week 4

Question 1

newborn exams happen when ?

Answer 1

2 when inpatient, first by delivery person, second before discharge, and then one in the first 3-5 days of life

Question 2

If you see a baby in the clinic, age 60 days or younger, with a temp … what do you do?

Answer 2

esp if 100.4 and higher, send to ER

Question 3

Newborn hearing screening tests what? what are the names of the 2 tests?

Answer 3

sensorineural hearing loss which means there is damage to the auditory nerve (CN VIII) 8
The Automated auditory brainstem response (AABR) screening OR the Otoacoustic emissions (OAE) screening test will be done before the baby is discharged.

Question 4

maternal history questions/ things to find out

Answer 4

• past pregnancies and how they went
• maternal illnesses
• maternal immunization status (example: rubella in mother can cause defects in baby)

Question 5

prenatal history things to find out

Answer 5

• when did prenatal care start
• gestation
• previous complications
• type of contraceptions used
• was it planned
• drugs or alcohol used during pregnancy
• medical conditions that occurred during pregnancy

Question 6

perinatal (birth) history things to ask

Answer 6

• spontaneous or induced?
• Apgar
• resessitation
• vaginal or c section
• placenta previa
• meconium aspiration
• fractured clavicle

Question 7

neonatal history

Answer 7

• BW. HC, length
• gender, race, date time of birth
• blood sugar
• vital signs upon birth and how they trended
• problems?
• estimated gestational age by physical score
• AGA, SGA, LGA
• genetic abnormalities
• sepsis

Question 7

crying baby when arrive to room, what first?

Answer 7

assess mouth and palete, then nurse baby to get quiet

Question 8

mottled baby skin- called what and caused from what

Answer 8

cutis marmorta
response to cold

Question 9

nevi are what

Answer 9

birthmarks

Question 10

cafe au lait spots count

Answer 10

6, referral to neurology for potential neurofibromatosis

Question 11

congenital dermal melanocytosis

Answer 11

packed pigment cells, usually in the sacral region, more common in people with darker pigmentation

resolve spontaneously in 5-7 years

Question 12

hemangomas

Answer 12

no problem- unless in GU or eye area, goes away by age 5 years ish

Question 13

salmon patches

Answer 13

also called stork bites- go away by one year

Question 15

caput and cephalohematoma

Answer 15

caput: misshaping of head, resolves in a week, presenting part of the head, crosses suture lines
cephalhematoma: blood forms , takes weeks to months to resolve, does not cross suture lines, sometimes have problems with jaundice

Question 16

concern with development of ears- what else are we worried about?

Answer 16

kidneys - they develop at the same time

Question 17

piltrum differences in fetal alcohol syndrome

Answer 17

smooth upper lip area and thin upper lip

Question 18

jaundice in first 24 hrs of life

Answer 18

red flag- caused by increased bilirubin production due to hemolysis

Question 19

two types of bilirubin

Answer 19

unconjugated (indirect)
conjugated (direct)

Question 20

expect to see jaundice when

Answer 20

2-5 days

Question 21

why do babies get jaundice

Answer 21

breakdown of fetal erythrocytes and then the body takes a bit to rid of those RBS

Question 22

in breastmilk jaundice, what is normal?

Answer 22

• peaks within 2 weeksa of birth
• progrssivly declines over next 3-12 weeks
• NOT becuase pt is not getting enough po intake
• total bili is less than5
• the high number should be coming from UNCONJUGATED

Question 24

Rule of 3s colic

Answer 24

Greater than three hours greater than three days a week, greater than 3 weeks long

Question 25

Occurrence age of colic

Answer 25

100% occur by 3 weeks

Question 26

Period of PURPLE crying

Answer 26

P- peak of crying
U- unexpected
R- resists soothing
P- pain like face
L- long lasting
E- evening