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OB Exam 1 > Week 2 (Newborn) > Flashcards

Week 2 (Newborn) Flashcards

1
Q

Neonatal Period

A

Birth to day 28 of life

  • changes include respirations, circulation, temperature regulation, digestion, waste, & weight
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2
Q

First period of reactivity

A

15-30 minutes after birth

  • HR may be 160 - 180
  • Period of decreased responsiveness from 60 - 100 minutes (newborn either asleep or has marked decrease in motor activity)
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3
Q

Second period of reactivity

A

2 - 8 hours after birth

  • tachycardia
  • tachypnea
  • increased muscle tone
  • improved color
  • meconium is usually passed
  • often gags or chokes on mucus that has accumulated in the mouth
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4
Q

Ductus arteriosus

KNOW THIS!!!!

A

Connects the pulmonary artery to the aorta

  • A blood vessel in a fetus that bypasses pulmonary circulation by connecting the pulmonary artery directly to the ascending aorta
  • closes within first 24 hours of life
  • takes 2-3 months to fully closed
  • can reopen (PDA) causes a murmur
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5
Q

Foramen ovale

KNOW THIS!!!!

A

Connects the two atria in the fetal heart

  • “hole in the heart”
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6
Q

Ductus venosus

A

Connects the umbilical vein to the inferior vena cava

  • bypasses the liver - allows blood to go to the heart & to the rest of the body quickly
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7
Q

Normal Fetal PaO2

KNOW THIS!!!!

A

20 - 30 mmHg

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8
Q

Do veins or arteries carry oxygen to the baby?

KNOW THIS!!!!

A

VEINS

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9
Q

How many arteries & veins are in fetal circulation?

A

2 arteries & 1 vein (AVA)

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10
Q

What is the most important physiologic change in a newborn?

KNOW THIS!!!!

A

initiation of breathing!!!!

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11
Q

What induces mild hypercapnia, hypoxia, & acidosis [normal is 7.30 - 7.40] that stimulate respiratory center?

A

labor

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12
Q

Chemical stimuli

KNOW THIS!!!!

A

acidosis after birth stimulates the respiratory center

  • contractions are also a chemical stimuli
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13
Q

Mechanical stimuli

KNOW THIS!!!!

A

pressure from labor pushes fetal lung fluid out

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14
Q

Thermal Stimuli

KNOW THIS!!!!

A

from womb temperature to outside temperature

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15
Q

Sensory stimuli

KNOW THIS!!!!

A

drying, suctioning, etc.

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16
Q

Surfactant

A

fluid produced to open alveoli

  • increased production with progressed gestation “backpack” will pull from if needed
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17
Q

If the baby isn’t breathing what measure should be taken?

KNOW THIS!!!!

A

positive pressure ventilation

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18
Q

Apnea

KNOW THIS!!!!

A

20 seconds of not breathing

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19
Q

Lung Sounds

KNOW THIS!!!!

A

Clear / wet from c-sections / inductions

  • tachy > 60
  • brady < 30
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20
Q

Normal Fetal HR

KNOW THIS!!!!

A

120 - 160 bpm

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21
Q

Normal Fetal BP

KNOW THIS!!!!

A

75 - 95 over 25 - 45

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22
Q

How long should you wait before clamping & cutting the cord?

A

30 seconds

  • allow blood volume to flow
  • risk for hyperbilirubin / jaundice
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23
Q

Normal Fetal WBCs & Platelets

KNOW THIS!!!!

A
  • WBCs: 9,000 - 13,000
  • Platelets: 150,000 - 300,000
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24
Q

What are the surroundings in which the infant can maintain a stable temperature with minimal oxygen consumption & a low metabolic rate?

A

Neutral thermal environment

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25
Q

What are the 4 modes of heat loss?

KNOW THIS!!!!

A
  • Convection
  • Radiation
  • Evaporation
  • Conduction
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26
Q

Convection Heat Loss

KNOW THIS!!!!

A

the flow of heat from the body surface to COOLER AIR

  • keep babies away from open windows & colder environments

  • Warm body heat is lost to a source of cooler air

COnvection = COol (air)

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27
Q

Radiation Heat Loss

KNOW THIS!!!!

