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Gender And Reproductive Health Finals > 4500 Class 10 Complicated Newborn > Flashcards

4500 Class 10 Complicated Newborn Flashcards

1
Q

Assessment and management of newborn feeding practices

A
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2
Q

How often to feed baby

A

Every 2-3 hours

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3
Q

How often do we give vit d to newborn? How much

A

Vit d

400IU

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4
Q

What is a colustrum

A

It is more concentrated than mature milk
A clear yellowish fluid
More concentrated than mature milk
Extremely ruch in immune globulins
High concentration of protein, fat-coluble vit. And minerals
Has less fat than transitional or mature milk

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5
Q

Has less immunoglobilins and less protein
Higher fat, higher cals

A

Transitional milk

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6
Q

How much void in mecomium expected in day 1?

A

1 each

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7
Q

In day 2, how much mecomium and voids expected?

A

2 voids, 1-2 stools

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8
Q

Ave duration of feed

A

20 mins

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9
Q

Acronym lach assessment stand for

A

L latch characteristics — infants mouth positioned over nipple, areola and breast so that it makes a seal between the mouth and breast which will allow for suction and facilitate milk removal

A AUDIBLE swallowing

T TYPE — flat, inverted or everted

C CONFORT — maternal comfort

H HOLDING skills

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10
Q

What is not normal in breast when feeding

A

Erythema, cracks

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11
Q

What % of weight loss if acceptable in newborn

A

5-7% weight loss in the first 3 days

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12
Q

Weight gain in day 4??? And onward

A

Newborn should be gaining 20-35 g/kg

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13
Q

When should newborn be back at birth weight???!

A

10-14 DAYS

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14
Q

How much % is not normal loosing from birth weight

A

8%!!!!

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15
Q

What is a late sign of hunger

A

Crying

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16
Q

Feeding cues

A

Hand to mouth

Sucking motions

Rooting reflex

Mouthing

Flexed arms and legs with clenched fists

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17
Q

Void and stool in newbown

Day 2-3

A

2-3 voids. Clear pale yellow

1 or more meconium or greenish brown transition stools

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18
Q

Void and stool day 3-5

A

3-5 void

3-4 stools changing to loose yellow

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19
Q

Void stool in day 3-7 of newborn

A

4-6 voids

3-6 yellow. Golden generally loose

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20
Q

Day 7-8 void and stool of newborn

A

Frequent and pale yellow void

5-10 +yellow stools

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21
Q

What to do with feeding on a sleftlip/palate newborn

A

Alter positioning

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22
Q

Occurs on days 2-5, lasts ~24 hours; girm, tender, swollen, hot, aerolae can become firm and nipple flattens

A

ENGLRGEMENT

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23
Q

Breat]st feed vit req?

A

Vit D of 400IU per day!

24
Q

When is complementary feeding prompted

A

After 6 montha

25
Q

Hemolytic disease of the newborn (HDN)

A
26
Q

Jaundice

A
27
Q

Hoe does jaundice presents

A

Yellow colorimg in sclera, skin and mucosal membranes

28
Q

Can either be physiologic versus pathologic

60% of fullteerm newborns and 80% of preterm newborns will experience physiologic jaundice

A

Jaundice

29
Q

Increased rbc at birth
Decreased lifespan of newborn rbs (60-90 days, N is 120)
Decreased ability of newborn liver to conjugate bilirubin in the 1st few days of life
Decreased vol of serum albumin to bind bilirubin]increased enterohepatic circ

A
30
Q

WHAT IS THE BEST METHOD TO LREVENT JAUNDICE

A

EARLY AND FREQUENT BREASTFEEDING

31
Q

Weight loss / weight expectations in first 3 days bersus day 10-14

A

5-7T weight loss over the 1st 3 days is normal!

Newborn should regain this weight within 10-14 days!Q!!

32
Q

How do you calculate % weight gain or loss

A

Net weight gain or loss DIVE BY previous weight MULTIPLY BY 100 = % weight gain or loss

33
Q

what are risks for jaundice

A

Prematurity: GA 35-38 weeks
Excessive weight loss
Sibling who had neonatal jaundice
Visible bruising
CEPHALOHEMATOMA
DAT + other hemolytic disease (G6 PD)
Ethnic backgrounf (East Adian)
Asphyxia (Apgar 0-3 beyond 5 min & cord pH <u)
Acodosis (pH of blood less than 7)
Albumin < 30g/L
Deosis
Temp instability
Lethargy/poor feeding

34
Q

It is a sign of neurotoxicity.

