Newborn Reflexes + Exam Flashcards

Question

Where should BP be obtained?

Answer 1

In both upper and lower extremities

Answer 2

(75-100)/(50-70)

Answer 3

100-160 bmp at rest

Answer 4

30-50 at rest

Answer 5

98.0 -98.6 degrees

Answer 6

A waxy white substance found on newborns immediately after delivery: Recent studies suggest that vernix may have antioxidant, moisturizing and antibacterial properties

Answer 7

Blue discoloration of the tips of the fingers and toes

Answer 8

A naturally occurring blue/gray discoloration of the skin of a newborn, most commonly seen on the sacral area

Answer 9

A birth mark that typically presents a salmon colored lesion on the face- it is also referred to as an angel's kiss

Answer 10

AKA nevus flammeus nuchae | A pink or red birth mark located on the back of a newborn's neck

Answer 11

Small, pinpoint white lesions that appear on the skin, typically the face. They are keratin-filled cysts just below the epidermis Don't squeeze them- resolve after a couple of days

Answer 12

Coffee colored birthmarks, often permanent and with time may increase in size or number Usually posterior back Document bc of neurofibromatosis

Answer 13

Fine hair that is often seen on the newborn and typically disappears within a few days to weeks. It is replaced later by hair known as vellus hair, and in adulthood called terminal hair

Answer 14

Soft membranous gaps between sutures that allow the fetus's head to more easily pass through the birth canal

Answer 15

2-3 mos after birth

Answer 16

6 mos after birth

Answer 17

6-18 mos after birth

Answer 18

The swelling of the head after delivery secondary to pressure or trauma from the vaginal canal Will reshape, but keep an eye on it

Answer 19

A subperiosteal hematoma that does not cross suture lines | Pose no risk of brain damage and are often self-resolving in the first days to weeks of life

Answer 20

Not a nl variant of birth and can lead to severe complications (anemia, resp. distress, seizures, shock death) Occur when emissary veins rupture, leading to the accumulation of blood below the aponeurosis of the scalp and above the periosteum Onset of swelling often occurs within 12-72 hours postpartum and will present as a fluctuate boggy mass over the scalp Occasionally babies will develop raccoon eyes

Answer 21

Examine and ensure red reflex is present in both eyes

Answer 22

Assess- newborns are obligate nose-breathers untile 4 mos | R/o choanal atresia

Answer 23

MC congenital nose malformation | Blockage of back of nose. Occlude a nostril to check whether it's even

Answer 24

Examine ears for placement, mobility, and cartilage

Answer 25

Measures how the acoustic nerve responds to sound. Clicks or tones are played through soft earphones into the baby's ears. 3 electrodes placed on the baby's head measure nerve response.

Answer 26

Measures sound waves produced in the inner ear. A tiny probe is placed inside the ear canal. It measures the response (echo) when clicks or tones are played into the baby's ears

Answer 27

Assess for any evidence of cleft palate, cleft lip or ankyloglossia -Use a wooden tongue depressor and a pen light -Examine the palate all the way to the uvula, which should be midline on exam Newborn should have minimal salivation, gag reflex should be intact, as should the sucking and rooting reflexes, gums are pink and moist, rarely will a neonatal tooth be present at birth

Answer 28

The fancy medical term for tongue-tied | The frenulum tethers the tongue to the anterior floor of the mouth

Answer 29

Examine the neck by palpating the sternocleidomastoid muscles and rotating the head to either side to r/o congenital torticollis Note any evidence of webbing of the neck Examine the clavicles to ensure there is no evidence of clavicular fx from a traumatic delivery

Answer 30

AKA Wry neck A dystonic condition resulting most commonly from a shortened sternocleidomastoid muscle Causes an asymmetric head and neck position Refer to PT

Answer 31

``` Low posterior hairline Short stature Heart-shaped face Webbing of neck Coarctation of aorta Broad chest with widely spaced nipples Cubitus valgus Streak ovaries, amenorrhea, infertility ```

Answer 32

Watch to see that the chest rises and fall with inspiration and expiration

Answer 33

Pigeon chest | More prominent

Answer 34

Funnel chest | Looks scooped out

Answer 35

Cyanosis Nostril flaring Expiratory grunt Any of these things warrant an additional work up

Answer 36

MC reason of crackles Defined by intermittent patterns of tachypnea, is most commonly seen in full term babies who are born via C-section Believed to be linked to retained fluid in the lungs from gestation, this is often a condition that resolves with supportive care within 24-48 hrs

Answer 37

Listen on both the anterior and posterior thorax of the newborn to assess heart tones -Murmurs that are transient and present at birth are typically benign -Furthermore, congenital cardiac defects may not produce any murmur at time of birth Next, feel both the brachial and femoral pulse of the infant. Absences of the femoral pulse, or evidence of a brachial-femoral delay is concerning for coarctation of the aorta and/or left sided heart defects

Answer 38

Diastasis recti and umbilical hernias

Answer 39

Comprised of 2 arteries and 1 vein, any deviation from this venous pattern would warrant immediate evaluation

Answer 40

Within first 2 wks of life

Answer 41

Auscultate the abdomen to ensure normoactive bowel sounds

Answer 42

Obstruction, often resulting from meconium ileus

Answer 43

A dark green, tarry substance The first feces to be passed by the newborn Within first 24 hrs of life

Answer 44

Meconium ileus Cystic fibrosis Imperforate anus

Answer 45

Approximately 2 cm below costal margin

Answer 46

Right kidney with deep palpation

Answer 47

Inspect the genitals noting that the labia majora is typically prominent Nonpurulant d/c considered nl Confirm the urethral meatus is located behind the clitoris by spreading the labia majora and using a pen light to examine the genitals

Answer 48

Typically large and should have 2 descended testicles present at time of birth -Undescended has risk for testicular cancer Scrotal swelling can be seen in the presence of hydrocele or hernia

Answer 49

The prepuce of the newborn male is often tight and cannot be retracted past the glans of the penis -Don't force retraction Avg age of initial retraction is 10-11 yo

Answer 50

Most newborns urinate within the first mins to hrs of life. | Newborns who have not urinated within the 24 hrs should be sent for additional workup such as renal u/s

Answer 51

Assess all major joints and muscle groups on the newborn. Spontaneous bilateral movements of all extremities should be observed Start by assessing the hands and palms for polydactyly, syndactyly or abnormal dermatoglyphic patterns, all of which can potentially indicate an underlying genetic disorder

Answer 52

AKA clubbed foot

Answer 53

Performed by adducting the hip (bringing the thigh towards the midline) while applying light pressure on the knee, directing the force posteriorly. If the hip is dislocated the test is considered positive

Answer 54

Performed by flexing the hips and knees of a supine infant to 90 degrees, thenp lacing anterior pressure on the greater trochanters, while abducting the infant's legs. A positive Ortolani sign is noted when the femoral head relocates anteriorly into the acetabulum, thus correcting for the Barlow maneuver

Answer 55

Check for any evidence of scoliosis, or abnl dimpling above the gluteal crease as this can be indicative of neural tube defects Brace when angle is lower, surgery if angle is higher

Answer 56

Observe the posture of the infant There should be flexion at the knees, hips and elbows -Infants with hypotonia often assume a frog leg position Next assess level of alertness -Lightly touch the cheek or foot of the baby to see that they are easily arousable Also assess reflexes