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Child Health > Sick Term Infants > Flashcards

Sick Term Infants Flashcards

1
Q

What structure is commonly used to give IV access in babies?

A

The umbilicus

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2
Q

How long dies it take for babies to become sick?

A

Not long at all = babies can become sick very quickly at any time from birth up until 28 days

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3
Q

When is the neonatal period?

A

From birth to 27 days

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4
Q

When do infections tend to present in babies?

A

Soon after delivery

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5
Q

What are the categories of the Apgar score?

A 
Appearance (skin colour)
Pulse
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
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6
Q

What Apgar score indicates a healthy baby?

A

Aiming for score of 2 in each category to give a total of 10

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7
Q

What Apgar score do stillborns normally have?

A

A score of 0

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8
Q

What should a baby’s pulse be?

A

Greater than 100 = term babies should be between 120-140 bpm, preterm babies should be up to 160 bpm

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9
Q

What makes up the history of a newborn clinical assessment?

A 
Maternal = PMH, pregnancy issues, drugs, infection risks
Infant = foetal growth and anomaly, delivery, resuscitation
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10
Q

What should be inspected in a newborn clinical assessment?

A

Tone, colour, level of arousal, work of breathing, heart rate, respiratory rate, capillary refill, oxygen saturation

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11
Q

What should the normal vital signs be in babies?

A

Respiratory rate = 40-60 bpm
Capillary refill = 2-3s
SaO2 = 95%

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12
Q

When may a baby develop apnoea?

A

When they are just beginning to become unwell

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13
Q

How do seizures present in babies?

A

They are subtle = apnoea, lip smacking, eye rolling, cycling of limbs

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14
Q

What are some signs that may indicate an unwell baby in a newborn clinical assessment?

A

Jaundice, low tone (floppy), seizures, poor feeding, bilious vomit

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15
Q

What temperature should babies be kept at?

A

Between 36.5-37.4 degrees

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16
Q

What makes up the initial management of a baby after delivery?

A

Temperature, airways and breathing, circulation (fluids, inotropes), antibiotics, metabolic homeostasis (glucose management, acid-base balance)

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17
Q

When should antibiotics be given to a sick baby?

A

Until infection is completely ruled out

18
Q

What is the blood volume of babies?

A

80ml/kilo

19
Q

What makes up the ongoing management of babies after delivery?

A

Diagnostic work up
Further support = ventilation, drugs, specific therapy, surgery, transfer to specialist centre
Care of family

20
Q

What is therapeutic hypothermia?

A

Cooling of baby to 33.5 degrees for 72 hrs = used to treat neurological ischaemia (protective against cerebral palsy)

21
Q

What are the main categories of causes of a sick baby?

A

Congenital abnormalities, metabolic, infection, pregnancy/birth related

22
Q

When may infection occur in a baby?

A 
Antenatal =  bacterial (Group B strep)
Perinatal = viral (enterovirus, herpes)
Postnatal = bacterial (staph)
23
Q

Where are some sites of infection in babies?

A 
Bloodstream = bacteraemia/septicaemia
CNS = meningitis
Respiratory = pneumonia
GU = UTI (more common in boys up to 28 days)
Others = skin (around umbilicus), bone (osteomyelitis), necrotising enterocolitis
24
Q

What are some common bacterial causes of infection in babies?

A

Group B strep (most common), E.coli, listeria myocytogenes (rare), staph aureus, staph, epidermidis (babies who’ve undergone operations)

25
Q

What are some viral causes of infection in babies?

A

Cytomegalovirus, parovirus, herpes, enterovirus

26
Q

What are some rarer cause of infection in babies?

A

Toxoplasma gondii, HIV, syphilis, TORCH

27
Q

What is hypoxic ischaemic encephalopathy?

A

Multi-organ damage due to tissue hypoxia = affects brain. kidneys and liver

28
Q

What are some features of hypoxic ischaemic encephalopathy?

A

Poor Apgar scores = active resuscitation required

Neurodevelopmental sequeli = variable prognosis

29
Q

How is hypoxic ischaemic encephalopathy treated?

A

Therapeutic hypothermia

30
Q

What causes transient tachypnoea of the newborn?

A

Fluid in lungs not being cleared as production of lung fluid hasn’t been stopped

31
Q

What does transient tachypnoea of the newborn look like on an x-ray?

A

Fluid in the horizontal fissures of the lung

32
Q

How common are pneumothoraxes in babies?

A

Very common = most babies aren’t unwell and it resolves without intervention

33
Q

What causes heart failure in babies?

A

Hydrops foetalis = may be due to rhesus disease (linked with maternal anaemia) or be chromosomal

34
Q

How may hydrops foetalis present?

A

Baby will have swollen liver, ascites/severe abdominal swelling and pleural effusions

35
Q

What are some congenital cardiac abnormalities found in babies that may cause sickness?

A

Tetralogy of Fallot, coarctation of the aorta, TAPVD, hypoplastic heart, transposition of great vessels

36
Q

When do cardiac abnormalities tend to present in babies?

A

Usually 2-3 days after birth

37
Q

What are some congenital respiratory disease in babies?

A

Tracheo-oesophageal fistula (baby turns blue after swallowing)
Diaphragmatic hernia

38
Q

What is Potter’s syndrome?

A

Rare renal congenital disease = causes renal agenesis

39
Q

What are some neurological congenital diseases of the baby?

A

Microcephaly, spina bifida

40
Q

What is myotonic dystrophy?

A

Muscular congenital disease = presents with transient myotonia in baby

41
Q

What are some metabolic diseases that cause babies to become unwell?

A 
Hypoglycaemia = related to reduced reserves or maternal diabetes
Acidosis = inborn error of metabolism
42
Q

What may hypoglycaemia be a sign of?

A

May be evidence of a more complex metabolic disorder

Child Health (27 decks)

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