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Flashcards in Management of the Newborn Deck (53)
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1
Q

What are the three major s/sx of hypoglycemia in the neonate?

A
  • Poor feeding
  • Poor tone
  • Jitteriness
2
Q

What causes macrosomia in the newborn born to DM mothers?

A

IGF increases tissue growth

3
Q

What causes the SGA seen with DM mothers? In whom is this more common in?

A

Maternal renovascular insufficiency

Longstanding poorly controlled DM

4
Q

What are the physical abnormalities that can occur with poorly controlled DM? (4)

A
  • Sacral agenesis
  • Femoral hypoplasia
  • Heart defects
  • Cleft palate
5
Q

What are the metabolic disturbances common with DM babies? (3)

A
  • Hypomagnesemia
  • Hypocalcemia
  • Hypoglycemia
6
Q

How do you prevent hypoglycemia in the newborn? Treatment if it occurs?

A
  • Early and frequent feeding

- Give D10 IV

7
Q

What is the target BG level for newborns?

A

greater than 45 mg/dL

8
Q

How soon should babies be fed if there is a risk for hypoglycemia?

A

Within 1 hour

9
Q

What is chorioamnionitis?

A

Rupture greater than 18 hours that leads to sepsis

10
Q

ROM greater than how many hours indicates a risk for chorioamnionitis?

A

18 hours

11
Q

When should GBS be screened for?

A

35-37 weeks

12
Q

How long should PCN treatment be done for prior to delivery?

A

at least 4 hours

13
Q

What are the major s/sx of GBS in the neonate? (4)

A
  • Cold
  • Excessive jaundice
  • Gray/pale/hypoxemia
  • Decreased tone
14
Q

True or false: transmission of GBS can occur before delivery

A

True

15
Q

Most neonate present with GBS infection within what time frame?

A

Within 24 hours

16
Q

Last onset GBS infection is defined when? Is this more commonly meningitis or pneumonia?

A

1 week to 3 months

Late = meningitis
Early = pneumonia
17
Q

True or false: increased use of IV Abx has decreased the risk for late onset GBS

A

False

18
Q

True or false: if GBS status is unknown, then Abx are recommended

A

True

19
Q

Mother who labor for longer than how long are at increased risk for GBS?

A

18 hours

20
Q

What is the treatment for asymptomatic infants with possible GBS infection?

A

Observe for ~48 hours

21
Q

What is the treatment of infants with symptomatic infants with GBS infx?

A

Begin lab and x-ray work up including cultures, and Begin Abx

22
Q

If no source for fever is found in the neonate less than 28 days, what is the work up? (4 +, what if cough, diarrhea)

A
  • CBC and BC
  • UA + UC
  • LP/CSF
  • HSV PCR of CSF
  • CXR if coughing
  • Fecal WBC if diarrhea
23
Q

What is fecal lactoferrin? When will this alway be positive?

A

Used to diagnose bacterial enteritis

Always positive if BF

24
Q

What are the three bacterial infections that are common in the neonate?

A

GEL

GBS
E.coli
Listeria

25
Q

What is the treatment for Fever of unknown etiology less than 28 days?

A

Hospitalize until 48 hours and abx if culture

26
Q

What is the treatment for GEL + herpes? (3)

A

Ampicillin
Gentamicin
Acyclovir

27
Q

Brushfield spots = ?

A

White spots in the iris that can be seen with T21

28
Q

What are the classic down syndrome features? (2)

A
  • Endocardial cushion defect

- MR

29
Q

What is an endocardial cushion defect?

A

The endocardial cushions are a subset of cells found in the developing heart tube that will give rise to the heart’s valves and septa critical to the proper formation of a four-chambered heart

30
Q

What is brachycephaly?

A

Wider head than long

31
Q

What is the definition of polyhydramnios?

A

More than 25 AFI by US

32
Q

What is AFI?

A

Amniotic fluid index

33
Q

What are the associations of polyhydramnios? (5)

A
  • Fetal GI abnormalities
  • Maternal DM
  • Neural tube defects
  • Hydrops
  • Multiple gestation
34
Q

What are the signs of tracheoesophageal fistulas?

A
  • Poor feeding
  • Excessive secretions
  • respiratory distress
35
Q

What is the most common type of TE fistula?

A

Upper esophageal atresia and TE fistula

36
Q

How do you diagnose esophageal atresia?

A

NG tube that comes back up

37
Q

What is the treatment for a TE fistula?

A

Immediate surgical correction

-Search for the VACTERL association

38
Q

What is the VACTERL association?

A
  • Vertebral anomalies
  • Anal atresia
  • Cardiac defects
  • TE fistula
  • Esophageal atresia
  • Renal and radial anomalies
  • Limb defects
39
Q

What is the definition of oligohydramnios?

A

Less than 5 AFI by US

40
Q

Oligohydramnios increases the risk for perinatal mortality by how much?

A

40x

41
Q

What is Potter syndrome? (5)

A

Fetal compression, causing:

  • GR
  • Fetal GU abnormalities
  • Pulmonary hypoplasia
  • position deformities of the fetus
  • flat face and low set ears
42
Q

What causes Potter syndrome?

A

Oligohydramnios in utero, causing fetal compression

43
Q

What are the long term consequences of Potter syndrome?

A
  • Renal insufficiency

- Pulmonary syndrome

44
Q

What defines late prenatal care?

A

16-20 weeks

45
Q

What is the standard of care for late prenatal care?

A

Test for drugs in the uterus and the cord

46
Q

What should always be obtained with late prenatal care?

A

Social services consult

47
Q

What are the s/sx of fetal EtOH syndrome? (3)

A
  • MR
  • Smooth philtrum
  • Thin upper lip
48
Q

Smooth philtrum + Thin upper lip = ?

A

Fetal EtOH syndrome

49
Q

What happens to tobacco use with prego?

A
  • IUGR
  • Heart defects
  • Limb deficiencies
50
Q

What causes the effects of tobacco on a fetus?

A

Vasoconstriction and decreased blood flow

51
Q

When is it appropriate to d/c a neonate who had late prenatal care? (4)

A
  • Results of drug screen
  • social services seen
  • Urine output and stool 1x or more
  • f/u can be arranged
52
Q

How is macrosomia defined?

A

by gestational age

53
Q

How long does an infant have to have VSS for, when the mother received late prenatal care?

A

12 hours