Physiologic jaundice Neuro exam components Level of alertness, posture & muscle tone, spontaneous mvmt, muscle strength, cranial nerves, DTR [check masseter reflex, moro/startle reflex, sucking reflex, tonic neck reflex, grasp reflex], sensory, behavior [habituation, consolability]
Not visible until after 24 hrs of age East Asian newborns bilirubin peaks higher and later than others
When newborn jaundice requires tx
Direct hyperbilirubinemia always! - no phototherapy! → bronze baby! lolol & when total bilirubin is at or w/in 3 pts of phototherapy threshold
How long O2 takes to reach nml lvls
10 min to get to 95% O2 *don’t give 100% O2 to newborn
The ___ Estimates gestational age based on 6 physical and 6 neuro criteria
New Ballard Score
New Ballard Score: the higher the score, the (closer/further) the baby is to full term?
The higher the score, the CLOSER to full term the baby is
What are the Neuro criteria of the New Ballard Score?
posture square window arm recoil popliteal angle scarf sign heel to ear
With increasing gestational age, there is: (↓/↑) translucency and (↓/↑) wrinkling of the skin (↓/↑) lanugo hair (More/less) creases on the sole of the foot (Larger/Smaller) and more well-defined breast tissue (Loss/gain) of eyelid fusion, (firming/smoothing) of pinna of the ear (↓/↑) rugae and pendulousness of the scrotum (as the testes descend) Formation of labia (Majora/Minora), then labia (Majora/Minora)
↓ translucency and ↑ wrinkling of the skin ↓ lanugo hair MORE creases on the sole of the foot LARGER and more well-defined breast tissue LOSS of eyelid fusion FIRMING of pinna of the ear ↑ rugae and pendulousness of the scrotum (as the testes descend) Formation of labia Minora, then labia Majora
When hemolysis presents in pathologic jaundice
< 24 hrs
Risk factors for hemolysis in pathological jaundice
newborns who weigh > 9 lbs often have polycythemia or ineffective erythropoiesis
What are the componenets of the APGAR score
Appearance, Pulse, Grimace, Activity, Respirations
The APGAR score doesnt predict ____, _____, or make _____
Doesn’t predict morbidity/mortality or make dx
What is a good APGAR score
When do you perform the APGAR score?
1 min and 5 min of life And every 5 min if CPR is occurring.
Small for gestational age - SGA is considered at ___ percentile weight
< 10th percentile weight
large for gestational age: LGA ] is considered at ___ percentile weight What predisposes a child to this?
> 90th percentile weight Gestational diabetes
____ is defined as; < 10th percentile in head circumference and can signal a problem with _____
microcephaly problem w/ brain growth
___ is defined as; > 90th percentile in head circumference
____ is defined as; birth weight < 10% but everything else is normal
asymmetric IUGR (intra-uterine growth restriction)
___ is described as; < 10% percentile in all 3 growth parameters - could be genetic syndrome, not good prognosis
Symmetric IUGR (intra-uterine growth restriction)
Cranial nerves needed for successful feeding (5)
5 [trigeminal] 7 [facial] 9 [glossopharyngeal] 10 [vagus] 12 [hypoglossal]