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S3 1538 > S3 M4 Newborns > Flashcards

S3 M4 Newborns Flashcards

1
Q

Initial breathing is a reflex triggered by

A

pressure change

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2
Q

Rooting reflex

A

Latching-on and sucking pattern

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3
Q

Babinski Reflex

A

The sole of the foot has been firmly stroked

The big toe then moves upward

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4
Q

Moro reflex

A

Happens when the baby is startled

Extending arms, legs and neck following by rapidly bring arms together

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5
Q

Galant reflex

A

hold newborn in ventral suspension (face down) and stroke along one side of the spine.

Normal reaction is for newborn to laterally flex toward the stimulated side.

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6
Q

Largest part of newborns body

A

Head

Keep wrapped to conserve heat

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7
Q

Why is vit k given to new borns

A

Vit K is a part of the synthesis process for various clotting proteins like prothrombin.

Babies don’t have a lot of K at the beginning, so they are susceptible to bleeding.

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8
Q

Birth weight

Normal
low
very low
extremely low

A

2.5-4 kg
less than 2.5 kg
less than 1.5 kg
less than 1 kg

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9
Q

New born vitals

Temp
HR
Resp
BP

A

97.7-99.5 F
110-160 bpm
30-60 breaths
50-70 systolic/30-45 diastolic

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10
Q

APGAR

A

Appearance COLOR
Pulse HEART RATE
Grimace REFLEX
Activity MUSCLE TONE
Respiratory RESPIRATORY EFFORT

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11
Q

Blink/pupillary reflex

A

Bring object close to eye, will blink

PEARL for pupils

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12
Q

Ortolani Maneuver

A

Move hips outward and up
Listen for clicking
Indicates hip dysplasia

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13
Q

Stepping reflex

A

Hold baby upright and incline forward

Baby should try to walk

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14
Q

Tonic neck reflex

A

AKA fencing reflex

Babys hands will assume position of a fencer depending on the side that the baby is looking

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15
Q

Palmar grasp

Plantar grasp

A

Place finger in open palm, baby will hold it

Place finger just below tows, toes will curl

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16
Q

Skin assessment

A

Smooth
Flexible
Good turgor
Well hydrated
Warm

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17
Q

Variations and common skin problems for babys

A

Jaundice
Acrocyanosis
Milia
Mongolian spots
Stork bites

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18
Q

Anocutaneous reflex

A

Stimulate perianal skin close to anus
Anus should wink

For anal patency

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19
Q

Average head circumference

A

32-38cm

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20
Q

What can cause a small head

A

Microcephaly due to

Rubella
Toxoplasmosis
SGA (small gestational age) status

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21
Q

What can a large head indicate

A

Hydrocephalus
Increased intracranial pressure

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22
Q

Vernix caseosa

A

Thick white substance to protect skin during first 2-3 days

don’t remove

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23
Q

Stork bites

A

superficial vascular areas on nape, eyelids, upper lip

immature blood vessels

normal variant

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24
Q

Milia and Epstein pearls

A

white/yellow unopened sebaceous glands

Milia if on chin, forehead and nose

Epstein if in mouth

normal, will disappear in 2-4 weeks

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25
Q

Mongolian spots

A

Benign blue or purple splotches

Lower back and buttocks as well as legs and shoulders

Concentration of pigmented cells

Disappear spontaneously within first 4 years

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26
Q

Erythema toxicum

A

Newborn rash

face chest back

looks like flea bites

disappears in days

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27
Q

Harlequin sign

A

Blood vessel dilation on only one side

affected side will be red

happens in underweight babies

no intervention needed

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28
Q

Nevus vasculosus

A

Strawberry marks

raised rough dark red skin found on head

seen in immature infants

appear after first few weeks of life

resolve by age 3

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29
Q

Molding WILL BE ON TEST

A

Elongating of the fetal head to accommodate passage through birth canal

resolves in 24 to 48 hours

CAN happen with c section

resolves in a week

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30
Q

Caput succedaneum

A

Localized edema of scalp due to birth pressure

pitting edema and petechia (red spots) and ecchymosis (redness)

