B8-080 CBCL Care of the Infant Flashcards by Felicia Jones

APGAR is assigned at […] and […] min of life

1 and 5

(if less than 7, continue every 5 min until improvement)

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medications administered to infant in the first few hours of life [3]

vitamin K
erythromycin eye ointment
hepatitis B vax

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what does APGAR evaluate?

Appearance
Pulse
Grimace
Activity
Respiration

(each category given score from 0-2)

Note: she says HR, RR, muscle tone, reflex irritability, color in her lecture

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if the cord has […] vessels, that could indicate genetic anomalies

two

(3 normal)

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if you are unsure of baby’s GA, you can use the […] method to evaluate them

ballard

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“hang on for life” reflex

baby extends/abducts arms when startled and then draws together

moro reflex (startle reflex)

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required newborn screening tests [3]

hearing
newborn screen: CF, PKU, thyroid, etc.
CHD

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high pitched crying
uncontrolled tremors
fragmented sleep
diarrhea/vomiting
frequent sneezing
sweating

in a newborn can be signs of

NOWS

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the highest risk of congenital anomalies due to teratogens occurs in the […] period

embryonic (weeks 3-8)

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causes of congenital anomalies are […] in 55% of cases

multifactorial

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intrinsic developmental defect that occurs during the embryonic period

malformation

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secondary breakdown of tissue with normal developmental potential

disruption

(ex. amniotic band)

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extrinsic mechanical distortion occurs during fetal period

deformation

(ex. club foot from low amniotic fliud)

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birth defects associated with smoking and pregnancy [4]

cleft lip/palate
club foot
gastroschisis
heart defects

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placental problems associated with tobacco exposure [2]

abruption (painful)
previa (painless)

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following delivery, babies born to mothers who smoked tobacco are at an increased risk of […]

SIDS

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congenital anomalies associated with opioids [4]

CVD anomalies (tet. and HLHS)
neural tube defects
gastroschisis
clubfoot

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failure of closure of the […] results in anencephaly

anterior neuropore

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[…] use in pregnancy is associated with prune belly syndrome and cryptorchidism

cocaine

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inhibits the transport of biotin and vitamin B6 across the placenta

ethanol

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blood entering the fetus through the umbilical vein is conducted through the […] to the IVC

ductus venousus

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in the fetus, the highly oxygenated blood reaching the heart via the IVC is direct through the […] into the left atrium

foramen ovale

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in the fetus, deoxygenated blood from the SVC passes through the RA -> RV -> main pulmonary artery -> […] –> descending aorta

ductus arteriosus

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describe the changes that occur in the heart when an infant takes a breath after birth

decreased resistance in pulmonary vasculature –>
increased left atrial pressure vs RA –>
foramen ovale closes

the increase in O2 and decrease in prostaglandins allows for closure of ductus arteriosus

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erythromycin is administered to newborns for [...] prophylaxis

gonorrhea

vitamin K is administered to newborns for [...] prophylaxis

bleeding

below the [...]% is considered SGA above the [...]% is considered LGA

below the [10]% is considered SGA above the [90]% is considered LGA

the first stool produced by baby is called [...]

meconium

failure of the [...] to close results in gastroschisis

ventral body wall

gastroschisis is most commonly linked to maternal use of [...] [2]

opioid tobacco smoke

pregnant women exposed to [...] are at an increased risk of having a baby with low birth weight

secondhand smoke

the umbilical vein drains into the [...] via the ductus venosus

IVC

[...] vessel cord is associated with congenital and chromosomal anomalies

two vessel (single umbilical artery)

benign neonatal hyperbilirubinemia is caused by [3]

increased fetal RBC turnover immature newborn liver (less UDP activity) increased enterohepatic circulation

how can failure of breastfeeding cause jaundice?

insufficient breastmilk intake leads to decreased bilirubin elimination in stool

how can breast milk cause jaundice?

increased B-glucoronidase in milk causes deconjugation

severe cases of benign neonatal hyperbilirubinemia can lead to

kernicterus (deposits in basal ganglia)

gastrulation occurs in the [...] period

embryonic (3-8) (formation of trilaminar disc)

the majority of the contributing factors to birth defects are [...]

