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Healthy Term Infant Flashcards

(49 cards)

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1
Q

what is normal birth weight

A

2.5-4 kg

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2
Q

what weight is large for gestational age

A

over 4 kg

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3
Q

what is small for gestation age weight

A

under 2.5 kg

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4
Q

when is term

A

37-41 completed weeks

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5
Q

what is the daily weight gain in the 3rd trimester

A

24g

7g per day in the last 4 weeks

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6
Q

what is importantly transferred in the 3rd trimester

A 
iron 
vitamins 
calcium 
phosphate 
antibodies
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7
Q

what is a cephalic presentation

A

vertex (head first)

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8
Q

what is the fetal environment like during contractions

A

hypoxic

fetal Hb helps release O2

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9
Q

what hormones enhance fetal adaptation during labour

A

cortisol and adrenaline

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10
Q

how does prolonged labour affect fetus

A

reduces fetal reserves (hypoxic environment during contractions)

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11
Q

summarise fetal adaptation

A 
First breath/cry
Alveolar expansion
Change from foetal to newborn circulation
Decreased pulmonary arterial pressure
Increased PaO2
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12
Q

what score helps monitor fetal adaptation

A

apgar

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13
Q

what are the components of apgar

A

scored out of 10 (0,1 or 2 per component)

  • HR
  • RR
  • responsiveness
  • tone
  • colour
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14
Q

what is a normal apgar score

A

> /= 8

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15
Q

do babies eat a lot in the first 24 hours

A

no have little calorific intake

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16
Q

what is haemorrhagic disease of the newborn

A

coagulation disorder in new borns due to vitamin K deficiency

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17
Q

what systems can haemorrhagic disease of the newborn cause

A

GI
lung
CNS- intracranial haemorrhage

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18
Q

what is given to prevent haemorrhagic disease of the newborn

A

vitamin K either IM or orally

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19
Q

what maternal infections convey a high risk of transmission to fetus

A 
hep B and C
HIV
syphilis 
TB 
group B strep
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20
Q

what vaccinations do mothers get

Study These Flashcards
A

pertussis and influenza

21
Q

what is screened for at birth

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A 
Universal hearing screening
Hip screening -  clinical and USS
Cystic fibrosis (immunoreactive tryptin screened for)
Thyroid function testing (TSH measured) 
Haemoglobinopathies
Metabolic disease
(phenylketonuria (PKU) 
medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
 maple syrup urine disease (MSUD)
isovaleric acidaemia (IVA)
glutaric aciduria type 1 (GA1)
homocystinuria (pyridoxine unresponsive) (HCU))
22
Q

what does undiagnosed hypothryroidism in neonates have a direct link to

Study These Flashcards
A

lowered intellect

23
Q

when is the newborn exam done

Study These Flashcards
A

generally around 24hrs of life

24
Q

what is looked for in the babies head on newborn exam

Study These Flashcards
A

occipital frontal circumference
overlapping sutures
fontanelles
ventouse/ forceps marks
moulding
cephalhaematoma (bruising between periosteum and spicranial aponeurosis - doesnt cross suture line, often looks like two little horns, can calcify)
caput succedaneum (swelling and oedema in outer layer of skin, often gone/ reduced n 12-14hrs)

25
what is the difference between caput succedaneum and cephalhaematoma
cephalhaematoma- doesnt cross suture lines, between epicranial aponeurosis and periosteum, can calify, often looks like two little horns caput- can cross suture lines, beneath skin
26
what is looked for in the eyes in a neonate exam
``` size red reflex conjunctival haemorrhage squints iris abnormalities ```
27
what is the lack of red reflex in child presumed to be
cataract until proven otherwise
28
why is it important to screen for bilateral congenital cataracts
if missed until 8 week check up then vision unlikely to develop after Tx if found at newborn scan and treated the good outcome for vision
29
what is looked for in ears on neonate exam
position external auditory exam tags/ pits folding (low set ears/ pits and tags can be sign of syndrome) very important to ask about family Hx of early hearing loss
30
what is looked for in the mouth in a neonate exam
``` shape philtrum tongue tie palate neonatal teeth ebsteins pearls sucking/ rooting reflex ```
31
what can a smooth philtrum be a sign of
fetal alcohol syndrome
32
what can tongue tie affect
breast feeding
33
what can cleft palate go on to cause
problems for feeding, speech and hearing
34
what is the risk of neonatal teeth
aspiration- usually get dentist to take them out
35
what are ebsteins pearls
collections of skin cells which almost always go away
36
what is look for in the face in a neonate exam
facial palsy | dysmorphism
37
how do you tell which side of the face has a paly
the side that looks weird is the side that is fine- baby will be screwing eyes up and opening mouth to cry, eye that is open is side affected
38
what resp signs are looked for on neonate exam
``` chest shape nasal flaring grunting tachypnoea (>60) in drawing breath sounds ```
39
what cardio things are looked for in a neonate exam
``` colour/ saturation (SaO2) (CHD screening) femoral pulse apex thrills/ heaves heart sounds ```
40
what are components of tetralogy of fallot
pulmonary stenosis large ventricular septal defect overriding aorta
41
what is looked for on the abdomen in a neonate exam
does is move with respiration distention hernia umbilicus bile stained vomiting passage of meconium - if none at 48 hrs big concern anus - need to make sure its patent gastroschisis- bowel comes out of abdo cavity exomphelus- contents of the abdomen herniate into the umbilical cord through the umbilical ring, are contained within peritoneal membrane
42
what is looked for in the GU part of a neonate exam
normal passage of urine normal genitalia descended testes- if not by 6 months get op hypospadius
43
what are the MSK parts of the neonate exam
movement and posture limbs and digits spine - spina bifida, sacral dimples hip exam
44
what harness for DDH
pavlik for 2-4 weeks, frog leg position
45
how is DDH diagnosed
clinical exam and USS
46
what are the neurological component of the neonate exam
``` alert, responsive cry tone posture movement primitive reflexes ```
47
what are the primitive reflexes
``` sucking and rooting moro (startle) ATNR (fencing) stepping grasp ```
48
what skin things are look for in the neonate exam
birth marks port wine stain (abnormality of blood vessels) erythema toxicum (50% of babies get get, normal)
49
what health promotion is done for new parents
``` smoking, alcohol, drug use, diet social interaction feeding vaccination sleeping position baby box positive feedback and confidence parent child attachment community support ```

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