appears on suture lines

resolves in 3 days

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31
Q

Cephalohematoma

A

Swelling under one cranial bone with no skin redness

due to prolonged labor or use of tools for extraction

does NOT cross suture lines and is firm

appears on 2 day and resolves in months

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32
Q

Microcephaly

A

Head circumference more than 2 standard deviations below average

Reduced production of neurons

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33
Q

Microcephaly leads to

A

Seizures
Developmental delays

Vision, hearing, balance, feeding problems

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34
Q

What leads to microcephaly

A

Cytomegalovirus
Rubella
Toxoplasmosis
Trisomy

use of alcohol and drugs

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35
Q

Macrocephaly

A

Circumference more than 90% of normal

Typically related to hydrocephalus

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36
Q

Hydrocephaly

A

increased volume of cerebrospinal fluid (CSF) in or around the brain

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37
Q

Large fontanels

A

more than 6cm in anterior diameter
more than 1cm in posterior fontanel

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38
Q

Large fontanels are associated with

A

Malnutrition
Hydrocephaly
Congenital hypothyroidism
Trisomy

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39
Q

Small or closed fontanels (craniosynostosis)

A

lead to abnormal brain development

Associated with microcephaly

requires complex reconstructive approach

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40
Q

With baby face look for

A

full cheeks
symmetry

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41
Q

With baby nose look for

A

Smallness
midline placement
Ability to smell

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42
Q

With baby mouth look for

A

Midline
Symmetry
Intact soft and hard palate

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43
Q

With baby neck look for

A

Short
Creased
Moves freely
Baby holds head in midline

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44
Q

In baby eyes look for

A

Clearness
symmetry
online with ear
love

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45
Q

in baby ears look for

A

soft
pliable
quick recoil

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46
Q

in baby chest look for

A

round
symmetry
smaller than head

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47
Q

in baby abdomen look for

A

Protuberant (bulging) contour
soft
three vessels in umbilically cord

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48
Q

In baby genitals look for
male

female

A

Smooth glands
meatus centered at tip of dick

swollen genitals due to maternal estrogen

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49
Q

In baby spine and extremities look for

A

symmetry
free movement

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50
Q

If thrombocytopenia drops below 100,000

A

Dr will start C section

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51
Q

+1
+2
+3
+4

EDEMAS

A

2mm
4mm
6mm
8mm

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52
Q

Greater than 8mEq of magnesium is considered

A

Toxic

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53
Q

Trisomy 21

A

Down syndrome

presence of an extra 21 chromosome

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54
Q

Children with down syndrome are at a higher risk of what complications

A

Hearing/vision
Sleep apnea
Hypo/hyper Thyroidism
Heart disease
Gastrointestinal disorders
Hematological problems

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55
Q

Children with down syndrome develop on their own _

The earlier you start therapy the _

A

timetable

better

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56
Q

Physical examination for down syndrome appearance

A

Lack of muscle tone
Loose joints
Small head
Flat face
Large tongue

57
Q

Maternal age over _ indicates a GREAT risk for down syndrome

A

35

58
Q

Because down syndrome children grown slower use _ to document

Special ones are available to account for the condition

A

Growth chart

59
Q

Lab/diagnostics for downs

A

11-14 weeks
Nuchal translucency
PAPP-A
hCG

16-18 weeks
3/4 blood test
AFP
estriol

60
Q

Downs is truly diagnosed at

A

Birth

with a chromosome analysis

61
Q

Common assessments for complications of Downs

A

Echocardiogram
Vision/hearing check
Thyroid levels
Cervical radiography
Ultrasound

62
Q

Nursing management for downs

A

^ growth/development
v complications
^ nutrition
^ support/education

63
Q

Promoting growth and development with downs

A

Speech/language therapy
Occupation/physical therapy

64
Q

Promoting nutrition

A

During feeding use

Bulb syringe
Humidification
Position changing

to accommodate the larger tongue

65
Q

Because of muscle underdevelopment at birth, downs babies have a hard time

A

Sucking/feeding

66
Q

Because of a slower metabolic rate, downs kids have problems with

A

obesity

67
Q

Huntington disease

A

Nervous system disease

involves choreiform (coordination problem) movement
AND dementia
68
Q

Huntington is autosomal dominant meaning

A

Each child of a Huntington patient has a 50% chance of inheriting the disorder

69
Q

The gene for Huntington is mapped and

A

Can be tested for

70
Q

Patho of Huntington

A

Death of cells in cerebellum/basal ganglia (small ram horns in the middle of brain)

These cells are in control of movement

and

Death in cells of the cortex

71
Q

What is the cortex associated with

A

Thinking, memory, perception, judgment, behavior.