multifactorial

morphological alterations to already formed structures

disruption

result from mechanical forces that mold structures over a prolonged period of time

deformations

affect the formation of structures

malformations

external factors that cause birth defects

teratogens (genetics are not teratogens)

categories of teratogens [4]

chemical hormones infectious physical

examples of male mediates teratogenesis [3]

male germ cell mutations paternal exposure to secondhand smoke/hazards (mercury) transmission of teratogens in seminal fluid

a sacral dimple [with/without] a base is a normal finding

with (without raises concern for spina bifida)

a hip clunk raises suspicion for [...]

developmental dysplasia of the hip

circumcision decreases the risk of [...] [3]

HIV, HPV UTI in first year of life (important to consider geographical prevalence of HIV, HPV in risk/benefit ratio)

decreases the risk of UTI in the first year of life

circumcision

[milestones] cooing/gurgling

2 months

[milestones] stringing vowels together

4 months

[milestones] responds to simple requests, waves

12 months

[milestones] puts together sentences

2 yrs

[milestones] acts bored

2 months

[milestones] passes objects from hand to hand

4 months

[milestones] uses objects properly

12 months

[milestones] builds a tower of 4 blocks

2 yrs

condition that causes breathing problems in newborn babies

transient tachypnea of the newborn

risk factors for transient tachypnea of the newborn

C-section precipitous delivery (not enough time for fluid to be squeezed from lungs)

what is an appropriate amount of stool and wet diapers for a newborn?

1 stool and 1 wet per day of life

normal, blue-grey marking of the skin in newborns

dermal melanocytosis

exams that check for developmental dysplasia of the hip

Barlow and Ortolani

babies hands/feet are blue but is otherwise pink

acrocyanosis

if mom is Hep B+, what treatment should baby receive to prevent vertical transmission?

Hep B vaccine hep B IVIg

babies need to pass their first stool by [...] hours of life

24-48

delayed passage of meconium could be a sign of

CF (colonic dysmotility)

risk factors for hyperbilirubinemia

jaundice in first 24 hrs of life ABO/Rh incompatibility GA 35-36 weeks TSB/TcB in high risk zone (greater than 10)

risk factor for developmental dysplasia of the hip

Breech presentation (diagnosis confirmed via US in infants less than 4 mo)

gestation diabetes is a risk factor for [3]

hypoglycemia large for GA infants shoulder dystocia

in breastfeeding [...] milk supply is associated with jaundice

low

a prior sibling with jaundice increases the risk for

jaundice

reduces risk of anemia by allowing the newborn to receive all blood in the placenta

delayed cord clamping

helps the infant create clotting factors that decrease the risk of intracranial bleeding

vitamin K

given to all infants at birth to prevent gonococcal ophthalmia of of the newborn

erythromycin

leading preventable cause of blindness worldwide

gonococcal ophthalmia of of the newborn

[...] is used to treat chlamydia in pregnancy

azithromycin (doxy normally)

why are tetracyclines contraindicated in pregnancy?

binds to calcium --> inhibits bone growth

looks for different elements of neuromuscular and physical maturity to help determine gestational age

Ballard exam

the [...] reflex is caused by an abrupt position change or loud noise

moro/startle

neural tube defects are associated with [...] deficiency

folic acid (anticonvulsants interfere with folate metabolsim)

white keratin inclusions on the nose

millia

a benign, self-limiting rash that appears within the first week of life Small, red macules and papules that progress to pustules with surrounding erythema

erythema toxicum

normal newborn exam findings of the head [2]

moulding puffy eyes

When the infant is lying supine, turning the head to one side elicits extension of the ipsilateral extremities and flexion of the contralateral extremities (fencing posture).

tonic neck reflex

Holding the infant upright in a standing position elicits a walking motion, with alternating flexion and extension of the legs

step reflex

Pressing or placing something into the infant's palm causes the fingers to flex towards the palm

grasp reflex

jaundice appearing **after** first 24 hours of life resolves without intervention

benign neonatal hyperbilirubinemia

breastmilk jaundice is caused by increased [...] in breastmilk

beta glucoronidase

breastfeeding jaundice is caused by

suboptimal intake

what is the result of untreated Rh incompatibility?

hemolytic disease of the newborn

if a mother is HIV+, what treatment should the baby receive after birth?

start zidovudine within 6-12 hours bathe baby immediately, breastfeeding not recommended test at 24 hours of life and again at regular intervals after discharge

most common genetic mutation causing CF

F508

live attenuated vaccines [3]

varicella rotavirus MMR

B8-080 CBCL Care of the Infant Flashcards

(93 cards)