The Full Term Infant Flashcards
What is considered full term in an infant?
37-42 weeks
What is the average daily weight gain of a term baby?
24g
What is considered normal weight loss for a baby after birth?
Loss of up to 10% birth weight
What will be the features of a preterm infant in comparison to a pre-term?
Preterm baby will be - thinner, less muscle tone, pinker due to less subcutaneous fat
What factors may make labour more difficult?
Hypoxic environment during contractions
Prolonged labour reduces foetal reserves - baby may become acidotic
Placental insufficiency
Growth restriction or excess
What adaptations does a baby make when it is born?
First Breath Alveolar expansion Change from foetal to newborn circulation Decreased pulmonary arterial circulation Increased PaO2
What is the apgar score?
This is a score that gives us an idea of how well a baby is doing after birth.
It is out of 10 and accounts for -
HR; RR; Responsiveness; Tone; Colour
Normal > 8
What is the impact of skin to skin contact after birth?
Establishes breast feeding
Keeps baby warm
Allows bonding between mum and baby
What is haemorrhagic disease of the newborn?
This is when baby doesn’t have enough vitamin K and develops a coagulopathy - there is then potential for GI; pulmonary or CNS bleed.
Therefore all babies born in scotland are given IM vitamin K supplement
What are possible infections based on maternal history?
Hepatitis B Hepatitis C HIV Syphilis TB Group B Streptococcus
What is included in the newborn screening test?
Universal hearing screening Hip screening Cystic Fibrosis Haemoglobinopathies Metabolic diseases - PKU etc.
What are possible examination finding on the babies head?
Incorrect head circumference Overlapping sutures Fontanelles Ventouse/Forcep marks Moulding of the head Cephalhaematoma Caput succedaneum
What are fontanelles?
Soft spots on the baby’s skull where the bony plates have not yet come together
What is a cephalhaematoma?
When the small blood vessels rupture between the baby’s scalp and skull. This is usually caused by trauma e.g. forceps
What is caput seccedaneum?
This is a lump on the baby’s scalp caused by pressure
What is the difference between caput succedaneum and cephalhaematoma?
They are both swellings on the scalp however a cephalhaematoma is caused by blood and a caput succedaneum is caused by pressure on the scalp
What are we looking for when we examine the eyes?
Size Red reflex - cataracts; tumours? Conjunctival Haemorrhage Squints Iris abnormality e.g. collaboma
What is a collaboma?
This is a gap in the structures of the eye
What are we looking for when we examine the ears?
Position
External auditory canal
Tags/pits
Folding
What are we looking for when we examine the mouth?
Shape Philtrum Tongue tie Cleft palate Neonatal teeth Ebdteins pearls Appropriate sucking/rooting reflex
What is philtrum?
This is the groove between the upper lip and nose. In conditions such as foetal alcohol syndrome this may be absent
What are ebsteins pearls?
Small, harmless cysts in the newborns mouth that contains white cells
What are we looking for when we asses the face?
Facial Palsy
Dysmorphia e.g. down’s syndrome
What do we look for when we asses respiration?
Chest shape Nasal flaring Grunting Tachypnoea In-drawing Breath sounds
What do we look for when we asses cardiology?
Colour/Saturation - think CHD? Pulses - femoral Apex beat Any thrills/heaves? Present heart sounds
What do we look for when we asses the abdomen?
Moves with respiration? Distention Hernia Normal umbilicus Bile stained vomiting Passage of meconium Anus
What do we asses when we examine the genitourinary system?
Normal passage of urine
Normal genetalia
Undescended testes - is they are undescended we assume ambiguious genetalia
Hypospadius
What is hypodspadius?
A birth defect in boys in which the opening of the urethra is not located at the tip of the penis.
What do we asses in the musculoskeletal system?
Movement and posture
Limbs and digits
Spine - spina bifida?
Hip examination
What do we asses as part of a neurological examination?
Alertness and responsiveness Crying? Muscle tone posture Movement Primitive reflexes
What are the primitive reflexes in newborn babies?
Sucking
Rooting
Moro - drops the baby’s head back and it is startled
Asymmetrical tonic reflex - turning the baby’s head to one side causes extension of the arm and leg on this side
What do we look for upon examination of the skin?
Normal erythema
Mongolian blue spots
Cavernous haemangioma
Port wine stain
What is a cavernous haemangioma?
An abnormal tangle of tightly packed, thin-walled capillaries that are prone to bleeding.
