Newborn Assessment Flashcards

1
Q

What are risk factors for Neonatal Encephalopathy?

A

Prothrombic disease
Primagravida
Infertility
Pre-E
Multiples
Prolonged 2nd stage
Prolonged ROM
Chorioamnionitis

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2
Q

After which gestational age can you diagnose Neonatal Encephalopathy?

A

35 weeks

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3
Q

What are fetal risk factors for Neonatal Encephalopathy?

A

IUGR
infection
Genetics
Placental embolism
Cardiac disease
Abnormal FHR

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4
Q

What is the definition of Hypoxic Ischemic Encephalopathy?

A

This is caused by hypoxemia or poor blood supply due to severe and prolonged low blood pressures

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5
Q

What type of event is HIE known as?

A

Intrapartum event- this happened on our watch

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6
Q

What is the biggest difference between Neonatal Encephalopathy and Hypoxic Ischemic Encephalopathy?

A

NNE does not always have to be a hypoxic event, this can be caused from infection

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7
Q

How much bigger should the newborn’s head than the chest?

A

2-3 cm

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8
Q

What is a normal newborn Hemoglobin level?

A

14-20 g/dL

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9
Q

What is a normal newborn Hematocrit level?

A

43-60%

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10
Q

What is a normal newborn Platelet level?

A

150-300,000

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11
Q

What is a normal newborn WBC level?

A

10-30,000

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12
Q

What are the four types of heat loss?

A

Evaporation, conduction, convection, and radiation

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13
Q

How does the newborn lose heat from evaporation?

A

This is from a wet body surface area- keep warm and dry, wrapped up, and humidified O2.

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14
Q

How does the newborn lose heat from conduction?

A

Loss to a cool solid surface touching the newborn- warm mattress, skin-to-skin, warm stethoscope, cover scales, warm blankets

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15
Q

How does the newborn lose heat from convection?

A

This is loss of body heat to the cool air- warm blow by, avoid drafts, hats, incubators, heat up in rooms

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16
Q

How does the newborn lose heat from radiation?

A

Loss to objects not in direct contact with the neonate to a cool surface- apply incubator cover, and store clothes inside the incubator.

17
Q

What are the three periods in the newborn transition period?

A
  1. Reactive Period: first 30-60 minutes when infant is alert/active, strong desire to suck, period breathing, retract, flaring
  2. Relative Inactivity: next 2-3 hours when the infant is sleepy and difficult to awaken, clearing breath sounds, and stable RR and HR
  3. Second period of Reactivity: around 4-6 hours after napping
18
Q

When do you start to see symptoms on Group Beta Strep infection?

A

Within 24 hours up to 7 days post delivery.

19
Q

How does Rh factor affect pregnancies?

A

This is an issue with an Rh-negative mother and an Rh-positive baby.
In the first delivery, the mixing of fetal RBC’s reabsorbed into maternal circulation and creates antibodies.

20
Q

What are some other ways that fetal blood cells can mix with maternal circulation?

A

Trauma, miscarriage, and amniocentesis.

21
Q

What are symptoms of hemolytic disease of the newborn?

A

Severe anemia, hypoalbuminemia, IUGR, jaundice, heart failure, hydrops fetalis.

22
Q

What are the two types of jaundice?

A
  1. Pathologic: occurs from hemolytic disease, bruises, or hematoma
  2. Physiological: this is 2-3 days after birth
23
Q

How does phototherapy help in the treatment of jaundice?

A

This breaks down the RBC’s down easier to excrete through stool.

24
Q

What is kernicterus?

A

This is a syndrome that occurs of acute bilirubin encephalopathy causes permanent damage to the brain.

25
Q

What are symptoms of kernicterus?

A

Permanent upward gaze, hearing loss, and poor tooth enamel

26
Q

Which immunoglobulin is high in colostrum?

A

IgA

27
Q

What are the two types of IUGR?

A
  1. Asymmetric: disproportional head circumference to length and weight- this will be detected later in the pregnancy
  2. Symmetric: proportional but decreased growth, weight, length, and head circumference below 10th percentile- this will track early in the pregnancy
28
Q

What is the difference between IUGR and SGA?

A

IUGR is due to a pathologic issue
SGA is not due to a pathologic issue

29
Q

What is a sign of meconium aspiration?

A

Barrel chest in the newborn.

30
Q

True or false: Caput in the newborn crosses the suture lines?

A

True: A cephalohematoma does not cross the suture lines

31
Q

When performing chest compressions on a newborn, what should the depth be?

A

1/3 diameter

32
Q

What are the blade sizes you should use for intubation?

A

1 blade for term, 0 blade for preterm, and 00 for severe preterm