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20 Cards in this Set
- Front
- Back
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Types of fetal ultrasound measurements (6) |
- Crown-rump length (best to look at, if it changes probably something wrong with baby's growth) - Biparietal diameter -Femur & humerus length (good indicator for downs, but not unless > 1 factor found. Also asians/hispanics) - Abdominal circumference - best in last trimester to see if baby is losing weight -Chest circumference -Nuchal translucency (downs/cystic hygroma) |
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What two measurements assess nutrition specifically? (and other physical findings - 7) |
Skin fold thickness & Mid-arm circumference Also: hair, cheeks, neck & chin, arms, back, chest, abdomen |
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AGA vs LGA vs SGA |
AGA - weight between 10th & 90th percentile for GA LGA - > 90th % SGA - < 10th % |
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LBW vs VLBW vs ELBW |
LBW - < 2500 gm VLBW - < 1500 gm ELBW - < 1000 gm |
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IUGR |
Inappropriate growth for GA... Should NOT be used interchangeably with "SGA" (may be AGA but still didn't grow well if IUGR) Some infants may be growth restricted by aren't < 10% on chart |
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Symmetrical vs Asymmetrical growth restriction |
Symmetrical - proportionate decrease in weight, length, and HC. D/t: congenital viral infections, single gene defects, chromosome abnormalities. Brain growth DOES correlate with head circumference (decreased HC may mean brain growth restriction) Asymmetrical - decrease in only ONE parameter; usually low weight with normal HC/length. This is brain/head SPARING, associated with decreased placental function or nutritional deficiency. Occurs in 3rd trimester d/t: PIH, poor maternal caloric intake, chronic fetal stress |
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Most common cause of LGA baby |
Frequently born to diabetic mother with poor glucose control --> maternal hyperglycemia, fetal hyperglycemia & hyperinsulinemia Insulin acts as a GROWTH HORMONE = macrosomia |
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Why do we classify? (4) |
- Helps establish levle of risk for neonatal and long-term morbidity and mortality - AGA @ lowest risk for mother and baby - If preemie & SGA? = HIGHEST risk - SGA, LGA, & IUGR - at risk for perinatal & long-term problems |
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Crown/rump length should be ____ of length |
2/3 |
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Term vs Preterm measurements |
Term - weight, length, HC, plot against a standard growth curve Preterm - daily weight, weekly HC & length, plot agains growth curves (monitor THEIR increases) |
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Specific HC measurement considerations Normal size Purpose of transillumination? |
Measure 3x for accuracy and take middle 1; may be inaccurate at first dt molding, etc Normal: 33-35.5 cm (varies 31-38 cm) General rule: HC in cm = 1/2 the length in cm + 10 Plot on standard curve < 10th% = microcephaly > 90th% = macrocephaly Transillumination may be helpful, a ring > 2 cm larger than light source implies increased fluid or decreased brain tissue |
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Growth rate correlates with _____ Normal head growth per month |
GROWTH RATE CORRELATES WITH BRAIN GROWTH Excessive vs limited head growth, chart on graph and monitor weekly Expected growth = 2 cm/month |
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Anterior fontanelle (found WHERE and how it is measured) |
Formed at intersection of metopic, coronoal, & sagittal sutures Measure AF DIAGONALLY from bone to bone Size is variable - barely palpable to 4-5 cm Large fontanelle may indicate hypothyroidism (& large posterior fontanelle) Closes @ 18-24 months AF OK as long as you can get a fingertip in (~ 0.6 cm) |
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Tense or bulging anterior fontanelle may be sign of: Sunken may be a sign of: |
- Increased ICP - With crying - "Bulge" may be seen in older preterm babies whose skull growth has not kept up with brain growth --> assess while the baby is upright, almost sitting Sunken AF? May be dehydration |
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Posterior fontanelle found where? Specifics. |
Formed @ sagittal suture and lamboidal sutures. A "3rd" fontanelle may be felt, defect in parietal bone -- will eventually straighten out Small, closes @ 2-3 months of age or closed @ birth Report if palpable or not, do not measure Large? may be sign of hypothyroidism. Each day you don't treat hypothyroid = 1 IQ point decreased |
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Normal Ear position |
Draw line from inner canthus to occiput (May be rotated d/t molding/caput) |
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What do you assess when looking @ eyes (5)? |
Shape Abnormal placement or small palpebral fissures (syndrome/chromosomal anomaly) Hypertelorism Hypotelorism Epicanthal folds |
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Average chest circumference & where do you measure |
Measure horizontally around upper body @ level of nipples Measure during expiration Average 33 cm +/- 3 cm Term infant ~ 2 cm smaller than HC |
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Internipple distance |
Measure from outside of one areola to outside of the other Should be < 1/4 of chest circumference Term ~ 7.75 cm / Preterm ~ 4.75 vm Wide spaced nipples - thinking Turner's (usually also see other s/s) |
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Extremity length |
Only done when body is disproportionate (Dwarfism) |
