The Newborn (SIM) Flashcards
5 basic criteria to identify high risk newborn
breathing/crying, good muscle tone and pink color, term and absence of meconium
Routine newborn care consists of
warmth, clearing the airway, observing vital signs
Normal temp of newborn
36.5-37.4C
Normal heart rate of newborn
120-160bpm
Normal respiratory rate of newborn
40-60 breaths per min
Normal BP of newborn
depends on sex and gestational age
Which statement is FALSE
a. neurologic and developmental evaluation of the newborn is best done 2-3 days after birth
b. neurologic and developmental evaluation of the newborn is best done after the transition phase when the newborn has stabilized
c. Percussion is never done in examination of the newborn
d. through assessment of the newborn include inspection, auscultation and palpation
C
What is the Ballard examination for?
categorizing growth
For whom is the Ballard examination valid?
Neonates <26y.o.
When should extremely premature infants undergo the Ballard examination?
witihn 12hours before skin color changes which may alter assessment
When should full term infants be tested?
ASAP witihn 72 hours
Which develops first? Flexor/Extensor Tone?
Flexor
True of passive flexor tone except EXCEPT
A. is not dependent on infant’s level of active motor activity
B.develops earlier in the lower ex
C. not the basis for basic neurologic maneuvers but extensor tone instead
D. eliciting the so called primitive
reflexes like the tonic neck, palmar and plantar grasp reflexes alter the passive flexor tone of the
joint being tested
C
The following statements are true EXCEPT
a. most manuevers should be done with the head in the middle without grasping hands and soles
b. in doing the scarf sign maneuver, the hand is pulled across the chest
c. in performing PE on the newborn, inspection and uscultation should be done first
d. there are no fixed values for normalcy in the newborn, only ranges of values
B
[posture score]
Full flexion of arms and legs
4
[posture score]
Moderate flexion of arms and legs
2
[posture score]
Arms and legs extended
0
[posture score]
Slight or moderate flexion of arms and legs
1
[posture score]
Legs flexed and abducted, arms slightly flexed
3
Test done by exerting gentle pressure on 3rd metacarpal and observing the angle between the hypothenar eminence and the anterior aspect of the forearm
Square Window
[square window score]
>90degrees
-1
[square window score]
0 degrees
4
[square window score]
45degrees
2
[square window score]
90degrees
0
[square window score]
60degrees
1
[square window score]
30degrees
3
[arm recoil score]
Remains!extended 180 degrees,or with random movements
0
[arm recoil score]
Small amount of flexion, 110 – 140 degrees
2
[arm recoil score]
Minimal flexion 140-180degrees
1
[arm recoil score]
moderate flexion, 90-100degrees
3
[arm recoil score]
brisk return to full flexion, <90
4
[Popliteal angle score]
180deg
-1
[Popliteal angle score]
160deg
0
[Popliteal angle score]
140deg
1
[Popliteal angle score]
120deg
2
[Popliteal angle score]
100deg
3
[Popliteal angle score]
90deg
4
[Popliteal angle score]
<90deg
5
[Scarf sign score]
elbow at contralateral shoulder (true scarf sign)
-1
[Scarf sign score]
contralateral axillary line
2
[Scarf sign score]
midline
4
[Scarf sign score]
contralateral nipple line
3
[Scarf sign score]
Ipsilateral nipple line
5
[Scarf sign score]
Ipsilateral axillary line
6
[Heel to ear score]
Heel to ear
-1
[Heel to ear score]
Heel to chin
1
[Heel to ear score]
Heel to groin
4
[Heel to ear score]
Heel to umbilicus
3
[Heel to ear score]
Heel to nipple line
2
[Heel to ear score]
Heel to nise
0
parameter most prone to change in extremely premature neonates
skin
Describe the distribution of Lanugo when it is sparse?
lanugo @ lumbosacral but limited/none @ scapula
[arm recoil score]
Small amount of flexion, 110 – 140 degrees
2
correct position when examining female external genitalia
hips flexed, things abducted to 45deg
[arm recoil score]
moderate flexion, 90-100degrees
3
[arm recoil score]
brisk return to full flexion, <90
4
The following statements are TRUE about the posture of the newborn (there may be multiple answers)
a. Flexion of hips, knees, elbow
b. Adduction of hips and arms
c. fist clenched with thumbs concealed
d. A and B
e. A and C
E
[Popliteal angle score]
160deg
0
[Popliteal angle score]
140deg
1
[Popliteal angle score]
120deg
2
[Popliteal angle score]
100deg
3
[Popliteal angle score]
90deg
4
[Popliteal angle score]
<90deg
5
[Scarf sign score]
elbow at contralateral shoulder (true scarf sign)
-1
[Scarf sign score]
contralateral axillary line
2
[Scarf sign score]
midline
4
[Scarf sign score]
contralateral nipple line
3
[Scarf sign score]
Ipsilateral nipple line
5
[Scarf sign score]
Ipsilateral axillary line
6
[Heel to ear score]
Heel to ear
-1
[Heel to ear score]
Heel to chin
1
[Heel to ear score]
Heel to groin
4
[Heel to ear score]
Heel to umbilicus
3
[Heel to ear score]
Heel to nipple line
2
[Heel to ear score]
Heel to nise
0
parameter most prone to change in extremely premature neonates
skin
score of male genitalia when scrotum touches examining surface
4
correct position when examining female external genitalia
hips flexed, things abducted to 45deg
The following statements are TRUE about breastfeeding EXCEPT
a. Proper positioning emphasize chest-chest contact
b. Baby’s mouth should be wide open at the jaw, lips everted landing at base of nipple
d. Optimized lactation can be achieved by frequent latching on
e. Feeding follows a definite schedule
e
T/F for early troubleshooting of breastfeeding issues, observation of either the mother or the newborn is required
F; should be BOTH the infant and mother, observed while breastfeeding
The following statements are TRUE about the posture of the newborn (there may be multiple answers)
a. Flexion of hips, knees, elbow
b. Adduction of hips and arms
c. fist clenched with thumbs concealed
d. A and B
e. A and C
E
