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Child Health > Healthy Term Infants > Flashcards

Healthy Term Infants Flashcards

1
Q

After what point is an infant considered term?

A

After 37 weeks of completed gestation

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2
Q

When is an infant classified as being post-term?

A

After 41 weeks of completed gestation

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3
Q

What is the normal weight of a term infant?

A

Between 2.5-4kg

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4
Q

What would a birth weight of < 2.5kg be classed as?

A

Small for gestational age (SGA)

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5
Q

What would a birth weight of > 4kg be classed as?

A

Large for gestational age (LGA)

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6
Q

How much weight does a foetus gain in the third trimester?

A

Daily weight gain of 24g

About 7g of fat gained per day in the last 4 weeks

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7
Q

What materials are exchanged by transplacental transfer in the third trimester?

A

Iron, vitamins, calcium, phosphate, antibodies

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8
Q

How does term delivery usually take place?

A

Spontaneous or induced labour
Vaginal delivery or C-section
Cephalic (vertex) or breech position (or other)

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9
Q

What is the normal labour environment like?

A

Hypoxic during contractions
Placental insufficiency
Growth restriction or excess

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10
Q

What does foetal Hb help with during labour?

A

Release of oxygen

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11
Q

What does prolonged labour cause?

A

It reduced foetal reserves

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12
Q

What do increased cortisol and adrenaline levels during labour do?

A

Enhances adaptation of baby to new environment

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13
Q

What are the steps in perinatal adaptation?

A

First breath/cry, alveolar expansion, change from foetal to newborn circulation, decreased pulmonary arterial pressure, increased Pao2

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14
Q

What should be done immediately once a baby has been delivered?

A

Early/immediate skin to skin contact and suckling

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15
Q

What is the Apgar score?

A

Objective measure of perinatal adaptation = score out of ten (score of 0-2 in each category)

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16
Q

What are the components that make up the Apgar score?

A

Heart rate, respiratory rate, responsiveness, tone, colour

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17
Q

What is considered a normal Apgar score?

A

> = 8

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18
Q

What is skin to skin contact important in establishing?

A

Breast feeding

19
Q

What is the change in control of glucose homeostasis in newborns?

A

Dramatic change from continuous glucose infusion ti intermittent bolus enteral feeds

20
Q

What is the calorific intake like for well grown term infants in the first 24hrs?

A

They have very little intake

21
Q

What is attachment?

A

Hormonal and emotional response to infant

22
Q

What are some features of haemorrhagic disease of the newborn?

A

Rare

Potential mortality/morbidity (GI, lungs, CNS)

23
Q

What causes haemorrhagic disease of the newborn?

A

Lack of vitamin K = deficiency impairs production of coagulation factors

24
Q

Why is haemorrhagic disease of the newborn more common with formula feeding?

A

Vitamin K is transferred via breastmilk and can be inadequate in formulas

25
Q

What is one way haemorrhagic disease of the newborn can be diagnosed?

A

By measuring PIVKA = not usually needed

26
Q

What is infection risk of newborns based on?

A

Maternal history = mother testing positive for hep B and C, HIV, syphilis, TB or Group B strep

27
Q

What are some vaccinations given to prevent infection?

A

Maternal pertussis and influenza vaccines, routine vaccination schedule, hep B at birth, BCG in first month

28
Q

What are some screening tests done for newborns?

A

Newborn examination and universal hearing screening
Hip screening = clinical and USS
Cystic fibrosis and haemoglobinopathies
Metabolic diseases

29
Q

What are some metabolic diseases screened for in newborns?

A

Phenylketonuria (PKU)
Medium-chain acyl-CoA dehydrogenase deficiency
Maple syrup urine disease
Isovaleric acidaemia

30
Q

What is the newborn examination?

A

Top to toe examination is carried out by midwifery staff immediately after delivery
Formal neonatal examination carried out after 24hrs

31
Q

What is being assessed in an examination of the new-born’s head?

A

OFC, overlapping sutures, fontanelles, ventouse/forceps marks, moulding, cephalhaematoma, caput succedaneum

32
Q

What is being assessed when the ears are being examined?

A

Position, external auditory canal, tags/pits, folding, family history of hearing loss

33
Q

How are the eyes assessed in an examination of the newborn?

A

Size, red reflex, conjunctival haemorrhage, frequent squints, iris abnormality

34
Q

What is being looked at when the mouth is being examined?

A

Shape, philtrum, tongue tie, palate, neonatal teeth, Ebsteins pearls, sucking/rooting reflex

35
Q

What are some abnormalities looked for on examination of the face?

A

Facial palsy, dysmorphism

36
Q

How is respiratory function assessed on examination?

A

Chest shape, nasal flaring, grunting, tachypnoea, in-drawing, breath sounds

37
Q

What is assessed on examination of the cardiovascular system?

A

Colour/O2 saturation, pulses (femoral, radial), apex, heart sounds, thrills and heaves

38
Q

What is being looked for on examination of the abdomen?

A

Moves with respiration, distension, hernia, umbilicus, bile-stained vomiting, passage of meconium, anus

39
Q

What are features of the examination of the GU system?

A

Normal passage of urine, normal genitalia, undescended testes, hypospadius

40
Q

How is the MSK system assessed in an examination?

A

Movement, posture, limbs and digits, spine, hip examination

41
Q

What is being assessed on examination of the neurological function of a newborn?

A

Alert and responsive, cry, muscle tone, posture, movement, primitive reflexes

42
Q

What are the primitive reflexes of a newborn?

A

Sucking, rooting, Moro, ATNR

43
Q

What are some features of health promotion in a newborn?

A

Foetal origin of adult disease
Parental habits = smoking, alcohol, drug use, diet
Social interaction and vaccination
Feeding and sleeping position

44
Q

How should families be dealt with when they have a newborn?

A

Advise of changing family structures
Parenting = not always instinct
Positive feedback and confidence = parent-child attachment
Community support
Recognising baby blues vs post natal depression

Child Health (27 decks)

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