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Flashcards in Healthy term infant Deck (37)
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1

Define what a term baby is 

  • This is a baby born after 37+0 wks & < 41+6 wks 
  • Considered pre-term if before this and post-term if after this 

2

What is the normal weight range of a newborn ?

  • 2.5 - 4kg 
  • Considered LGA if >4 and SGA if < 2.5

3

What happens to the weight of a baby during the 3rd trimester ?

Its weight dramatically increases: 

  • Average male at 28 weeks = 1150g, 3.5% fat
  • Average male at term = 3550g, 15% fat

 

4

Transplacental transfer of what occurs during the 3rd trimester ?

Iron, vitamins, calcium, phosphate & antibodies

5

When the baby is born light, tough and temp all help stimulate what?

The change from fetal to newborn circulation 

6

Why should you be wary of hypoxia when carrying out the initial assessment of a baby ?

Because labour is a hypoxic environment 

7

What is used to assess a newborn baby?

 APGAR score 

8

When is the APGAR score used and what does it objectively measure ?

Used at min 1&5 following birth as an objective measurement of perinatal adaptation

9

What do you assess when carrying out the APGAR score and what is a normal score ?

Scored out of 10, with ≥ 8 being normal 

10

After initial assessment of the baby using APGAR score, you want to wrap the baby up to keep them warm & feed them (establish breastfeeding) & establish attachment. 

List the important things to be done following APGAR score assessment 

  • Ensure skin to skin contact - important for emotional development 
  • Prophylactic IM Vit K given - to prevent haemorrhagic disease of the newborn (caused by Vit K deficiency) 
  • Mother will have been screened during pregnancy for Heb B, HIV, Syphilis & Hep C - so will know if extra precautions, vaccinations or prophylactic treatment is needed 
  • Monitor baby with newborn early warning chart (essentially NEWS chart for a newborn)
  • Snuggle bundle 
  • BCG only given if risk of TB exposure 

11

What vaccinations may mothers get given ?

Pertussis & influenza (should already be vaccinated in the UK)

12

What will babies born to mothers with Hep B recieve at birth ?

Hep B vaccination 

13

What does the 6-in-1 vaccination consist of ?

diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B vaccinations 

14

Routine vaccination protocol - what is the first potential vaccination someone will recieve and when ?

BCG at birth - if risk factors e.g. recent travel or e.g. TB in the family in the past 6 months 

15

Routine vaccination protocol what is the first (sometimes second if BCG) vaccinations someone will recieve and when ?

Done at 2 months: 

  1. 6-1 vaccine
  2. Oral rotavirus vaccine
  3. Men B

 

16

Routine vaccination protocol what is the second vaccinations someone will recieve and when ?

Done at 3 months: 

  1. 6-1 vaccine
  2. Oral rotavirus vaccine
  3. PCV

17

Routine vaccination protocol what is the third vaccinations someone will recieve and when ?

Done at 4 months: 

  1. 6-1 vaccine
  2. Men B

18

Routine vaccination protocol what is the forth vaccinations someone will recieve and when ?

Done at 12-13 months: 

  1. Hib/Men C
  2. MMR
  3. PCV
  4. Men B

19

Routine vaccination protocol what is the fifth vaccinations someone will recieve and when ?

Done annually between ages 2-8:

  1. Flu vaccine 

20

Routine vaccination protocol what is the sixth vaccinations someone will recieve and when ?

Done at 3-4 years: 

  1. '4-in-1 pre-school booster' (diphtheria, tetanus, whooping cough and polio)
  2. MMR

21

Routine vaccination protocol what is the seventh vaccinations someone will recieve and when ?

Done at 12-13 years old: 

  1. HPV vaccination

22

Routine vaccination protocol what is the 8th vaccinations someone will recieve and when ?

Done between ages 13-18: 

  1. '3-in-1 teenage booster' (tetanus, diphtheria and polio)
  2. Men ACWY

23

What screening tests should a newborn undergo?

  1. Have a universal hearing screening before discharge 
  2. Hip screening - clinical (burlow & ortalani) +/- USS 
  3. Newborn head to toe exammination when born and a formal one around 24hrs 
  4. At about 5 days they have a blood heel spot test to screen for a number of diseases

24

What is screened for on the blood heel spot test ?

  • Cystic fibrosis 
  • Congenital hypothyroidism 
  • Sickle cell disease 
  • 6 metabolic conditions; Phenylketonuria, Medium-chain acetyl CoA dehydrogenase deficiency (MCADD), Maple syrup urine disease (MSUD), Isovaleric acidaemia (IVA), G;utaric aciduria type 1 (GA1), Homocytinuria (HCU)

25

What are the main components of the newborn exammination which are assessed?

  • Head 
  • Eyes 
  • Ears 
  • Mouth 
  • Face 
  • Resp 
  • Cardio 
  • Abdo 
  • Genitourinary 
  • MSK 
  • Neuro 
  • Skin 

26

What is checked when assessing the head during the newborn exammination?

  1. OFC 
  2. Fontanelles (ant & post) & sutures - if bulging its a sign of increased ICP), sunken may be a sign of dehydration
  3. Checking for signs of trauma e.g. cephalohaematoma 

27

What is checked when assessing the eyes during the newborn exammination?

  1. Red reflexes (absent in cataracts & retinoblastoma) 
  2. For squints 
  3. Iris abnormalities 
  4. Conjunctiva 
  5. Size of pupils 

28

What is checked when assessing the ears during the newborn exammination?

  1. Shape, position 
  2. Tags/pits 
  3. External auditory canal 

29

What is checked when assessing the mouth during the newborn exammination?

  1. Check palate intact - by sticking finger in and feeling roof of mouth
  2. Sucking/rooting reflex (when finger in mouth)
  3. Teeth 
  4. Tongue 
  5. Philitrum 
  6. For cleft palates 

30

What is checked when assessing the face during the newborn exammination?

  1. Any signs of facial nerve palsy (impaired at birth) 
  2. Dysphorphism - signs of congenital disease