PEDIA 1 Flashcards
Causes of ASPHYXIATION
○ Umbilical cord clamped
○ No more O2 from placenta
○ Hypoxia
○ Hypercapnia/Hypercarbia
dangerous state (fatal) kasi may
direct effect sya sa brain! Lahat ng vital
center is magre-react, V/S, LOC etc
Acidosis
Neonates must breathe after birth!
If not,
asphyxiation may result! (hypoxia,
hypercapnia, acidosis)
A crying baby is a breathing baby
TRUE
USE BULB SYRINGE NEVER WALL
SUCTION
TO REMOVE OXYGEN as Oxygen can cause
blindness
use pulse
oximeter
on the sole of the foot
SUCTION ONLY WHEN?
BOTH ARE COLOR
GREEN: mucus and meconium
Suction with bulb syringe PRN
TO PREVENT ASPIRATION
Use only a bulb syringe in
suctioning
to avoid
stimulating the vagus nerve
leading to bradycardia
Using a wall suction
you are
exerting a strong negative
pressure; you are not only
suctioning the secretions but also his/her oxygen reserves =
HYPOXIA
Too much O2 can what?
Can make the
baby blind
Retrolental Fibroplasia
for term babies
Retinopathy of Prematurity (ROP)
for
preterm babies
Reason why DR has aircon
to prevent
infection to come inside (maintenance of
environmental asepsis)
Extreme hypothermia can cause cold stress
causing what?
ACIDOSIS
Prone to cold stress due to?
extreme hypothermia
Decreased O2, Increased CO2 can lead to?
ACIDOSIS
BROWN FATS ALSO KNOWN AS
BABY FATS
By product of brown fats
Ketones/ Fatty Acids
60% of their weight is brown fats
= intended to?
to hold, sustain, or
cushion their abdominal organs
in place
Dry baby immediately after birth to?
to stimulate the baby to cry and to dry
his/her skin
what is SSC?
skin to skin contact
CHEST CIRCUMFERENCE
31-33 cm
HEAD CIRCUMFERENCE
33-35 cm
Radiant warmer is ideal because
○ it is not close to the baby (18-24 inches) /
2 feet
○ Heat is even from head to toe and also
circulation
APGAR SCORE
Done at 1 minute then at 5 minutes
WHO SUGGESTED APGAR SCORING?
Dr. Virginia Apgar
Score of 0 - 3: POOR CONDITION
○ Resuscitation needed/ NICU
○ Will not undergone skin to skin contact
with the mother
Score of 4 - 6: FAIR CONDITION BUT GUARDED
CLOSE MONITORING
○ Baby goes to NICU
○ Wala ding rooming in dito (yung ilalabas
din siya kasama ng mother sa ward for the
skin to skin contact and breastfeed etc)
Score of 7 - 10: GOOD CONDITION
○ Allowed to do “Unang Yakap”
○ Rooming-in (adapting)
EYE CARE (Crede’s Prophylaxis)
Prevents Ophthalmia Neonatorum due to maternal
gonorrhea or chlamydia
when is crede’s prophylaxis done?
Done to ALL babies delivered either CS or NSD after
initial bonding / or complete breastfeeding
responsible for breastmilk
Prolactin
When is the best time to give crede’s prophylaxis?
After the mother and the baby have
already bonded and/or complete breastfeeding;
when to clamp umbilical cord
Clamp when no longer pulsating, at 2cm and 5cm
from the base
Prevent infection of umbilical cord by
cleaning the
umbilical cord with WATER AND SOAP only
do not use what when cleaning the umbillical cord?
DO
NOT USE betadine, hydrogen peroxide and alcohol
(we don’t use chemical based)
How do we promote drying of the umbilical cord?
Promote drying by natural technique of air exposure
redness around the cord and foul smelling
CORD INFECTION
Ano ang dapat na ituro sa mother when she puts
diaper to the baby?
Air exposure is the best, so turuan ang
mother to fold the waistband of the diaper down
to expose the cord
VITAMIN K Site of Injection?
Vastus Lateralis (most highly developed muscle)
how many dose of vitamin K?
1mg IM in the vastus lateralis
when are we using the gluteal muscle as site of injection?
We are using gluteal muscle as the site of
injection as it is developed na
Babies are not given a bath within?
6 hours
What should not be done to the vernix caseosa on a newborn?
Do not remove the excess
What time ba dapat magpaligo ng NB
kapag nasa bahay na?
ANYTIME pwede paliguan as long as
the BABY IS NOT SICK
R.A 7600 or
Rooming-In/ Breastfeeding Act of 1992
Provide Optimum Nutrition
Executive Order #51
MILK CODE OF THE PHIL.
What is the minimum frequency for breastfeeding a newborn?
At least 8 times a day
How long can pumped breast milk be frozen for?
Pumped breast milk can last up to 1 year when frozen.
What is the guideline for thawing frozen breast milk?
Frozen breast milk should be thawed by immersing it in warm water.
What is the role of IgG antibodies during pregnancy?
