Pediatrics Flashcards
What is considered late preterm delivery?
34 to 37 weeks gestation
What is the normal respiratory rate of a newborn?
40-60 breaths per minute
What is the normal heart rate of a newborn?
120-160 beats per minute
What is the purpose of the APGAR score?
quantifiable measurement for the need and effectiveness of resuscitation
What is the normal blood pressure for a newborn?
65/50 mmHg
What are the 5 aspects that go into an APGAR score?
- appearance (skin color= pink)
- pulse (>100)
- grimace (reflex irritability= crying)
- activity (muscle tone = active movement)
- respiration (quality of breathing)
(max score is 10)
What does the APGAR score at 1 minute signify?
conditions during labor and delivery
whether baby needs resuscitation
What does the APGAR score at 5 minutes signify?
- represents effectiveness of resuscitation efforts
2. prognostic of survival
What should be done if the APGAR score is 0-3?
resuscitation (ventilation)
What should be done if the APGAR score is 4-6?
closely monitor newborn
What is the most common cause of red eyes (conjunctivitis) in a newborn at 1 day of life?
chemical irritation (usually due to silver nitrate drops in developing countries)
What is the most common cause of red eyes (conjunctivitis) in a newborn at 2-7 days of life and what is treatment?
Neisseria gonorrhoeae
tx: ceftriaxone
What is the most common cause of red eyes (conjunctivitis) in a newborn at more than 7 days of life and what is treatment?
Chlamydia trachomatis
tx: oral erythromycin
What is the most common cause of red eyes (conjunctivitis) in a newborn at more than 3 weeks of life?
Herpes simplex infection
tx: acycolvir and topical vidarabine
What is done at the time of birth to prevent ophthalmia neonatorum (due to Neisseria gonorrhoeae or Chlamydia trachomatis)?
erythromycin or tetracycline ointment with silver nitrate drops
(most effective against Neisseria gonorrhoeae)
What is a consequence of vitamin K deficient bleeding?
hemorrhagic disease of newborn
vitamin K used to produce factors 2, 7, 9, 10 and protein C and protein S
Why do newborns lack vitamin K at birth?
colon lacks normal bacterial flora that produces vitamin K
What is the treament used to prevent development of hemorrhagic disease of the newborn?
IM injection of vitamin K at birth
A neonate who did not receive routine newborn care presents with bright red blood in diaper, bleeding from belly button and lethargy most likely suffers from ….
Hemorrhagic Disease of the Newborn (vitamin K deficiency b/c did not receive prophylactic vitamin K shot)
What diseases are commonly tests in a newborn screen? (8)
- PKU (phenylketonuria)
- congenital adrenal hyperplasia (CAH)
- Biotinidase
- Beta thalassemia
- Galactosemia
- Hypothyroidism
- Homocysteinuria
- Cystic fibrosis
What vaccine is given to babies at the time of birth?
Hepatits B
give hep B immunoglobulin if mom was Hep B surface antigen positive
What causes transient polycythemia of a newborn?
hypoxia due to cord clamping at delivery stimulates erythropoeitin
(associated with splenomegaly)
A neonate is born via C-section with a respiration rate higher than 60 bpm without any other symptoms or signs most likely suffers from …
transient tachypnea of newborn
due to lack of fluid expulsion from the lung via vaginal delivery; lung immaturity; surfactant insufficiency
What is the next best step in a neonate with tachypnea (RR > 60) lasting more than 4 hours?
(evaluate for sepsis and start antibiotics)
- blood culture
- urine cultures
- lumbar puncture (if lethargy, temp irregular, feeding problems)
- CXR