sick newborn Flashcards
clinical assessment of the newborn
- maternal history
- fetal history (growth, anomaly, delivery, resus)
- tone
- level of arousal
- colour
- vital signs
when is Apgar score measured
at 1min and 5 mins
what temperature should a baby be
37.5
what should a babies resp rate be
40-60/minute
what should heart rate be in a baby?
120-140/min
what should cap refill be in a baby
2-3 seconds
what colour should a baby be
pink/blue/white
what should oxygen sats be in a baby
95%
how would you manage any circulation problems
- fluids
- inotropes
initial management of newborns
- temperature
- airway and breathing (oxygen?)
- circulation
- metabolic homeostasis (glucose management, acid-base balance)
- antibiotics
how does sepsis present in a newborn
- quiet
- poor feeding
- floppy
- tachypnoea
- apnoea
- tachycardia
- bradycardia
- temp instability
sites of infection in babies
- blood stream
- CNS
- respiratory
- GU - UTI
most common bacterial infection in babies
group B streptococcus
what antibiotic for gram positive and negative
benzylpenicillin
what antibiotic for additional gram negative cover
gentamicin
viruses seen in babies
- cytomegalovirus
- parvovirus
- herpes
- enterovirus
- syphilis
respiratory pathologies in newborn
- TTN
- pneumothorax
- meconium aspiration/RDS
circulatory problems in newborns
- persistent pulmonary hypertension
- foetal anaemia
clinical signs of respiratory distress
- tachypnoea
- recession
- grunting
- blue
what is TTN
transient tachypnoea of the newborn
- due to delay in clearing lung fluid
- lung fluid usually clears into interstitium and then to lymphatic system
- resolves over first 24 hours of life
what can a pneumothorax be secondary to
- resuscitation
- infection
- meconium
- surfactant deficiency
what is RDS due to
surfactant deficiency
what is RDS associated with
- IUGR
- maternal diabetes
- infection
- birth asphyxia
- multiple birth
- PROM
- meconium aspiration
treatment for RDS
respiratory support and surfactant replacement
what does meconium aspiration syndrome cause
- airway obstruction
- inflammation
- surfactant dysfunction
what are some cardiac abnormalities
- tachypnoea
- cyanosis
- murmur
- femoral pulses
- circulatory collapse
examples of congenital cardiac diseases
- tetralogy of fallot
- transposition of great arteries
- coarctation of aorta
- hypoplastic heart
congenital diseases of the lungs
- tracheo-oesophageal fistula
- diaphragmatic hernia
most dangerous cause of bilious vomiting
malrotation or volvulus
how does galactosaemia typically present
day 10 infant with jaundice and sepsis