A

Loss of heat from the patient’s body to the environment

  • window, fan, AC, natural drafts, & cold walls - keep baby away from cooler sources

  • Body heat is lost due to a cooler object nearby
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28
Q

Evaporation Heat Loss

KNOW THIS!!!!

A

Heat loss from liquid turning to vapor

  • cold with the wetness – must dry off baby immediately after birth!

  • moisture from the skin & lungs is lost to the air
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29
Q

Conduction Heat Loss

KNOW THIS!!!!

A

Loss of heat from the BODY SURFACE to COOLER SURFACES in direct contact

  • Cold changing tables, medical instruments, & surfaces the baby’s body will touch
  • PREVENT: keep infants partially covered on a warm surface during exams or diaper changes & warm stethoscopes & other instruments before putting them on the baby

ConDuction = Direct

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30
Q

Thermogensis

A

Generation of heat

  • babies do NOT shvier
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31
Q

Brown Fat

KNOW THIS!!!!

A

A dark-colored adipose tissue with many blood vessels involved in the rapid production fo heat in babies

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32
Q

Newborn Voiding

KNOW THIS!!!!

A

Should void by 24 hours of life

  • day 1 = 1 void
  • day 2 = 2 void
  • etc.
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33
Q

Meconium

KNOW THIS!!!!

A

the first BM of the newborn

  • dark
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34
Q

Maternal —— does not pass the placenta. Risk for hypoglycemia from compensation; extra fat “Buddah babies”

A

maternal insulin

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35
Q

When will a newborn’s blood sugar fall to the lowest level after birth?

KNOW THIS!!!!

A

2 hours

36
Q

Tremors (jitters)

A

Continuous quivering or shaking

  • stop with gentle restraint
37
Q

Seizures

A

Sudden, uncontrolled electrical disturbances in the brain

  • do not stop with restraint

S/S:
* eye deviation
* staring
* apnea
* high HR
* increased salivation

38
Q

What affects 60 - 90% of newborns; peaks at day 3-5 (peaks 5-7 for preterm) & the normal range is 6-7 mg/dL?

A

Jaundice

39
Q

Physiological Jaundice

A

From increased bilirubin

  • surplus of RBCs
  • 60 - 80% of babies
40
Q

Breast Non Feeding Jaundice

A

Infants nursing infrequently or inefficencly are at risk for elevated bilirubin levels

  • decreased calories
  • dehydration
  • delayed meconium stooling
41
Q

Breastmilk Jaundice

A

Occuring in the breastfed infant

  • breastmilk PREVENTS bilirubin breakdown
42
Q

Pathologic Jaundice

A

caused by ABO incompatability

43
Q

Chorioamnionitis

A

Inflammation of the chorion & amnion (amniotic sac)

44
Q

Vernix Caseosa

A

waxy or “cheesy” white substance found coating the skin of newborns

  • keep on skin = protection
45
Q

Acrocyanosis

A

Temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands, & fingernails, feet, & toenails

  • may last for a few hours & disappears with warming
46
Q

Circumolar Cyanosis

A

A bluish discoloration around the mouth

47
Q

APGAR Score

KNOW THIS!!!!

A

An evaluation of a newborn infant’s physical status

performed at 1, 5, 10 minutes & every 5 minutes until 20 minutes; snapshot in time

  • 7 - 10 = no difficulty
  • 4 - 6 = moderate difficulty
  • 0 - 3 = distress
48
Q

What is Occipital Frontal Circumference (OFC)?

A

Head Circumference

49
Q

Eye Prophylaxis

KNOW THIS!!!!

A

Prevents gonorrhea transmission from mother to baby

  • erythromycin 0.5 - 1 mg within 1-2 hours
  • do NOT wipe it off
50
Q

Vitamin K

KNOW THIS!!!!

A

Given to prevent hemorrhage because the baby’s gut is sterile

  • aquamephyton 0.5 - 1 mg
51
Q

Hep B Vaccine

KNOW THIS!!!!

