Newborn Evaluation and Common Problems Flashcards
(33 cards)
What is the difference between neonatal and infant mortality? (by definition)
Neonatal: first 28 days
Infant: first year
Top causes of infant mortality
- congenital malformations, deformations, chromosomal
- premature, low birth weight
- maternal complications
- SIDS
- Accidents
Risk factors for neonatal infection
premature
maternal GBS colonization
maternal fever
rupture membranes
Newborn Hct and retics
around 50
with high reticulocytes around 8%
Reasons for intrauterine growth restriction
maternal problems (preeclampsia, HTN) placental problems (nutrients) fetal problems
Is head sparing good or bad?
Good! If you see head sparing on growth chart with tiny baby, at least you know the head/brain growth is on the right trajectory. No sparing is v. concerning
Reasons for intrauterine growth (too much)
GD, growth syndromes
Definition of prematurity
less than 37 completed weeks from LMP
if LMP is unknown, use Ballard Score
The gestational limit to viability
22 weeks (lungs are v. important!)
Preterm survival is 90% at how many weeks?
28 weeks
Why does premie go into respiratory distress syndrome?
they have decreased surfactant production, which is the liquid film on your alveloi that prevent their collapse and allows for gas exchange
*give artificially
Premature respiratory diseases
Respiratory distress syndrome
bronchopulmonary dysplasia
chronic lung disease
apnea
Necrotizing enterocolitis of neonate
distended erythematous abdomen, it is invaded by GI tract bacteria
pneumatosis intestinalis
Why would a baby’s head be built up with pressure?
intraventricular hemorrhage- will probably die
What component of the Apgar score is most important?
the score at 5 minutes correlates with developmental issues
What does Apgar score measure?
HR, Resp effort (cry), muscle tone, reflex irritability, color
What major things happen when baby transitions to life outside of the womb?
- initiate regular breathing
- clear fetal lung fluid
- change fetal circulatory pattern
- thermoregulation (put em in a bag)
Asphyxia: definition, arterial pH, apgar
not enough O2 at time of deliver
cord arterial pH <7
Apgar score 0-3 for >5 min
Cephalohematome
site of head bleed
Erb’s Palsy
brachial plexus injury when coming out of canal
VATER Association
refers to congenital malformations Vertebral anomalies, VSD Anal atresia Tracheo Esophageal fistula with esophageal atresia Renal anomalies and Radial dysplasia
Causes of respiratory distress in full term neonates
- Retain fetal lung fluid (self resolving)
- Meconium aspiration
- Pneumonia from GBS
- Pneumothorax
- Congenital heart disease
- Airway obstruction
How do you deal with meconium aspiration?
suction via endotracheal tube
Causes of baby desaturation
brain/ventilator drive or effort defect nerve or muscle weakness airway obstruction parenchymal lung disease cardiac disease (shunt, pulm HTN, congen heart dis)
