Flashcards in Neonate lab packet Deck (56):
How soon should the first physical exam be performed?
Within 24 hours of birth
When is the silverman score used?
On admission to the nursery
For movement of the upper chest compared to abdomen, what gets a 0? 1? 2?
0 = synchronous movement
1 = lag or minimal sinking of upper chest as abdomen rises
2 = Marked see-sawing of upper chest with rising abdo
For expiratory grunt, what gets a 0? 1? 2?
0 = none
1 = Audible with stethoscope only
3 = Audible without stethoscope
What are the first components of the silverman score?
-Movement of upper chest compared to abdomen
-Flaring of nasi
How much bigger should the head circumference be compared to the chest for a normal infant?
1-2 cm more
What is the definition of preterm infant?
Less than 37 weeks gestation
What is the definition of late preterm infant?
34 - 36 6/7 weeks
What is the definition of a term infant?
37 - 41 6/7 days
What is the definition of a post-term infant?
What is the rooting reflex?
What is Moro's reaction?
baby fall, then should extend hands, followed by flexing
What is the scarf sign?
The infant's arm is pulled laterally across the chest; in the hypotonic infant, the elbow will cross the midline; in a term infant with normal tone, the elbow will not reach the midline.
What is the heel to ear sign?
Holding the baby’s foot in one hand, draw the leg towards the ear to see how much resistance there is to the maneuver.
The foot should go to about the level of the chest or shoulder, but not all the way to the ear. If it does = hypotonia
What is the Landau reflex? When is this present?
It emerges 3 months after birth and lasts until up to 12 months to 24 months of age.
What are the 5 physical criteria that can be used to asses for term?
-Diameter of breast nodule
-Testes and scrotum/labia minora
What is a plethoric coloration? What does it suggest?
What is sclerema?
Hardening of the skin and SQ tissue associated with life threatening disorders like septicemia, shock
What is caput succedaneum? Does it cross suture lines?
Diffuse edema of the scalp due to mechanical forces during the birth process.
Crosses suture lines
What is a cephalohematoma? Does it cross suture lines?
Subperiosteal bleeding, confined to a particular area of the skull.
Does not cross suture lines
Should you ever aspirate a cephalohematoma? Why or why not?
No--risk of infection
What is the significance of subconjunctival hemorrhages after delivery?
Common, and benign
What are the s/sx of heart failure in the neonate?
-Cardiomegaly and hepatomegaly
-Pallor with normal hemoglobin
-Excessive weight gain
The umbilicus has how many vessels?
2 arteries and 1 vein
True or false: vaginal discharge in the neonate is normal
True--d//t estrogen from mother
How soon should stool and urine pass in the neonate?
Within 24 hours.
What are the major neuro screens in the newborn?
True or false: prediction of later brain dysfunction can be made with consistent accuracy on the basis of neurological abnormalities
False-- long term f/u needed
What triggers the Moro reflex? What indicates a normal response?
-Startling the infant or dropping infant
-abduction of the arms and elbows away from the body, and extension of the wrists and fingers
True or false: premature infants do not usually show good traction reflex
What indicates severe hypotonia with the Landau reflex? In whom can this be normal in?
Complete collapse of the baby over the examiner's hand, into the shape of an inverted U
-may be normal in premature, but NEVER in term babies
How does jaundice progress in the newborn?
Head to toe AFTER 24 hours
What is the most common tumor in infancy?
What are strawberry hemangiomas?
Concentration of immature blood vessels that develop within the first 2 months
What is the prognosis for cavernous hemangiomas?
Grows rapidly in the first 6 months, then begins to shrink at 12-18 months
What causes metatarsus adductus?
Gestational age before what week is a risk factor for jaundice?
Less than 37 weeks
What are the factors associated with a decreased risk of jaundice? (3)
-Gestational age after 41 weeks
-Exclusive bottle feeding
What ethnicity has a higher rate of jaundice? Lower?
Higher = Asian
Lower = blacks
AAP recommends that any infant discharged at less than 72 hours been seen for f/u when?
Within 3 days of d/c
Does Jaundice blanch?
What level of bilirubin is normal in neonatal jaundice?
17 mg/dL = 95th percentile
Reducing substance in urine = ?
What level indicates an abnormally high indirect bili in the neonate?
More than 2 mg/dL
Any infant jaundiced when indicates the need for work up?
Before 24 hours or after 3 weeks
What is the schedule for feeding an infant?
How much do infants sleep?
20 hours /day
What is the best position for sleeping in the neonate?
Does 'pushing' or 'grunting' with stooling common in neonates?
Yes--does not signify constipation
When does the cord detach?
within 2 weeks
Is alcohol appropriate measure to use to keep the umbilical cord clean?
How often should bathing be performed in the neonate?
What is the special care needed for uncircumcised infants?
What is cradle cap, and what is the treatment for it?
neonatal seborrhoeic dermatitis-- a yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies. It is usually not itchy and does not bother the baby. Cradle cap most commonly begins sometime in the first 3 months
Gentle scrubbing followed by an application of baby oil
A rectal temp of greater than what indicates the need for immediate medical attention? Is it appropriate to use antipyretics?
Do NOT use antipyretics