OnlineMedEd: Pediatrics - "Newborn Management"

Question 1

What things should you prepare while waiting for delivery?

Answer 1

• Towels to dry the baby
• Baby warmer (make sure it’s on) to warm the baby
• PPV mask
• Suction

Question 2

The goal of stimulation is to prevent _____________.

Answer 2

primary apnea

Question 3

List three ways to stimulate a baby.

Answer 3

• Rub back
• Dry with towels
• Tap feet

Question 4

What SpO2 levels are acceptable in the first minute of life?

Answer 4

60% - 65%

Question 5

First suction ___________.

Answer 5

the mouth (then the nose)

Question 6

The goal for heart rate in the first minute is ______________.

Answer 6

greater than 100

Question 7

If the heart rate is less than 100 in the first minute, what should you do?

Answer 7

Suction baby and give PPV –the bradycardia is probably due to low oxygen.

Question 8

List the three heart ranges in the 1-minute to 5-minute window and what they indicate.

Answer 8

• Greater than 100: baby is ok; monitor
• 60 to 100: likely a respiratory issue; give PPV
• Less than 60 with oxygen normal: likely a cardiac issue; do CPR

Question 9

Apgar scores less than __________ prompt intervention.

Answer 9

7

Question 10

In the 1-minute to 5-minute window, aim for SpO2 levels in the ________ range.

Answer 10

80% - 85%

Question 11

After minute _______, oxygen levels should be above 90% (or at least close to it).

Answer 11

5

Question 12

What are the Apgar categories?

Answer 12

The word itself is a mnemonic:
•Appearance: blue, acrocyanosis, or pink
•Pulse: absent, less than 100, or greater than 100
•Grimace: no grimace with strong stimulation, grimace with strong stimulation, or grimace with light stimulation
•Activity: no activity, some activity but not against resistance, or strong activity with resistance
•Respirations: absent, irregular, or present

Question 13

Describe transient tachypnea of the newborn.

Answer 13

• Caused by c-section (because baby wasn’t properly squeezed through the birth canal, which helps expel fluid from the lungs)
• Presents with grunting and tachypnea
• Self-limiting, but PPV can help open up lungs
• X-ray will show hyperextended diaphragm and wet lungs

Question 14

Transient tachypnea of the newborn needs to be distinguished from respiratory distress syndrome. Although prematurity is a big suggestive factor for RDS, what test can distinguish the two?

Answer 14

X-ray

Radiography of RDS will show hypoinflation with atelectasis, while TTN will show hyperinflation with wet lungs.

Question 15

What two treatments can be given to newborns with RDS?

Answer 15

• Intubation

* Surfactant

Question 16

What babies get hypoglycemia?

Answer 16

• LGA babies from diabetic mothers

* SGA babies with IUGR

Question 17

Hypoglycemia can also be a sign of _____________, so don’t assume it’s just because of gestational diabetes.

Answer 17

sepsis

Question 18

List the four categories of things to do in a non-urgent newborn exam.

Answer 18

•Measure: height, weight, and head circumference
•Shots & drops: vitamin K, HBV vaccine, and erythromycin drops
•Look at the cord: should see two arteries and one vein (TAVO)
•Physical exam:
- General: jaundice
- HEENT: examine fontanelles, sutures, red reflex, and palate
- Chest: lung sounds, heart sounds, respiratory effort
- Abdomen: gastroschisis, omphalocele, urachal remnant
- GU: testicular descent, hypospadias, epispadias, imperforate hymen, imperforate anus
- MSK: Ortolani and Barlow