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Reproduction > Healthy Term Infant > Flashcards

Healthy Term Infant Flashcards

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

A

pertussis and influenza

21
Q

what is screened for at birth

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

A

lowered intellect

23
Q

when is the newborn exam done

A

generally around 24hrs of life

24
Q

what is looked for in the babies head on newborn exam

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
Q

what is the difference between caput succedaneum and cephalhaematoma

A

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
Q

what is looked for in the eyes in a neonate exam

A 
size
red reflex 
conjunctival haemorrhage 
squints 
iris abnormalities
27
Q

what is the lack of red reflex in child presumed to be

A

cataract until proven otherwise

28
Q

why is it important to screen for bilateral congenital cataracts

A

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
Q

what is looked for in ears on neonate exam

A

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
Q

what is looked for in the mouth in a neonate exam

A 
shape 
philtrum 
tongue tie 
palate 
neonatal teeth 
ebsteins pearls 
sucking/ rooting reflex
31
Q

what can a smooth philtrum be a sign of

A

fetal alcohol syndrome

32
Q

what can tongue tie affect

A

breast feeding

33
Q

what can cleft palate go on to cause

A

problems for feeding, speech and hearing

34
Q

what is the risk of neonatal teeth

A

aspiration- usually get dentist to take them out

35
Q

what are ebsteins pearls

A

collections of skin cells which almost always go away

36
Q

what is look for in the face in a neonate exam

A

facial palsy

dysmorphism

37
Q

how do you tell which side of the face has a paly

A

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
Q

what resp signs are looked for on neonate exam

A 
chest shape 
nasal flaring 
grunting 
tachypnoea (>60)
in drawing 
breath sounds
39
Q

what cardio things are looked for in a neonate exam

A 
colour/ saturation (SaO2) (CHD screening) 
femoral pulse 
apex
thrills/ heaves 
heart sounds
40
Q

what are components of tetralogy of fallot

A

pulmonary stenosis
large ventricular septal defect
overriding aorta

41
Q

what is looked for on the abdomen in a neonate exam

A

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
Q

what is looked for in the GU part of a neonate exam

A

normal passage of urine
normal genitalia
descended testes- if not by 6 months get op
hypospadius

43
Q

what are the MSK parts of the neonate exam

A

movement and posture
limbs and digits
spine - spina bifida, sacral dimples
hip exam

44
Q

what harness for DDH

A

pavlik for 2-4 weeks, frog leg position

45
Q

how is DDH diagnosed

A

clinical exam and USS

46
Q

what are the neurological component of the neonate exam

A 
alert, responsive 
cry 
tone 
posture 
movement 
primitive reflexes
47
Q

what are the primitive reflexes

A 
sucking and rooting 
moro (startle)
ATNR (fencing) 
stepping 
grasp
48
Q

what skin things are look for in the neonate exam

A

birth marks
port wine stain (abnormality of blood vessels)
erythema toxicum (50% of babies get get, normal)

49
Q

what health promotion is done for new parents

A 
smoking, alcohol, drug use, diet 
social interaction 
feeding 
vaccination 
sleeping position 
baby box 
positive feedback and confidence 
parent child attachment 
community support

Reproduction (51 decks)

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