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40 Cards in this Set
- Front
- Back
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If newborn is healthy and has 8-10 Apgar scores at 1 and 5 minutes respectively, what do we do? |
1) Suction mouth and nose 2) clamp umbilical cord |
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When to give nasogastric tube to newborn? |
When GI decompression required |
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Normal Newborn Vital Signs |
RR:40-60 HR 120-160 |
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Late preterm neonate |
34-37 |
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Term neonate |
≥ 38 wks |
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What does Apgar score indicate?
What does Apgar score NOT predict? |
quantifiable measurement for need and effectiveness of resuscitation
It does NOT predict mortaility |
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What does 1 minute Apgar score evaluate? |
conditions during: Labor & Delivery |
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What does 5 minute Apgar score evaluate |
Response to resuscitative efforts |
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Is low Apgar score associated with Cerebral Palsy? |
NO |
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What does APGAR stand for? |
Appearance - skin color Pulse Grimace - Reflex irritability Activity - muscle tone Respiration |
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Appearance scores for Apgar: |
0 = Blue all over (cyanosis due to hypoxia) 1 = Normal except extremities (cyanosis in more distal blood vessels) 2 = Normal all over |
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Pulse scores for Apgar: |
0 = Asystole or <60 bpm 1 = 50-100 bpm 2 = >100 bpm |
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Grimace to irritation scores for Apgar |
0 = No response 1 = Grimace with feeble cry 2 = Sneeze or cough |
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Activity score for Apgar |
0 = No muscle tone 1 = some flexion 2 = active movement |
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Respiration score for Apgar |
0 = Absent 1 = weak or irregular 2 = strong |
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Conjunctivitis |
Inflammation of the conjunctivae (thin clear tissue covering white part of eye and lining inside of eyelid |
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Most likely cause of conjunctivitis (red eyes) at 1 day?
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Chemical irritation |
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Most likely cause of conjunctivitis at 2-7 days? |
Neisseria Gonorrhea |
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Most likely cause of conjunctivitis at > 7 days? |
Chlamydia Trachomatis |
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Conjunctivitis at > 3 weeks? |
HSV |
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ophthalmia neonatorum |
Conjunctivitis caused by infection contracted by newborns' eyes during delivery through birth canal infected with either Neisseria gonorrhoeae or Chlamydia trachomatis.
Usually painful, swollen, w/ discharge |
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prophylactic Tx at birth to prevent ophthalmia neonatorum |
2 Types of Drops 1) Erythromycin or Tetracycline Ointment 2) Silver Nitrate
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1 week old with intracranial bleeding and mucosal bleeding born to parents who do not believe in vaccines? |
Think Vitamin K was not administered at birth via intramuscular injection. Gut flora flora might not be sufficiency colonized to produce sufficient Vitamin K. Liver still immature and breast milk poor source of Vitamin K. |
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Vitamin K difficiency Bleed typical presentation |
bleeding from 1) GI tract 2) belly button 3) urinary tract -> Hematuria |
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Screening tests done on all neonates prior to discharge |
PKU Congenital Adrenal Hyperplasia Biotinidase Defficiency Beta Thalassemia Galactosemia Hypothyroidism Homocysteneuria CF PG-CCBBHH |
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Additional Most commonly Tested Disorders in Newborns |
G6PD Deficiency Hearing Test |
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G6PD Deficiency |
Loss of reducing potential in RBC's Leads to Hemolytic crisis Tx: reduce oxidative stress/specialized diets X-linked |
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PKU |
Phenylalanine Hydroxylase deficiency Phenylalanine builds up Leads to Mental Retardation Tx: Restriction of Phenylalanine in diet for at least first 16 years of life -AR disorder
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Galactosemia |
Rare Abnormal metabolism of Galactose Cut out Lactose from diet |
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Congenital Adrenal Hyperplasia |
General term for several AR (Aut Reces) diseases that result in errors of steroidogenesis
Tx: Replace glucocorticoids and mineralocorticoids as needed and possibly do genital reconstructive surgery
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Why is CAH called a Hyperplasia? |
Inefficient cortisol production -> ↑ACTH-> overgrowth (hyperplasia) and overactivity of the steroid-producing cells of the adrenal cortex |
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Congenital Hypothyroidism |
Can result in cretinism = stunted physical and mental growth due to untreated congenital deficiency of T3/T4 |
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Hearing test |
Tests for Congenital Sensurineural Hearing loss
Tx: Cochlear implantation |
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Cystic Fibrosis |
AR mutation in CFTR If CFTR (channel protein controlling flow of H2O & Cl- ions in and out of cells) is blocked, there is thickening of sweat, digestive fluids, and lung mucus
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Classic lab findings for CF |
1) elevated sweat chloride 2) mutations in CFTR gene
and/or 3) abnormal function of at least 1 organ system |
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What newborns should get HBIG (Hep B Ig) in addition to HBV vaccine? |
newborns with HBsAg + mothers
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Transient Polycythemia of the Newborn |
Hypoxia during delivery stimulates EPO -> ↑ circulating RBC's
First breath will ↑ O2 -> ↓ erythropoeitin -> normalization of Hgb
Therefore: Splenomegaly normal finding in newborns.
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Transient Tachypnea of the Newborn |
Compression of rib cage by passing through mother’s vaginal canal
Newborns delivered via C-section may have excess fluid in lungs and therefore be hypoxic. This can cause transient tachypnea
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Tachypnea lasting > 4 hrs |
Considered sepsis
Evaluated blood and urine cultures |
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When to do Lumbar puncture w/ CSF analysis/culture?
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when the newborn displays neuro signs irritability lethargy Temp irregularity feeding problems |