A

Given at birth, 1-2 months, 6-18 months

OR

  • HBIG for positive mom’s to prevent transmission
52
Q

Perinatal history

A
  • family history – htn, DM, preeclampsia, infection
  • how was delivery
  • how long was mom ruptured? – if over 18 hrs = risk of infection
53
Q

Infection risk increases in a mom who has been ruptured for over how many hours?

KNOW THIS!!!!

A

18+ hours

54
Q

AGA

KNOW THIS!!!!

A

Appropriate for Gestational Age

  • 50th percentile
55
Q

LGA

KNOW THIS!!!!

A

Large for Gestational Age

  • 90th percentile
56
Q

SGA

KNOW THIS!!!!

A

Small for Gestational Age

  • 10th percentile
57
Q

Preterm

KNOW THIS!!!!

A

before 37 weeks

58
Q

Late Preterm

KNOW THIS!!!!

A

34 - 36 weeks

59
Q

Full Term

KNOW THIS!!!!

A

39 - 40 weeks

60
Q

Post Term

KNOW THIS!!!!

A

After 42 weeks

61
Q

Post Mature

KNOW THIS!!!!

A

Infant born after 42 weeks gestation

62
Q

Ballard Score

A

Test used to estimate gestational age

  • based on 6 neuro & 6 physical criteria
  • done by 12 hours of life
63
Q

Erythema Toxicum

A

Newborn rash

  • normal finding
64
Q

Nevus Simplex

A

“Storke Bite”, pink red capillary on face or neck

65
Q

Milia

A

Small raised white spots on the nose, chin, & forehead

66
Q

Root Reflex

KNOW THIS!!!!

A

When baby’s cheek is rubbed the baby will automatically turn TOWARD the stimuli

67
Q

Moro Reflex

KNOW THIS!!!!

A

Startle reflex

68
Q

Palmar Reflex

KNOW THIS!!!!

A

Infant grasps your finger when you place it in their palm

69
Q

Babinski Reflex

KNOW THIS!!!!

A

Infant reflex where if you stroke their foot, the baby’s toes fan OUTWARD

70
Q

Tonic Neck

KNOW THIS!!!!

A

Infant lies in a “fencing position”

  • may prepare infant for involuntary reaching
71
Q

Truncal Incurvation

KNOW THIS!!!!

A

Body curves toward side of trunk that is stroked

72
Q

Stepping Reflex

KNOW THIS!!!!

A

Reflex that causes newborn babies to make little stepping motions if they are held upright with their feet just touching a surface

73
Q

Breast Crawl

KNOW THIS!!!!

A

Newborn’s instinct to move toward the nipple & suckle

74
Q

When does the anterior fontanelle close?

KNOW THIS!!!!

A

12 - 18 months

75
Q

When does the posterior fontanelle close?

KNOW THIS!!!!

A

2 - 3 months

76
Q

Caput Succedaneum

KNOW THIS!!!!

A

Soft tissue dependent edema of the scalp

  • will resolve in the first week of life
  • NORMAL FINDING
  • edema crosses the suture line
77
Q

Cephalohematoma

KNOW THIS!!!!

A

Bleed that does NOT cross suture lines

  • independent edema
78
Q

Subgaleal Hemorrhage

A

Bleeding into the subgaleal compartment

  • shock
  • high mortality
79
Q

Normal RR

KNOW THIS!!!!

A

30 - 60 BPM

80
Q

Simian Crease

KNOW THIS!!!!

A

A single straight palmar crease

  • abnormal finding associated with Down Syndrome
81
Q

Hydrocele

A

Sac of clear fluid in the scrotum

82
Q

Hypospadias

A

Abnormal congenital opening of the male urethra on the UNDERSURFACE of the penis

83
Q

CCHD (critical congenital heart disease)

A

Asses O2 on R hand (preductal), L foot > 95% AND difference should be < 3%

  • > 3% is abnormal and indicative of CCHD
84
Q

Sucrose

A

Given to babies during circumcision to stimulate opioid receptors

85
Q

Circumcisions

A
  • Yellow exudate after circumcision – do NOT remove
  • Have they voided?

Types:
1.) gomco
2.) mogen
3.) plastibell

OB Exam 1 (5 decks)

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