Death in these cells results in huntington associated dementia

72
Q

Symptom triad of Huntingtons

A

Motor dysfunction (chorea- jerky movement)

Cognitive impairment (attention/emotion recognition)

Behavior features
(apathy/blunt affect)

73
Q

As huntington progresses and body starts to constantly jerk and move involuntarily, speech will become incomprehensible and patient will be at risk for

A

Choking/aspiration

74
Q

Chorea

A

Involuntary jerking

Huntington

75
Q

With increased loss of muscle control, the huntington patient will lose

A

Bladder/bowel control

76
Q

Huntington onset occurs at

A

35-45y

77
Q

Personality changes in huntington are

A

severe

depression, apathy, anxiety, psychosis, delusions etc.

78
Q

Assessment for Huntington

A

Fam history and characteristic symptoms

Genetic marker CAG repeats in HTT

CT/MRI of brain

79
Q

Cure of huntingtons

A

None

focus on treating symptoms

80
Q

Med for huntingtons

A

Tetrabenazine specifically for Huntington chorea

Benzodiazepines and neuro drugs also help

81
Q

Med for controlling psych huntington symptoms

A

SSRI
Tricycline antidepressants

82
Q

Therapies for huntingtons

A

Physical/occupational
Speech/social

83
Q

Genotype

Phenotype

A

25000 genes

Observable characteristics of those genes

84
Q

Adenine=
Guanin=

A

Thymine
Cytosine

85
Q

How many chromosomes do humans have

which one is responsible for sex

A

46 total
23 paired

23rd

86
Q

Mitosis vs meiosis

A

Duplication of almost all body cells 46chromosomes

Duplication of reproductive cells
23chromosomes

87
Q

Nondisjunction during meiosis can lead to

A

Trisomy, downs
Monosomy, turners

88
Q

Gene mutations leads to

A

Huntington
Fragile X
Mytonic dystrophy
etc.

89
Q

X-linked recessive inherited conditions mostly affect

transmitted

A

Males

Vertically

90
Q

Autosomal dominant inherited conditions vs autosomal recessive inherited conditions

