Routine neonatal care Flashcards
What is considered the normal weight of an infant
2500-4000g
What is the normal apgar for an infant
Above 7 at 1 minh
When should the umbilical cord be clamped
After about 2 mins to allow for the placental blood to enter the fetus
What does clamping after the 2 min help with
It gives the fetus some extra blood and in doing so prevents anemia and iron deficiency within the first year
When should the baby be given to the mother
As soon as possible to enhance bonding
Why is it important to give the baby a Vit K injection IM
This helps to prevent haemolytic disease in the infant
What should be done for the infants eyes
Antibiotic ointment should be placed in the eyes to prevent conjunctivitis
What is mean by in room care of the infant
This means that the infant is kept with the mother in the same room
What are the 6 main benifits to rooming in
- It strengthens bonding
- Avoids schedualed feeding and allows the infant to feed when needed
3.Promotes kangaroo care - Decreases the risk of infection
- Decreases the number of staff needed
- Increases the mothers confidence
What are the only 3 reasons why a baby should be washed
- Melconium staining
- Maternal blood
- Maternal faecal matter
How many nappies should a baby have per day
A baby should wet roughly 6 nappies per day
How long should the umbilical cord take to fall off
1-2 weeks
When should a baby’s weight rebound and how much do they normally lose
By day 7 they should rebound. They lose roughly 10% of their body mass
What are the 2 main vaccinations that infants should get and when should they get them
- Polio
- BCG
They should get them around day 5
What causes vaginal discharge in female infants
The maternal estrogen
What causes enlarged breasts in both male and female infants
Maternal estrogen
Should the foreskin be pulled back and cleaned
No
What are the teeth called that infants are born with
Natal teeth
Is a coccygeal dimple normal
Yes
What should be done if an infant is born with a wide fontanelle
If the head circumference is in the 90th percentile then refer the infant to a level 2 or 3 hospitals as there is a risk of hydrocephalus
What are the 5 components of the fetal neurological exam
- Head circumference
- Red reflex
- Posture
- Tone
- Primitive reflexes
What does the red reflex test for
Retinoblastoma and Cateracts
What is the rooting reflex
If the mouth or cheeks are stimulated then the baby will suckle
What is the suckling reflex
If an object is placed in the babies mouth then it will start suckling
What is the moro reflex
A sudden loss of support or loud sound will cause the baby to splay the arms and tilt the head back
What is the grasp reflex
If something is placed in the babies hand it will grasp it
What is the atonic neck reflex
When the head is turned to the side the baby will extend the arm on the same side and flex the arm on the other side
What is the Galant Reflex
It the baby is stroked on one side when it is on its back it will cause the infant to bend its trunk to the side that it was stroked
What is the boggy swelling of a fetus skull called and what does it indicate
Caput succundum, it has no pathological significance
What is a cephalohematoma and how does it differ from a sub-aponeurotic bleed
A cephalohaematoma is a bleed that occurs between the periosteum and the parietal bone of the skull but never crosses the suture lines of the bone
What is the treatment needed for a cephalohematoma
No treatment is needed however the patient may develop jaundice upon reabsorption of the blood, it should not be drained as it can increase the chances of infection
What is a subaponeurotic haematoma
This is a bleed under the aponeurotic membrane that connects the frontalis and the occipital muscles
What are the complications from a sub-aponeurotic hematoma
As the aponeurosis is large it can accumulate a lot of blood thus the infant can present with shock and pallor
What are the possible treatments for a subaponeurotic hematoma
1mg Vit K and a blood transfusion to prevent shock
What is the most common cause of facial palsy and what is the prognosis
The pressure of the forceps blades during delivery, the recovery should be spontaneous
What is the cause of brachial nerve palsy in an infant
Excessive traction on the head and neck
What are the 2 possible causes of low numbers of platelets in infants
- Decreased production: This occurs in infections like sepsis and syphilis
- Decreased numbers: Congenital disorders and in immune thrombocytopenia
What are the 4 possible causes of excessive bleeding in infants
- Damage to vessels
- Decreased no. of platelets
- Abnormal platelet function
- Low clotting factors
What causes the infant platelets to not function well
If the mother takes high amounts of asprin
What causes low amounts of clotting factors 5
- Haemoragic disease
- Inherited haemophilias
- Preterm infants
- Consumptive DIC
- Maternal warfarin treatment
Briefly describe what hemorrhagic disease is
This is where is where the infant has low levels of Vit K and so can not form all of the clotting factors that are required
What is the clinical presentation and the treatment for a patient with hemorrhagic disease
Clincal presentation: Vomiting blood and melena stools
Treatment: 1mg of Vit K and blood transfusion
What are the 2 possible causes of an infant vomiting blood or having melena stools
- Maternal blood: This is either ingested in the birth process or is bleeding from the nipple
- Hemorrhagic disease
What is the test to check if the blood is from the infant or from the mother
APT test
5 mls of the sample is added to 1ml of 1%NaOH if the solution stays pink then it is fetal
Which clotting factor is most commonly affected by inherited hemophilia
8
What are the 2 tests that are used to check for developmental hip dysplasia and how are they done
- Barlow test: Here you flex and adduct the thighs bringing them closer to the midline and then apply slight downward pressure. If the hip dislocates then it is positive
- Orotolani test: Abduct the legs [O: Outwards] this will then relocate the hips