IgG antibodies cross the placenta from the mother to the baby.
When should complementary feeding start for infants?
Complementary feeding should start at 6 months of age.
What is the preparation method for infant formula?
Infant formula should be sterilized by boiling for 10 minutes from the boiling point.
What type of breast milk substitute is recommended?
Infant formula is the recommended breast milk substitute.
What are the risks of propping a feeding bottle?
Propping a feeding bottle can lead to aspiration and otitis media in the baby.
How should a baby be burped after feeding?
Burp the baby by rubbing or tapping their back.
When is newborn screening performed?
Newborn screening is performed by heel prick when the baby is at least 24 hours old and not more than 72 hours old.
What are some unnecessary procedures for newborns?
Unnecessary procedures include routine suctioning, early bathing, footprinting, giving sugar water or formula, and using bottles or pacifiers.
What is physiologic jaundice?
Physiologic jaundice is normal and typically appears within the first 24 hours and disappears by the 10th day for preterm infants.
What are the signs of respiratory distress in newborns?
Signs include fast breathing, flaring of nostrils, grunting sounds, and severe chest indrawing.
What causes respiratory distress in premature infants?
Respiratory distress is caused by immature alveoli with less surfactant.
What are the signs of apnea in premature infants?
Signs of apnea include prolonged apnea for more than 20 seconds and central cyanosis.
What is the purpose of kangaroo care for premature infants?
Kangaroo care helps maintain body temperature and promotes bonding between the mother and baby.
What are the signs of hematologic difficulties in newborns?
Signs include jaundice and hyperbilirubinemia.
What nutritional difficulties do premature infants face?
Premature infants are prone to aspiration and gastric distention due to uncoordinated sucking and swallowing.
What is kernicterus?
Kernicterus is brain damage caused by bilirubin entering the brain.
What are the key points regarding breastfeeding and breast milk storage?
- Breastfeeding should be on demand.
- No mixed feeding is allowed.
- Pumped breast milk can be frozen for up to 1 year.
- Label frozen milk with date and time.
- Thaw frozen milk in warm water, not in the microwave.
- Breast milk provides passive natural immunity.
What is the access point of infection in newborns?
Umbilical cord
What is the management protocol for preventing infection in the nursery?
Strict compliance with nursery aseptic protocol
What should be avoided by nurses in the nursery?
Nurses with illness
What dietary changes are recommended for pregnant women to prevent infection?
Low sodium diet and increased protein intake
What is a possible outcome of placental degeneration?
Intrauterine fetal death (IUFD)
What is fetal distress indicated by?
Meconium-stained amniotic fluid
What happens to the uterus during preterm delivery in diabetic mothers?
It overstretches due to excess glucose
What is the effect of maternal diabetes on the fetus?
Intrauterine hyperinsulinism leading to macrosomia
Normal sound of breathing
Broncho vesicular
abnormal; there’s something
wrong in breathing
Adventitious sound
what we hear for newborn
with prolonged apnea = collapsed lungs
GRUNTING SOUNDS
artificial surfactant
Survanta
Most common cause of death after discharge?
because of infection
Placental degeneration causing
decreased
utero-placental perfusion
What are the physical characteristics of post-mature infants?
Long, thin, dry cracking skin, no vernix and lanugo
Hypoxia is due to?
placental insufficiency
What is congenital adrenal hyperplasia (CAH)?
A condition characterized by decreased cortisol and severe salt loss
Baby with CAH condition cannot what?
cannot produce
adequate cortisol
Why sodium is important in our body?
sodium is important in our body, without these, there would be possible cellular dehydration
What is the management for congenital adrenal hyperplasia?
NaCl supplement
What is galactosemia?
Inability to metabolize galactose in milk
What is the problem in galactosemia?
The problem here is that the galactose is not
converting
What is the management for galactosemia?
No animal source milk and no breastfeeding
What is phenylketonuria (PKU)?
Inability to utilize an essential amino acid causing mental retardation
What is the management for PKU?
Special formula:
■ Lofenalac
■ Phenelac
What is glucose-6-phosphate dehydrogenase (G6PD) deficiency?
Breakdown of RBC causing anemia
What is the management for G6PD deficiency?
Avoid “triggers” like beans, naphthalene,
sulfas, peanuts
What is congenital hypothyroidism (cretinism)?
Deficiency in thyroid hormones causing physical and developmental delay
What is the management for congenital hypothyroidism?
Thyroid supplement for life (Synthroid)
What is maple syrup urine disease?
A rare genetic disorder characterized by deficiency of an enzyme required to metabolize cthe three amino acids (BCAAs)
leucine, isoleucine and valine
Signs and Symptoms of maple syrup urine disease?
Distinctive sweet odor of infants’ urine, poor feeding, vomiting, lack of energy
(lethargy), and delayed development. If untreated, can lead to seizures, coma, and death
What is the management for maple syrup urine disease?
Limit the 3 amino acids, KETONEX®-1, an amino acid-modified infant formula with iron
