Ob Flash Cards - Final

Front 1

What does APGAR stand for? What is a bad score?

Back 1

Appearance
Pulse rate
Grimace
Activity
Respiratory effort
0-10 scoring. If <5 resuscitative measures may be necessary.

Front 2

Appearance scoring (APGAR)

Back 2

0: blue, pale
1: body pink, extremities blue
2: completely pink

Front 3

Pulse rate scoring (APGAR)

Back 3

0: absent
1: below 100
2: above 100

Front 4

Grimace scoring (APGAR)

Back 4

0: no response
1: grimace
2: cries

Front 5

Activity scoring (APGAR)

Back 5

0: limp
1: some flexion of extremities
2: active motion

Front 6

Respiratory effort scoring (APGAR)

Back 6

0: absent
1: slow and irregular
2: strong cry

Front 7

When are APGAR assessments done?

Back 7

1 and 5 minutes after birth.

Front 8

What is a Ballard Score?

Back 8

measures fetal maturity as it relates to weeks gestation in very LBW infants - measures physical and neuromuscular maturity
-score of 30 to 50 indicates full term baby
-score of -10 to 34 indicates preterm baby
-can be used with very low birth weight babies
-accurate to within +/- 2 weeks
-do within first 48 hours of birth
-measures 6 external physical signs and six neuromuscular signs

Front 9

Why do we give Vitamin K to newborns?

Back 9

They do not have the intestinal flora to produce the vitamin in the first week after birth. Vitamin K promotes formation of clotting factors in the liver and prevents hemorrhagic disease in the newborn.

Front 10

AGA percentile & weight?

Back 10

Appropriate for gestational age

Between 10-90 percentile
2500 - 4000g

Front 11

LGA percentile & weight?

Back 11

Large for Gestational age

Above 90th percentile
> 4000g

Front 12

SGA percentile & weight?

Back 12

Small for gestational age

Below 10th percentile
< 2500g

Front 13

Term

Back 13

Between 37 and 42 weeks

Front 14

Preterm

Back 14

Before 37 weeks gestation

Front 15

Postterm

Back 15

After 42 weeks gestation

Front 16

How is mortality related to gestational age and birth weight?

Back 16

low birth weight = increased mortality
low gestational age = increased mortality

Front 17

5 Signs and symptoms of respiratory distress in a newborn

Back 17

grunting - noise on exhalation
retractions
nasal flaring
cyanosis
lack of respiratory effort

Front 18

Where is pulse taking on a newborn? How long? What range is acceptable?

Back 18

apical pulse 4-5th intercostal space, left of midclavicular line. for 1 minute.

<100 bad 120-160 okay.

Front 19

How and why to maintain temperature with newborns?

Back 19

Dry and wrap in blanket
newborns can not shiver
heat loss and cold stress can cause hypoglycemia in newborn

Front 20

Newborn vital signs

Back 20

Temp 36.5 C- 37.2 C
Temp 97.7 F - 98.9 F
Pulse 100-180 Brady < 80, Tachy > 180
Respirations 30-60
BP 60-80 / 40-50

Front 21

Newborn Medications

Back 21

“Eyes and Thighs”- 2 medications need to be given: Put in Vastus Lateralis muscle

Vitamin K- 25 gauge 5/8 inch needle- given for clotting

Erythromycin Ophthalmic- put in eyes – for Chlamydia and gonorrhea in birth canal.

Front 22

How can a baby better regulate their temperature with mom or dad?

Back 22

skin to skin contact

Front 23

What are Milia?

Back 23

white dots on nose, forhead and chin or mouth.

caused by blocked sebaceous glands

will go away on own, benign

Front 24

Newborn Rash

Back 24

Will go away by 3 weeks

Front 25

Vernix

Back 25

waxy or cheesy white substance on skin, very good for newborn skin,
will absorb naturally, do not add products to it

Front 26

Mongolian spots

Back 26

dark spots, collections of capillaries, look like a bruise
completely benign, most common on dark skinned babies

Front 27

Lanugo

Back 27

fine hair most commonly found on preterm neonates
tends to be most on back and chest

more premature = more lanugo

Front 28

Acrocyanosis

Back 28

cyanosis in hands and feeds, takes a few days to go away

Front 29

Nevi

Back 29

stork bite, will blanch when touched, will fade by 2 y/o

Front 30

Strawberry Hemangioma

Back 30

will be textured, will appear later - after birth and will fade by 9 y/o

Front 31

Port-Wine stain

Back 31

most often on head and neck, will not change colors when touched. Tx most often laser surgery

Front 32

4 Forms of thermoregulation in the newborn

Back 32

Evaporation - wet surface of baby exposed to air
Conduction - comes into direct contact with something colder
Convection - heat transfers to air around the infant
Radiation - heat transfers to cooler objects not in contact with newborn (?)

Front 33

Newborn weight loss in first 5 days?

Back 33

Will lose 5-10% in first 5 days and then
return to birth weight by 2 weeks.

Front 34

Newborn renal function

Back 34

Should void in first 24 hours. Twice in second 24 hours, 3 times in 3rd 24 hours.

Increases on day 3-4 when mother's milk comes in, then voids 6-8 voids/24 hours.

Front 35

Newborn stools and color

Back 35

meconium (dark olive color, tarry, sticky) at first

1st stool at 48 hours, 3 stools per 24 hours once milk comes in.
yellow (digested milk)
tan (formula)
black (iron fortified formula)

Front 36

Jaundice in newborns
Levels
When & how it appears

Back 36

> 5mg/dL Bilirubin will show signs (yellow skin)
term infants: appears after 24 hours, and ends by 7th day.
preterm: appears after 48 hours, ends by 10th day.
starts at head and progresses downwards.

Front 37

Risks of newborn jaundice, untreated.

Back 37

High levels of bilirubin will cross blood brain barrier and cause irreversible brain damage (kernicterus)

Front 38

Jaundice symptoms

Back 38

High pitched cry
absent moro reflex
Poor feedings