Perinatal/ Newborn health screening Flashcards Preview

FNP STUDY > Perinatal/ Newborn health screening > Flashcards

Flashcards in Perinatal/ Newborn health screening Deck (50):
1

What % is appropriate for gestational age?

between 10th and 90th

2

What % is LGA

weight >90th percentile

3

What % is SGA

Weight ,10th percentile. Symmetric vs symmetric

4

Average length of newborn

20-21 inches

5

average weight of newborn

7 lbs

6

average head circumference

13-14 inches

7

vital sign of newborn

temp .100.4 considered fever, pulse 120-170 BPM, Respiration 30-80 BMP, blood pressure ,112/74 mmHg

8

milia in the newborn

pinpoint white papules on face, prominent on cheeks, nose, chin, and forehead.
Spontaneously disappears within 3-weeks of life. If persists or widespread distribution, may indicate a genetic syndrome

9

miliaria

obstructed sweat (eccrine gland) ducts, sometimes referred to as prickly heat

10

erythema toxicum

most common newborn rash, usually appears between 2 to 5 days after birth, characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules, resolves on the 14th day. If fever or appetite changes, needs medical

11

Port-wine stain

vascular birthmark (malformation) consisting of superficial and deep dilated capillaries in the skin; produce a reddish to purplish discoloration of the skin; permanent

12

What do you need to rule out for port-wine stains?

Rule out sturge-Webber: serious neuro condition with seizures- ocular (glaucoma) characteristics

13

How should hips be during neuro exam of the newborn?

Hips should be adducated and partially flexed with knees flexed, arms adducted, elbows flexed, and fists clenched

14

Rooting reflex, how to elicit, when appears and disappears

appears in newborns, disappears by 3-4months, elicit by stroking cheek, newborn should turn head to that side

15

sucking reflex, how to elicit, when appears and disappear

Appears in newborn, disappears 3-4 months. Elicited by anything touching root of mouth

16

moro reflex, how to elicit, when it appears and disappears

appears in newborn, diapers in 3-4 months, elicited by The Moro reflex is elicited by taking the baby in both hands, the head being supported by one hand and the buttocks by the other. With the baby’s head in a midline position, the hand supporting it is quickly dropped to a position approximately 10 cm below its original supporting position, and the head is caught by the hand in its new position. In response, the baby will throw out both arms and legs symmetrically.The legs and head extend while the arms jerk up and out with the palms up and thumbs flexed. Shortly afterward the arms are brought together and the hands clench into fists, and the infant cries loudly.

17

grasp reflex (palmar; plantar). How to elicit, when appears and disappears

appears in newborn. Palmar disappears 3-6months, plater disappears in 4 months. elicit by placing finger n center of babes hand or ball of foot.

18

pacing/ stepping reflex, appears, disappears and how to elicit

appears in newborns, disappears in 1-2 months. Elicit by holding baby under arms and placing soles to flat surface

19

tonic neck. Appears, disappears, and eliciting

Appears in newborn, disappears by 3 months, and elicit by With this reflex, tilting the head back while lying on the back causes the back to stiffen and even arch backwards, causes the legs to straighten, stiffen, and push together, causes the toes to point, causes the arms to bend at the elbows and wrists, and causes the hands to become fisted or the fingers to curl. The presence of this reflex beyond the newborn stage is also referred to as abnormal extension pattern or extensor tone.

20

babinksi reflex

fanning of toes. appears in newborns, disappears in 12 months or when walking. the Babinski reflex is also present at birth and fades around the first year. The Babinski reflex appears when the side of the foot is stroked, causing the toes to fan out and the hallux to extend. The reflex is caused by a lack of myelination in the corticospinal tract in young children. The Babinski reflex is a sign of neurological abnormality in adults.
The lateral side of the sole of the foot is rubbed with a blunt implement so as not to cause pain, discomfort or injury to the skin; the instrument is run from the heel along a curve to the metatarsal pads. There are three responses possible:
1. Flexor: the toes curve inward and the foot everts; this is the response seen in healthy adults.
2. Indifferent: there is no response.
3. Extensor: the hallux dorsiflexes, and the other toes fan out - the Babinski's sign indicating damage to the central nervous system.
As the lesion responsible for the sign expands so does the area from which the afferent Babinski response may be elicited. The Babinski response is also normal while asleep and after a long period of walking.

21

caput succedaneum

crosses midline (fluid under the skin, simple swelling). Resolves in 2-3 days

22

cephalohematoma

does not cross midline (blood under periosteum); requires closer examination

23

more than 1 hair whorl meaning

could mean poor brain growth

24

Anterior fontanel

largest fontanel (2-5cm), closes by about 18 months

25

posterior fontanel

may not be palpable at birth, closed by 2-3 months

26

Common causes of wide fontanels

prematurity, IUGR, hydrocephalus, down syndrome, hypothyroidism

27

red reflex replaced by a black spot

means no clear pathway from the lens to the retina

28

red reflex replaced by a whitish color

may suggest retinoblastoma or congenital cataracts

29

if sclera is deep blue

osteogenesis should be ruled out

30

colobomas (embryonic fissure defect)

mild forms only affect the iris. In more sever cases, the choroid and optic nerve can be involved with suspicion for CNS midline defects such as optic nerve hypoplasia

31

heterochromia

different eye color

32

cloudy cornea

cataracts

33

salt and pepper speckling

brshfield spots of the iris is associated with down syndrome

34

choanal atresia

narrowing or blockage of the nasal airway by tissue, present at birth

35

microstomia

small mouth, is observed in trisomy 13 and 18

36

micrognathia

recessed chin- seen in pierre-robin syndrome, treater-collins syndrome, hallermann-streiff syndrome

37

normal breathing for newborns

are abdominal breathers

38

abnormal breathing patterns

retractions, stridor, grunting, breast enlargement

39

radio-femoral pulse delay

consider coarctation, pulse oximeter reading of all 4 extremities

40

% of newborns that have murmurs

85%

41

PMI location

3rd and 4th intercostal space (ICS), left midclavicular like (LMCL)

42

normal abdominal contour in newborns

rounded

43

umbilical cord number of vessels

2 arteries, 1 vein

44

developmental dysplasia of the hips (DDH). How to test

With hips flexed at 90 degrees and knees together, begin by abducting, then adduct while the examiners fingers are over the greater trochanter

45

ortolanis click

a click is heard or felt as dislocation is reduced (when abduct then adducting)

46

barlows maneuver and tx

feeling of a slip as the femoral head slips away from the acetabulum causing the dislocation. tx: abduct with harness or surgery

47

Sensitivity

+=+, if the patient has, it is positive

48

specificity

-=-, if the patient does not have, it will be negative

49

Mandatory screening for all 50 states

PKU, galactosemia, hemoglobinopathies (sickle cell, thalasemmia), congenital hypothyroidism

50

what increases risk of genetic problems

advanced parental age, family history of birth, fetal exposure to intrauterine infections