week 4 Flashcards
newborn exams happen when ?
2 when inpatient, first by delivery person, second before discharge, and then one in the first 3-5 days of life
If you see a baby in the clinic, age 60 days or younger, with a temp … what do you do?
esp if 100.4 and higher, send to ER
Newborn hearing screening tests what? what are the names of the 2 tests?
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.
maternal history questions/ things to find out
- past pregnancies and how they went
- maternal illnesses
- maternal immunization status (example: rubella in mother can cause defects in baby)
prenatal history things to find out
- 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
perinatal (birth) history things to ask
- spontaneous or induced?
- Apgar
- resessitation
- vaginal or c section
- placenta previa
- meconium aspiration
- fractured clavicle
neonatal history
- 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
crying baby when arrive to room, what first?
assess mouth and palete, then nurse baby to get quiet
mottled baby skin- called what and caused from what
cutis marmorta
response to cold
nevi are what
birthmarks
cafe au lait spots count
6, referral to neurology for potential neurofibromatosis
congenital dermal melanocytosis
packed pigment cells, usually in the sacral region, more common in people with darker pigmentation
resolve spontaneously in 5-7 years
hemangomas
no problem- unless in GU or eye area, goes away by age 5 years ish
salmon patches
also called stork bites- go away by one year
caput and cephalohematoma
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
concern with development of ears- what else are we worried about?
kidneys - they develop at the same time
piltrum differences in fetal alcohol syndrome
smooth upper lip area and thin upper lip
jaundice in first 24 hrs of life
red flag- caused by increased bilirubin production due to hemolysis
two types of bilirubin
unconjugated (indirect)
conjugated (direct)
expect to see jaundice when
2-5 days
why do babies get jaundice
breakdown of fetal erythrocytes and then the body takes a bit to rid of those RBS
in breastmilk jaundice, what is normal?
- 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
Rule of 3s colic
Greater than three hours greater than three days a week, greater than 3 weeks long
Occurrence age of colic
100% occur by 3 weeks
Period of PURPLE crying
P- peak of crying
U- unexpected
R- resists soothing
P- pain like face
L- long lasting
E- evening
