Newborn Management

Question 1

What should be done in the first minute of life?

Answer 1

Stimulation
ex. Rub/pat back, tap feet, suction

Question 2

Why should a newborn be stimulated in the first minute of life?

Answer 2

To prevent primary apnea

Question 3

Between minutes 1-5 and 5-10 of the newborn’s life, what should be obtained?

Answer 3

APGAR scores 1 and 2

Question 4

APGAR scores are from 0-10. Below what number is concerning?

Answer 4

< 7

Question 5

APGAR

Answer 5

Appearance
Pulse
Grimace
Activity
Respirations

Question 6

APGAR

Answer 6

Appearance
Pulse
Grimace
Activity
Respirations

Question 7

What is Transient Tachypnea of the Newborn?

Answer 7

Grunting and mild breathing issues in a healthy term baby

Question 8

If there is grunting and mild breathing issues in a healthy TERM baby, what should you consider?

Answer 8

Transient Tachypnea of the Newborn

Question 9

What will the CXR show with Transient Tachypnea of the Newborn?

Answer 9

Hyper-inflated lungs that are wet

Question 10

What is the treatment for Transient Tachypnea of the Newborn?

Answer 10

PPV

Question 11

What causes Respiratory Distress Syndrome?

Answer 11

Underdeveloped lungs with insufficient surfactant production in a premature infant

Question 12

What will be seen on CXR with RDS?

Answer 12

Ground glass appearance
Air bronchograms
NO focal opacities

Question 13

If you see hypoextended lungs with atelectasis in a premature infant, what should you suspect?

Answer 13

RDS

Question 14

What is the treatment for RDS?

Answer 14

Surfactant with intubation

Question 15

What are the symptoms of Hypoglycemia in a newborn?

Answer 15

Asymptomatic or jittery, tremors, seizures, lethargy

Question 16

If a baby is jittery, has tremors/seizures or is lethargic, what should you suspect?

Answer 16

Hypoglycemia

Question 17

What is a long-term complication of RDS?

Answer 17

Bronchopulmonary Dysplasia

Question 18

How does Bronchopulmonary Dysplasia arise?

Answer 18

Long-term RDS with little surfactant results in scarring of the lungs which leads to persistent oxygen requirement

Question 19

What will the CXR show with Bronchopulmonary Dysplasia?

Answer 19

Ground glass opacities

Question 20

What is an eye disease that is a consequence of prematurity and low oxygen?

Answer 20

Retinopathy of Prematurity

Question 21

What occurs with Retinopathy of Prematurity?

Answer 21

Low oxygen leads to random and increased angiogenesis in the eye

Question 22

What is the treatment for Retinopathy of Prematurity?

Answer 22

Laser ablation of the vessels

Question 23

What type of brain hemorrhage are premature babies susceptible to?

Answer 23

Intraventricular hemorrhage

Question 24

How do you diagnose an intraventricular hemorrhage?

Answer 24

Cranial doppler

Question 25

Necrotizing Enterocolitis is dead bowel in a premature baby. What is an initial sign?

Answer 25

Bloody bowel movement

Question 26

What will the abdominal XR show with Necrotizing Enterocolitis?

Answer 26

Air in the wall of the gut (pneumatosis Intestinalis)

Question 27

What is the treatment for Necrotizing Enterocolitis?

Answer 27

NPO --> TPN IV antibiotics with possible surgery