Week 4 - NB lecture Flashcards
Test and check VDRL for what disease?
syphilis
Group B Strep is cx at ___-___ wks gestation
35-36
___ in mom typically presents as cold-type symptoms, but can have mental retardation effects in newborns.
Rubella
____ ___ can cross the placenta and if unknown or uncured, can cause liver failure/damage down the road.
Hepatitis B
Chlamydia is tx’ed w/opthalmic ___ and oral ___.
erythromycin, erythromycin
Normal apgar score between: ___-___.
8-10
The ___ the score, the worse-off the newborn.
lower
Apgar scoring should continue until a final score of ___ or more is reached.
7
C-sec babies do not reabsorb pulmonary fluid like vag births do and have the potential to cause ___ or “wet lungs”.
aspiration
The Ballard exam measures the ___ level of the newborn and looks at ___ and ___ characteristics.
maturity, physical, neuromuscular
SGA = \_\_\_ AGA = \_\_\_-\_\_\_ LGA = \_\_\_
10%
10-90%
90%
Normal “square window” on infant’s wrist is ___ degrees.
45
The more creases along the foot = the ___ mature the infant.
more
The more lanugo (hair on neck) = the ___ mature the infant.
less
Cold stress, hypoglycemia, hypocalcemia, and polycythemia are ___ risk factors.
SGA
Shoulder dystocia, birth trauma, hypoglycemia, and polycythemia are ___ risk factors.
LGA
Normal vitals in infants:
HR: ___-___
RR: ___-___
Temp: ___-___ (celsius)
120-160
30-60
36.5-37.3
Temperature in NB can be impaired by ___, ___, and ___.
hypoxia, sedatives, anesthetics
The larger the surface area of the body, the ___ heat loss.
more
For general appearance of respiratory, look for ___, ___, and ___.
grunting, flaring, retracting
Erythema toxicum is a normal NB ___ and usually gets worse before better. Disappears in about 2 wks.
rash
Mongolian spot (or ___ ___ ___) is a ___/___ spot that causes a darkened pigmented area and usually goes away on its own.
slate blue nevy, brown/blue
___ ___ are darkened freckles usually appearing on African-American NB and is a normal finding.
Pustular melanosis
___ ___ is a cottage cheese like substance found on NB when comes out of utero and is a normal protective lubricant.
Vernix caseosa
___ is when the hands and feet are blue after delivery and is normal.
acrocyanosis
Vesicles seen on the trunk is typically seen in ___ and is assumed that until cultured and proven otherwise. Treated w/___.
Herpes, acyclovir
When listening to NB’s heart, listen to ___, ___, ___, and ___.
RUSB, LUSB, LLSB, apex
Cardiac impulse w/in first 24 hrs post-delivery heard and felt best at ___.
xiphoid
The ___ heart sound is usually not split in first 3 hrs of life and will hear ___ and ___ at same time.
second, S1, S2
___ murmurs common in first 48 hrs.
Systolic
Rales should disappear after ___-___ hrs of life.
2-4
Diaphragmatic hernia is where there is a ___ in the diaphragm, so the intestines move into the ___ and compress on the ___.
hole, chest, lungs
___ is where air escapes into a collapsed lung. Breath sounds will be ___ or ___.
Pneumothorax, diminished, absent
___ ___ is where there is weak musculature of the diaphragm muscles, creating an ___ that is normal.
diastasus recti, outpouching
Mucous drainage is common in first ___ days. However, question infection if eyes are ___ and ___.
2, swollen, red
The organism, ___ is common after vaginal delivery.
E-coli
Red reflexes r/o ___.
retinoblastoma
Epicanthal folds can be indicative of ___ ___ if seen in non-asian NB.
down syndrome
___ ___ are broken blood vessels in eyes d/t normal trauma from delivery.
Subconjunctival hemorrhages
Bruising and hematomas should be monitored, bc they can lead to ___.
jaundice
___ does NOT cross the suture line, whereas ___ does, so have to be careful for bleeding and ___.
Cephalhematoma, caput, jaundice
___ ___ is a blockage of the nares where baby is unable to breathe thru nose. Could be indicative if baby turns blue while ___.
