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child health > the sick new born > Flashcards

the sick new born Flashcards

1
Q

what is the definition for a term infant?

A

babies born at 37 weeks gestation and above

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2
Q

what is neonatal period?

A

the first 28 days in life

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3
Q

what would be taken in a history to clinically assess a neonate?

A

Maternal:

  • PMH
  • pregnancy issues
  • drugs
  • infection risks

Fetal:

  • fetal growth
  • fetal anomaly
  • delivery
  • resuscitation
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4
Q

what would be inspected in a clinical assessment of a neonate?

A
  • tone
  • level of arousal
  • colour
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5
Q

what vital signs are taken in a clinical assessment of a neonate?

A
  • heart rate, perfusion
  • respiratory rate
  • cap refill
  • SaO2
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6
Q

what scoring system is used to assess neonates quickly after birth?

A

-Apgar score

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7
Q

when is Apgar score done?

A

usually scored at 1 minute and then at 5 minutes and sometimes longer if necessary

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8
Q

what is measured in Apgar soring?

A 
Appearance (skin colour)
Pulse
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
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9
Q

what is normal RR in a newborn baby?

A

40-60 breaths/minute

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10
Q

what is a normal HR in a newborn baby?

A

120-140 bpm

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11
Q

whart is a normal capillary refill time in babies?

A

2-3 seconds

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12
Q

what is a normal SaO2 in a baby?

A

95%

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13
Q

what occurs to SaO2 in babies when born?

A

-O2 sats will gradually increase and don’t reach above 90% until about 10 minutes old

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14
Q

what is the normal temperature for babies?

A

36.5- 37.4 degrees Celcius

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15
Q

what is initial management of newborns?

A
  • temperature (36.5-37.4)
  • assess and support baby’s breathing
  • circulation may need supporting using fluids and in very unwell babies use inotroped
  • metabolic homeostasis must be established (glucose management, acid-base balance correction)
  • antibiotics if infection
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16
Q

what usually causes antenatal infection?

A

-bacterial infection

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17
Q

what usually causes perinatal infection in babies?

A

-viral infection

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18
Q

what usually causes postnatal infections in babies?

A

-fungal infection

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19
Q

how does sepsis present in a newborn baby?

A
  • quiet
  • poor feeding
  • tachypnoea
  • apnoea
  • tachycardia
  • bradycardia
  • temperature instability
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20
Q

where can infection present in neonates?

A
  • blood stream
  • CNS
  • respiratory
  • GU

others:

  • skin
  • bone
  • GI
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21
Q

what is an example of a blood stream infection?

A

-bacteraemia/ septicaemia

22
Q

what is an example of a CNS infection?

A

-meningitis

23
Q

what bacterial infection is common in mums and what is done to pick it up early?

A

-group B strep

screening progamme in place for pregnant women

24
Q

when is staphilococcus aureus infection usually seen in neonates?

A

-when IV fluids used and needles

25
Q

what are some common bacterial infections seen in neonates?

A
  • group B streptococus
  • E.coli
  • staphylococcus aureus
  • staph epidermis
  • staph capitis
  • Klebsiella Oxytoca
  • Listeria monocytogenes
26
Q

what is first line antibiotic choice for neonatal sepsis?

A

Benzylpenicillin and gentamicin

27
Q

what is the most common bacteria in neonatal sepsis?

A

Group B strep

28
Q

what are some examples of viruses that may affect a neonate?

A
  • cytomegalovirus
  • parvovirus
  • herpes viruses
  • enteroviruses

Other:

  • syphilis
  • toxoplasma gondii
  • HIV
  • TORCH
29
Q

what are some examples of viruses that may affect a neonate?

A
  • cytomegalovirus
  • parvovirus
  • herpes viruses
  • enteroviruses

Other:

  • syphilis
  • toxoplasma gondii
  • HIV
  • TORCH
30
Q

what causes syphilis?

A

-Treponema Pallidum readily crossing the placenta

31
Q

when are babies at highest risk of catching syphilis?

A

-when mum has early stage syphilis (infection within last 2 years)

32
Q

what can reduce a mother passing on syphilis to her neonate?

A

-if treatment is given 30 days prior to delivery

33
Q

what are some pregnancy/birth related respiratory pathologies?

A
  • TTN
  • pneumothorax
  • meconium aspiration
  • RDS
  • birth asphyxia
34
Q

what are some clinical signs of respiratory distress?

A
  • tachypnoea
  • subcostal and intercostal recession
  • grunting
  • blue
  • low sats
35
Q

who is TTN (transient tachypnoea of the newborn) usually seen in?

A

-in term infants delivered by caesarean section

36
Q

what is transient tachypnoea of the newborn (TTN)?

A

-a breathing disorder seen shortly after birth due to delay in clearing lung fluid

37
Q

how is lung fluid cleared out in a healthy newborn?

A

-usually clears into interstitium and then in to lymphatic system

38
Q

what does the clearing out of lung fluid depend on ?

A

-dependant on active Na channels, activated by adrenaline

39
Q

how long does it take for transient tachypnoea of the newborn to resolve?

A

-resolves over the first 24 hours of life

40
Q

what would a CXR of a neonate with transient tachypnoea of the newborn (TTN) show?

A

-CXR shows fluid in horizontal fissure

41
Q

what causes a pneumothorax to occur in a neonate?

A

-can occur spontaneously

secondary to:

  • resus
  • infection
  • meconium
  • surfactant deficiency
42
Q

what causes respiratory distress syndrome?

A

-surfactant deficiency

43
Q

who is RDS more common in?

A

-preterm infants

44
Q

what is RDS associated with?

A
  • IUGR
  • maternal diabetes
  • infection
  • birth asphyxia
  • multiple birth
  • PROM
  • meconium aspiration
45
Q

how does RDS appear on a CXR?

A

-ground glass appearance

46
Q

what is treatment for respiratory distress syndrome??

A

-respiratory support and surfactant replacement

47
Q

who is meconium aspiration syndrome more common in?

A

-more common in later gestation

48
Q

what is meconium aspiration syndrome?

A

-when a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery

49
Q

what can meconium aspiration syndrome cause?

A
  • airway obstruction
  • inflammation
  • surfactant dysfunction
50
Q

what is hypoxic ischaemic encephalopathy?

A

-multi organ tissue damage due to tissue hypoxia

child health (28 decks)

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