It is where there is a loss of startle reflex, poor feeding/sucking, lethargic, poor muscle tones (may be subtle), high pitched cry, irritability, seizures, coma death

A

ACUTE BILIRUBIN ENCEPALOPATHY

35
Q

What is KERNICTERUS

What is it characterized by(name 3!!)

A

Hearing loss, cerebral palsy, gaze abnormalities

It is an irreversible brain damange from CHRONIC BILIRUBIN ENCEPGALOPATHY

36
Q

What PATHOLOGIC JAUNDICE??

A
  1. Jaundice that presents in the first 24 hours after birth. IT IS ALWAYS CONSIDERED ABNORMAL (pathologic) and needs to be investigated
  2. If TSB increases more than 100mcmol/L in 24 hours
  3. Is TSB > 256 mcmol/L at any time
  4. If caused by pathological condition (e.g. HDN)
37
Q

Characteristics of a PHYSIOLOGIC JAUNDICE

A

Jaundice that does not reach concerning levels based on the gestational age of the infant

Presents after 24 hours of age

It os not due to underlying condition

USUALLY RESOLVE WITHOUT TREATMENT

*Jaundice related to breat/chest feeding

38
Q

When should serum bilirubin measured?

A

If jaundice still rpesent at 203 weeks of age

39
Q

What would be required at ANY TIME serum bilirubin falls in higher than acceptable range?

A

PHOTOTHERAPY

40
Q

This usually occurs due to isoimmunic\zation or ABO incompatibility.

Can cause anemia.

A condition where rbc are broken down or destroyed

How to we treat this?

A

HDN/ aka erythroblastosis

Tx is PHOTOTHERAPY. Exchange transfusion on rose case

41
Q

How do we visually assess for jaundice?

A

Apply gentle pressure over a bony prominencefor 2-3 secs then assess for yellow color in the blanced area

42
Q

What is orimary site for tcb reading

A

Forehead unless bruised and discoloored, then use intang’s sternum if equired

43
Q

What is a high TSB

A

Greater than256

44
Q

What to do is baby appears jaundiced < 24 hours of age

A
  1. Screen using TcB
  2. Plot TcB on nomogra
  3. Notify pcp
  4. Obtain order for TSB and DAt
45
Q

When do we assess newborn with jaundice?

A

Weight loss of more than 7%

Decreased milk intakr

Decrease in stools (less than 3stools in day 4)

Decrease in urine output (less than 4-6 by day 4)

46
Q

What do we expect with Infants of Diabetic Mothers/Birthers

A

Hypocalcemia and hypomagnesemia

Cardiomyopathy

Hyperbilirubinemia and polycythemia

RDS

Cardiac anomalies; VSD

Congenital hyperinsulinemia

47
Q

When to check the glucose of IDM when they are >= 35 weeks gestation at birth

A

2 hours after birth, after first feed

48
Q

What is the goal serum blood glucose of IDM????

A

> = 2.6 mmol/L

49
Q

Diagnostics may include in neo infections

A

CBC, blood and urine cultures, lumbar puncture, CRP, ciral cultures, CXR, liver func and enzymes, fungal culture,

50
Q

What will chlamydia do to the infant

A

Conjuctivitis

Pneumonia

51
Q

Intervention to newborn when mom have gonorrhea

A

Eye prophylaxis

52
Q

What is tx for thrush, it is common in breast feed infants

A

Nystatin

53
Q

What too to measure adverse exposure affecting newborns

When

A

Finnegan neonatal abstinence scale

2 years of age

54
Q

What does these suggest

A

Crynf/comsoable in 5 min and % of time spent crying

Time spent sleeping after a feed

Muscle tone (increased)

Tremors

RR > 60/min, with or withiut retractions

Sweating

Excessive sucking

55
Q

What substances can cause neuro symptoms but not withdrawal

A

Caffeine, cocoaine, meth, marijuana, hashish, nitrous oxide, vicotine

56
Q

What drugs can cause NAS when taken 72 hours prior birth

A

Narcs (methadone. Morphome. Heroin, fentanyl)

Alcohol

Barbituates\
Benzos

Inhalants

SSRI’sm
SSRI’sm

Gender And Reproductive Health Finals (6 decks)

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