Swanson _ Children and Adolescents Flashcards
Normal respiratory rate in a newborn?
RR < 60 breaths/minute
Top 3 diagnoses on the differential for respiratory stress in term infants?
(1) Transient tachypnea of the newborn (TTN)
(2) Meconium aspiration syndrome
(3) Neonatal infection/sepsis
Of note, TTN and meconium aspiration syndrome occur immediately after delivery, whereas infectious etiologies manifest hours to days after birth.
TTN pathophysiology?
TTN results from residual pulmonary fluid in the neonatal lung and is more common after precipitous ( < 3 hours) and Caesarian deliveries, when there may be delay in the prostaglandin-driven dilation of lymphatic vessels that allows for removal of lung fluid with an increase in pulmonary circulation.
Neonatal infection/sepsis - common pathogens (4)?
Group B streptococci
S. aureus
S. pneumoniae
Gram-negative rods
Empiric antibiotic therapy for neonatal infection/sepsis?
Ampicillin + gentamicin
Top 3 diagnoses on the differential for hyperbilirubinemia in the newborn?
(1) Physiological jaundice
(2) Blood group incompatibility
(3) Infection
Preventive strategies (2) against hyperbilirubinemia in newborns born at 35+ weeks gestation?
(1) Nursing 8-12 times per day for the first several days
(2) Avoidance of water or dextrose water in nondehydrated infants.
Newborns should be assessed for jaundice every ___ during the first day of life.
Every 8-12 hours
Workup of infants with clinical jaundice in the first 24 hours of life?
Total bilirubin level
Workup of infants with clinical jaundice that persists past 3 weeks of age?
Total and direct bilirubin levels to evaluate for cholestasis
Total bilirubin level of ___ or higher should be considered a medical emergency. These infants should be admitted to the hospital for ___.
Total bilirubin level of 25 mg/dL or higher should be considered a medical emergency. These infants should be admitted to the hospital for PHOTOTHERAPY.
Physiologic jaundice begins on ___ and usually resolves in ___.
Physiologic jaundice begins on DAY 2-3 of life and usually resolves in 1-2 WEEKS.
Neonatal fever is defined as a rectal temperature greater than or equal to?
38 C (100.4 F)
All infants 0 to 30 days of age with fever should be admitted to the hospital and treated with?
IV ampicillin + gentamicin
-OR-
IV ampicillin + 3rd generation cephalosporin
Laboratory studies indicated in the evaluation of infants with fever without an evident source (5)?
CBC with differential Blood culture Urinalysis Urine culture Lumbar puncture
Recommendation for breastfed babies that are not exposed to sufficient sunlight?
Vitamin D supplementation
Iron supplementation to reduce the possibility of anemia may be begun in breastfed infants at what age?
6 months of age
At what age should solid foods be introduced to the baby’s diet?
Frequency of introducing new foods?
6 months of age
Add one new food every 1 to 2 weeks
The minimum standard for the growth and development of the newborn is a weight gain of ___ per day
20 g/day
All infants should regain their birth weight by what age?
10 to 14 days of age
Measures of adequate hydration in the thriving newborn:
# of wet diapers per day? # of stools per day?
5-6 wet diapers per day
2-3 stools per day
During the first few weeks and months of life:
Ideal feeding schedule? # feedings per day?
Ideal feeding schedule is FEEDING ON DEMAND
8 to 12 feedings per day
Infants cry for a variety of reasons. Best advice is to assume that crying indicates?
Crying may or may not indicate hunger. Assume that the baby needs to be fed until proved otherwise. If the baby refuses the breast, check for other causes of crying.
The main determinant of a good milk supply?
Frequent, effective milk removal
