck/webbing | Clavicle fractures
48
Newborn Chest Exam
``` Respiratory rate (40) Grunting & retractions Check nipples Pectus carinatum Pectus excavatum ```
49
Newborn Cardiovascular Exam
Pulse: 120-180 BP: check arm/leg Pulses: radial, femoral, and brachial pulses Auscultate heart
50
Newborn Abdominal Exam
Full Protruding Round Inspect for masses
51
Newborn with Tense Abdomen
``` Intestinal obstruction Imperforate anus Hirschsprung disease Meconium ileus Perforated viscus Perforated peritonitis ```
52
Umbilical Cord Inspection
2 arteries | 1 vein
53
Newborn Female Genitalia Exam
Labia majora/minora Clitoris Possible withdrawal bleeding from vagina
54
Newborn Male Genitalia Exam
Testes Shape/size of penis Foreskin Location of urethral meatus
55
Define Cryptorchidism
Inability to palpate testes
56
Reasons for Hard Testis
Congenital torsion | Tumor
57
Define Hypospadias
Condition where the urethral meatus is displaced proximally on ventral aspect of penis
58
Newborn Anal Exam
Imperforate anus | Fistula
59
Newborn Musculoskeletal Exam
``` Count fingers/toes Palpate long bones Hips- Barlow's & Ortolani's Metatarsus adductus Internal tibial torsion Talipes Equinovarus (Clubfoot) Straight spine Pilonidal sinus ```
60
Define Clinodactyly
Interning of a finger
61
Define Metatarsus Adductus
Forefoot adduction from intrauterine crowding
62
Define Internal Tibial Torsion
In conjunction with Metatarsus adducts from intrauterine crowding
63
Define Talipes Equinovarus (Clubfoot)
Combination of metatarsus adducts, varus deformity, & shortening of Achilles tendon
64
Newborn Neuro Exam
``` Babinski sign Flexor tone > extensor tone Brachial plexus palsies Moro reflex Grasp reflex Plantar reflex Stepping reflex Rooting reflex ```
65
Causes of a "floppy" baby
Insult to CNS Congenital disorder Sepsis
66
Define Brachial Plexus Palsy
One of upper extremities flaccid secondary to difficult delivery with injury to brachial plexus
67
Define Moro Reflex
"Dropping" baby down | Symmetric abduction & extension
68
Define Grasp Reflex
Placing index finger in palm of hand will elicit grasp
69
Define Plantar Reflex
Touching base of toes causes toes to curl downward
70
Define Stepping Reflex
When placed in standing position, will elicit stepping reflex
71
Define Rooting Reflex
Stroking the cheek will cause infant will turn head towards stimulus and open mouth

Pediatrics (24 decks)

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