A

Vertical transmission

Horizontal transmission

91
Q

Variable expression

A

Variation of degree to which a condition is expression

Usually occurs with Autosomal DOMINANT conditions

92
Q

Do Autosomal recessive carriers have symptoms of conditions

A

NO

only autosomal DOMINANT carriers do

93
Q

Dominant vs recessive % of inheritance chance

A 
Dominant = 50%
Recessive = 25%
94
Q

X linked recessive pass down

A

50% chance of carrier MOTHER to pass to SON

95
Q

General term for having extra or missing chromosomes

A

Aneuploidy

96
Q

Breast cancer

A

Diseases of unregulated cell growth

Most common cancer in women

97
Q

Pathophysiology of breast cancer

A

Clonal, daughter cells are also mutated

growth depends on estrogen and progesterone levels

98
Q

2 categories of breast cancer

A

invasive (infiltrating) extends into surrounding tissue, can metastasize

noninvasive (in situ) have not extended beyond the duct

99
Q

Where does breast cancer metastasize

A

Bone

Lungs

Lymph nodes

Liver

Brain

100
Q

Most common breast cancer

A

Invasive ductal carcinoma

80% of all cases

101
Q

Invasive lobular carcinoma

A

originates in terminal lobular units of breast duct

ill-defined thickening

upper outer quadrant of breast

102
Q

cancer stages

0

1

2

3

4

A

in situ

less than 1in diameter

1-2in diameter spread to axillary lymph nodes

2in diameter spread to other lymph nodes and tissues

Cancer has metastasized to other organs

103
Q

Breast cancer risk factors

A

Age over 50

BRCA1 and BRCA2 genes

Increased breast density

White race

104
Q

Diagnosing breast cancer

A

Mammography

Magnetic resonance mammography

biopsy

hormone status

HER2/neu genetic marker

105
Q

Local treatment for breast cancer

A

Surgery and radiation

106
Q

Systemic treatment for breast cancer

A

Chemo

Hormonal therapy

Immunotherapy

107
Q

Preventative breast cancer surgery

A

Mastectomy

108
Q

Lumpectomy with radiation

A

Breast conserving surgery

Used in early stage localized tumors

Radiation begins 2-4 weeks after, goes on for several weeks

109
Q

Simple mastectomy

A

Removal of all breast tissue, nipple and areola

110
Q

Modified radical mastectomy

A

Also removes lymph nodes in the arm pit in case of spread

111
Q

After mastectomy, the woman can choose to have _ surgery

It is recommended to be done _ after mastectomy

A

Reconstructive

SOON

112
Q

Radiation therapy

A

Uses high energy rays to destroy microscopic cancer cells to reduce recurrence

Done 5 days a week for 6 to 8 weeks

113
Q

Side effects of radiation therapy

A

Inflammation

Edema

Swelling

Sunburn skin

Fatigue

114
Q

Chemotherapy

A

Use of drugs

Toxic to call cells and interfere with cell reproduction

Done in cycles of 3 to 6 months depending on severity

115
Q

Breast cancer side effects

A

N/V

Diarrhea

Constipation

Hair loss

Weight loss

Fatigue

116
Q

Most serious effect of chemo

A

Bone marrow suppression

117
Q

Hormone therapy for breast cancer

A

Endocrine therapy to counter effects of estrogen which contributes to cell growth

118
Q

Tamoxifen

A

Well know SERM aka Hormone therapy for breast cancer

Given for 5 years

119
Q

Immunotherapy

A

Increases immune response to cancer cells

Trastuzumab/pertuzumab

120
Q

Immunotherapy side effects

A

Cardiac toxicity

Thrombosis

Fever

N/V

Hepatic failure

121
Q

Postop breast cancer care

A

Pain management

Care of arm

Wound/Mobility care

Resp care

Emotional care

122
Q

phytochemical rich foods

Good for boost against cancer

A

Herbals tea

Garlic

Onion

Soy

Veg

123
Q

Self breast exams should be done

A

monthly

124
Q

Local vs systemic treatment for b cancer

A

surgery/radiation

chemo/hormone/immunotherapy

125
Q

Brachial plexus injury

A

Injury to arm of baby

will curve back

no nerve connection

126
Q

MIlia looks like

Erythema toxicum looks like

A

Small whitehead acne

Red acne

Both present at birth, if appears after birth REPORT, probably a reaction to skin product

127
Q

Nevus flammeus

A

Red skin areas like spilled wine

NO intervention

128
Q

When to do APGAR

A

1 min and 5 min after birth

129
Q

Down syndrome kids have dental care Q_months

A

6 may be on test

130
Q

Nutrition for down syndrome for preventing constipation

A

high fiber high water

may be on test

131
Q

Huntington disease is an autosomal _ gene

A

DOMINANT

WILL be on test

132
Q

BRCA 1 and BRCA 2 are autosomal _

so chance of passing down breast cancer is _

A

DOMINANT

50/50

WILL be on test

133
Q

BRCA is associated with cancer in what age category of women

A

20-30 y/o

134
Q

Anemia is autosomal

A

Recessive

135
Q

With anemia the first organ to get damaged is the

A

Spleen (helps fight infection)

Meaning, PT more susceptible to infections

136
Q

Hydroxyurea for Anemia

A

Raises fetal hemoglobin to counteract sickling of cells.

137
Q

Priority Sickle Cell Anemia management

A

Pain - Narcotics

138
Q

Tenderness and abdominal pain with Sickle Cell Anemia may indicate

A

Spleen damage

May be on test

S3 1538 (15 decks)

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