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Midwifery y1 Anatomy and Physiology > Y2 NIPE > Flashcards

Y2 NIPE Flashcards

1
Q

Which are the five steps of the neonatal examination?

A 
Preparation
Observation
Examination
Explanation
Documentation
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2
Q

Scalp

A

Bruising/swelling

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3
Q

Head

A

sutures and fontanelles, size, asymmetry/shape

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4
Q

Face

A

Characteristics for T21 etc. Cleft lip, Asymmetry

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5
Q

Mouth

A

Cleft lip, Teeth, Cysts, Cleft Palate, Macroglossia

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6
Q

Ears

A

Skin creases, Deformity/absence, pre-auricular skin tags, ?position

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7
Q

Eyes

A

Absence, Asymmetry, Red reflexes, Corneal opacities, Coloboma

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8
Q

Neck

A

Extra skin folds, Asymmetry, dimples, Swelling

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9
Q

Hands and feet

A

Asymmetry/Absence, skin creases, swelling.

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10
Q

Digits

A

Too few/too many, appearance of nails, Appearance of digits, Webbing.

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11
Q

Skin

A

Aplasia cutis, Birthmarks, Cuts and bruises, Pigmentation

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12
Q

Chest

A

Shape, Nipple position and number

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13
Q

Cardiovascular system

A

Heart position, Heaves and thrills, Heart sounds and murmurs (five spots), peripheral pulses

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14
Q

Respiratory system

A

Respiratory effort, Breath sounds

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15
Q

Abdomen

A

Distension, shape, Organomegaly, Tenderness

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16
Q

Umbilicus

A

Condition of cord and surrounding skin

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17
Q

Male genitalia

A

Testes, shape and size of penis, position of meatus, Urine stream.

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18
Q

Female genitalia

A

Appearance, Withdrawal bleeding.

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19
Q

Anus

A

Patency, Position, passage of meconium.

20
Q

Groin

A

Swelling

21
Q

Hips

A

Stability

22
Q

Spine

A

Deformity, overlying marks/defects

23
Q

CNS

A

Symmetry of reflexes, Appropriateness of reflexes, Ability to suck, Tone, Posture.

24
Q

Size

A

Weight, Length, Head circumference.

25
Q

What aspects need to be considered when looking in the case notes before undertaking a NIPE examination?

A
  • Family history
  • Past medical history
  • Past obstetric history
  • Present obstetric history
  • Details of birth
  • Wellbeing of baby at birth and following (APGAR etc)
26
Q

What maternal aspects need to be considered before a NIPE?

A 
Substance misuse 
Diabetes
Hypertension
Medication
Cardiac conditions
STIs
Family history
GBS present
RhD status
27
Q

What fetal aspects need to be considered before a NIPE?

A 
SGA 
IUGR
Macrosomia
Congenital abnormalities
Multiple pregnancy
28
Q

What intrapartum aspects need to be considered before a NIPE?

A 
Gestational age
Abnormal FHR pattern
Shoulder dystocia
PROM
Presence of meconium
APH
Operative delivery and why
Maternal fever/sepsis
29
Q

What equipment is needed to perform a NIPE ?

A

Stethoscope, Ophthalmoscope, Spatula, Tape measure, ?pulse oximeter

30
Q

What is the normal weight of a newborn?

A

Around 3,5 kg

31
Q

What is the average length of a newborn?

A

Around 50 cm

32
Q

What are Petechiae?

A

Petechiae are pinpoint, round spots that appear on the skin as a result of bleeding. The bleeding causes the petechiae to appear red, brown or purple. Petechiae (puh-TEE-kee-ee) commonly appear in clusters and may look like a rash. Usually flat to the touch, petechiae don’t lose color when you press on them. Can be a sign of low platelets, or congenital rubella/ congenital syphilis.

33
Q

What is the normal head circumference of a newborn?

A

32-36 cm in a term baby

34
Q

After how long after birth should “normal” swelling of the fontanels go away?

A

around 24 hrs

35
Q

How can you see the difference between caput and cephalohematoma?

A

Caput- indistinct border, CH- clear edge
Caput- present since birth, CH- appears after birth and increases for 2-3 days
Caput-swelling cross suture lines, CH, swelling does NOT cross suture lines
Caput- disappears within days, CH- can take weeks to resolve

36
Q

What are risk factors for cephalohematoma? Why are they critical to note?

A

Cephalohematoma occurs twice as often in males as in females, for unknown reasons. It is more common in primagravidas, in large infants, following instrument-assisted deliveries (with vacuum or forceps), following prolonged difficult labour, when cephalopelvic disproportion exists, when the head is in a deviant position (occipital posterior, occipital transverse), or when a scalp electrode has been placed. They can hide skull fracture, intracranial bleeding or a blood clotting disorder.

37
Q

What could ear dimples/tags/abnormal position indicate and what should be done about it?

A

Chromosomal abnormalities/ syndromes, referral to neonatal staff

38
Q

What is Talipes equinovarus?

A

Talipes equinovarus or club foot is the most common foot deformity in the UK occurring in 1:1000 births. The foot is plantar flexed (turned downwards and inwards the midline of the baby) and it can be structural or fixed. Newborn males are twice more likely to have this condition than females and in 50% of cases both feet are effected. The cause is unknown but can be associated with down’s syndrome or spina bifida therefore referral is required. Positional talipes is when the feet can easily be corrected with gentle manipulation and is caused due to constricted uterine space.

39
Q

How and why do we palpate the liver?

A

to ensure not enlarged over 1cm below the costal margin(may be present in congestive heart failure).

40
Q

normal respiratory rate for a newborn is?

A

40-60 breaths/minute

41
Q

Which reflexes are tested in the NIPE?

A 
Moro
Rooting
Sucking and swallowing
Palmar/Plantar Grasp
Walking and stepping
Crawling
42
Q

Questions regarding activity, behaviour cry and tone indirectly assess

A

Respiratory, cardiovascular, skeletomuscular, neurological

43
Q

Questions regarding color and temperature indirectly assess

A

Respiratory, cardiovascular, metabolic, immunological

44
Q

Questions regarding urinary output indirectly assess

A

renal, immunological

45
Q

Questions regarding feeding and stools indirectly assess

A

gastrointestinal and immunological

46
Q

Questions regarding skin integrety/ rashes/ spots indirectly assess

A

immunological

Midwifery y1 Anatomy and Physiology (24 decks)

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