Coanal atresia, eating
W/preauricular ___ ___, think ___-related and get renal ___.
skin tags, kidney, u/s
___ is a ligament under the ___ that prevents baby from breastfeeding well.
Angkyloglossia, tongue
___ means “short jaw” and can cause difficulty in latching on or breastfeeding.
Micrognathia
___ is where the neck muscle is shortened d/t a fixed position in utero. Must work w/PT to fix.
Torticollis
T or F: A broken clavicle will mend itself.
True
A brachial-plexus injury can usually heal, whereas a ___ can cause permanent damage
tear
Want to check b/p in ___ ext of NB.
right
For abdomen and GI, assess ___, ___, ___, and ___ edge.
symmetry, distention, masses, liver’s
Liver’s edge should be ___ cm below right costal margin. Anything beyond that could be a sign of liver ___.
2, enlargement
Should be ___ arteries and ___ vein in the umbilical cord. Falls off between ___-___ days.
2, 1, 7-14
___ ___ is where the NB has no anus and is a surgical emergency to place a ___.
Imperforate anus, colostomy
___ is fluid around the testicles, which is eventually reabsorbed and can take up to a ___.
Hydroceles, year
With ___ ___, you can’t tell if it’s male or female, so must do ___ to see if ovaries or testicles are present.
Ambiguous genitalia, u/s
___ is where the urethral meatus is at the 6:00 position on the shaft of the penis.
Hypospadius
___ skin tag is over-exposure to ___ and is commonly seen in female NB.
Hyman, estrogen
NB should void w/in ___ hrs of birth, otherwise perform renal ___.
24, u/s
NB should only poop in utero if they are in ___.
distress
___ is a GI medical emergency where there is a twist/strangulation of the intestines.
Volvulus
Galiazzi test checks for symmetry of the ___. Barlow maneuver checks for ___ of the ___. Ortolani maneuver checks for reduction/___ of the ___.
knees, dislocation, hips, dysplasia, hips
Need to check that pilonidal dimple is attached to base, so that it does not leak ___ ___.
cerebrospinal fluid
Common features of trisomy 21: ___ fold, ___ spacing in toes, ___-set ears, ___ pinky digit.
epicanthal, wide, low, short
The ___ exam is where you gently drop baby’s head and watch for ___ shape in arms.
Morrow, C
___ reflex is when the baby turns it’s head towards the side being touched.
Rooting
NB’s blood sugar should be above ___. Risk factors for hypoglycemia include: ___, ___, and infants of ___ moms.
45, SGA, LGA, diabetic
Symptoms of ___ include: jittery, tachypnea, hypotonic, poor feeding, apnea, temp instability
hypoglycemia
In NB, check BS every ___ x ___. If hypoglycemic, feed w/colostrum or formula. F/u w/glucose ___ mins after feeding.
hour, 3, 30
Hyperbilirubinemia can be caused by either increased ___ or decreased ___.
production, elimination
Tx for hyperbili: bili ___ and bili ___. NB excretes it by ___.
lights, blanket, pooping
RBC breakdown l/t ___. Bilirubin is bound to ___ and transported to the ___. Excreted into the ___ where it is eliminated.
bilirubin, albumin, liver, gut
Infants less than ___ wks gestation and who are ___ are at highest risk for hyperbilirubinemia.
38, breastfed
Jaundice w/in 24 hrs, east asian descent, blood group incompatibility, sibling received phototherapy, gestation 35-36 wks, cephalhematoma/bruising, and breastfeeding can all be major risk factors for ___.
hyperbilirubinemia
Other risk factors for hyperbilirubinemia include: ___ birth wt, ___, ___, and ___ disorders.
low, polycythemia, infection, genetic
Think ___ when jaundice is present.
sepsis
NB needs to have ___ urination and ___ stool before discharge.
one, one
Feedings should be ___-___/day. Wet diapers should be ___-___/day. Stools should be ___/___ and should be ___-___/day (minimum).
