RECOGNIZING A NORMAL NEWBORN Flashcards
CATEGORIES OF PRETERM BIRTH
Overall PT :
- Moderately PT:
- Very PT :
- Overall PT : <37 wks gestation
- Moderately PT: between 32 and 36 weeks
- Very PT : <32 weeks gesatation
- method of systematically assessing NB after birth
- Assessed at 1 and 5 minute of life infants immediately
- If the 5 min score is <7, additional scores should be
assigned every 5 min up to 20 min
APGAR SCORE
- between 34-36 6/7 wk
- 37 0/7 wks - 38 6/7 wks
- 39 0/7 wks — 40 6/7 wks
- 41 0/7wks - 41 6/7 wks
- 42 0/7 wks and beyonce
Late preterm: between 34-36 6/7 wk
Early Term: 37 0/7 wks - 38 6/7 wks
Full Term: 39 0/7 wks — 40 6/7 wks
Later Term: 41 0/7wks - 41 6/7 wks
Post Term : 42 0/7 wks and beyonce
- To obtain a more accurate idea of the GA
- Most accurate if performed within the 1st 12 hrs of life
- Infant’s true GA can he estimated with an accuracy of about 2 wks
- If scored age 18 W/T 2 wks of the GA suggested by the mother’s dates, then accept her dates as correct
Ballard Score
- Scalp pressure from the uterus
- Circular boggy areca of edema w ith indistinct borders
Caput succedaneum
Well-circumscribed fluid-filled mass; does not cross the midline
Cephalhematoma
- Not restricted by the houndaries of the sutures
- Larger and more diffuse
- Result in hypovolemuc shock
Subgaleal hemorrhage
genetic d/0, congenital intxn, drug exposure
Microcephaly
Hyrocephalus, storage dse, achondroplasia, cerebral gigantism, neurocutaneous syndrome, IEM
Megalencephaly
premature fusion of sutures
Craniosynostosis
- Large anterior fontanel: achondroplasia, Apert syndrome, hypothyroidism, cleidocranial dysostosis, congenital rubella syndrome, Halierman-Streiff syndrome, hydrocephaly, hyphophosphatasia, IUGR, Kenny syncrome, OI, PT, Trisomies, Vit. D def rickets
- Small fontanels: microcephaly craniosynostosis, CH of wormian bones
- Presence of third fontancl suggest T21, but seen in preterm infants
Fontales: anterior fontanel
- Atrophic or alopecic scalp
Sporadic or alopecic autosomal dominant - Asstd with T13, chromosome 4 deletion, or Johanson- Blizzard syndrome
Aplasia cutis congenita
- In utero positioning
- Asstd with torticollis and vertex positioning
Deformational plagiocephaly
- Symmetric acial palsy
- Absent/hypoplasia of 7th nerve nucleus
Mobius syndrome
Cornea >1cm in dia with photophobia and tearing or clouding
Glaucoma
- White pupillary reflex
- Cataract, tumor, chornoretinitts ROP
Leukocoria
- Abduction of the thighs with external rotation
- If the femoral head can be felt to slip forward into the acetabulum on pressure from behind, it is dislocated (positive) .
- Sometimes an audible “chunk” can be heard.
Ortolani test
- Pressure from the front
- lf the femoral head is felt to slip out over the posterior lip of the acetabulum and immediately slips back in place when pressure 1s released, there is dislocation or “unstable”
Barlow sign
4 mechanisms of heat loss
- Convection of heat energy the cooler surrounding air
- Conduction of heat to the colder materials touching the infant
- Heat radiation from the infant to other nearby cooler objects
- Evaporation from skin and lungs