8-12, 6-8, yellow/seedy, 3-4
APGAR stands for:
Activity (muscle/tone), pulse, grimace (reflex irritability), appearance (skin color), respiration
Growth parameters on a NB include what 3 things?
height/length, weight, head circumference
V/S on a NB include what 3 things?
pulse, temp, respirs (b/p not usually indicated)
What would a weak/absent femoral pulse possibly indicate?
Bounding pulses could indicate a ___ ___ ___.
coarctation of the aorta, patent ductus arteriosus
What is the best route to take a temp in NB?
tympanic
Respirs can vary according to what other measurement?
HR
Preterm infants may appear more ___ in skin color d/t less SQ fat.
red
The spaces that separate the cranial bones are called ___.
sutures
Anterior fontanelle if bulging is ___ and could indicate elevated ___ ___, such as in hydrocephalus. It is normal if NB is crying.
abnormal, intracranial pressure
Anterior fontanelle if depressed is ___ and could indicate ___.
abnormal, dehydration
Small hemmorhages on the sclera after birth is ___.
normal
Pupils are often ___ and do not respond well to light until week ___ of life.
constricted, 3
The tip of the ear should be at or above the ___ line.
canthal
Preaurical skin tags or pits can be associated w/___ abnormalities.
renal
NB should ___ at sudden loud noises, like clapping or snapping your fingers.
blink
Most NB’s are ___ breathers.
nasal
Epstein’s pearls are ___ in color and are a normal finding in NB that can show up on ___ and ___.
white,gums, palate
Respirs are typically intra-___.
abdominal
Intercostal retractions could indicate respiratory ___.
distress
When percussing lungs, sound should be ___-___.
hyper-resonant
Breath sounds are ___ pitched than adults.
higher
Persistent cyanosis could indicate ___ ___ ___.
congenital heart disease
Acrocyanosis is a sign that the infant is ___.
cold
The apical impulse is near the ___ process.
xiphoid
When auscultating HR, listen for ___ and ___ sounds, ___, and ___.
S1, S2, splitting, murmurs
Some murmurs are normal, but if heard should be ___ to a cardiologist.
referred
NB abdomen is normally ___ and larger than chest.
protuberant
To relax the abdomen while palpating, flex ___ up.
knees
Liver typically ___ cm below the right ___ ___.
2, costal margin
Skin turgor should snap back and return to color w/in ___-___ seconds.
1-2
If passage of meconium does not occur w/in ___ hrs of birth, perform a rectal exam.
12
The ___ test checks for hip dysplasia. Place legs in ___ position and then gently push flexed knees towards exam table. A ___ sound would indicate dislocation.
ortalani, flexed, click
The ___ test checks for hip dislocation. Place legs in ___ position and gently push down on legs. A ___ sound wound indicate dislocation.
barlow, flexed, click
When assessing bottom of feet, line should cross between ___ and ___ toe going from heel straight up.
second, third
Check for a dimple or tuft of hair at spinal/sacral region, which could indicate ___ ___.
spina bifida
The ___ reflex is where you gently pull on NB arms and quickly let go. Infant should reflex into a ___ shape w/arms and legs typically ___ simultaneously.
Moro, C, extend
The ___ ___ reflex is where the head is turned to one side. The arm and leg to which the head is turned ___, while the opposite arm and leg ___.
tonic neck, extend, flex
The ___ reflex is where a finger is ran down one side of infant’s back and the ___ turns to that side.
galant, trunk
The ___ reflex is where one foot is placed on the table, and the baby automatically performs a stepping movement w/the opposite foot.
stepping
The ___ ___ reflex is where the baby is held up and the head should remain ___, while the legs ___.
vertical suspension, midline, flex
