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Appreciating Complex Midwifery Care > Recognising the Sick Neonate > Flashcards

Recognising the Sick Neonate Flashcards

(49 cards)

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1
Q

What should be routinely be assessed on a baby?

A
  • ABC
  • Colour and temp
  • Behaviour
  • Vomiting/ Elimination
  • Feeding
  • Physical signs (skin)
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2
Q

What is the most common cause of Meconium Aspiration Syndrome?

A

Stress

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3
Q

What is the difference in care for babies that are breathing/not breathing after MAS?

A

Breathing = observe for signs of RDS over next 12 hours (mec obs)
Not breathing = Check for meconium, suction under direct supervision

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4
Q

What are the most common causes of grunting?

A
  • Hypothermia

- Septicaemia

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5
Q

What are the most common causes of nasal flaring and recessions?

A
  • TTN
  • RDS
  • Obstructed airway
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6
Q

What are the most common causes of tachypnoea?

A
  • TTN
  • RDS
  • Pneumonia
  • Congenital heart disease
  • Metabolic acidosis
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7
Q

What is TTN?

A

Transient Tachypnoea of the Newborn

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8
Q

What is RDS?

A

Respiratory Distress Syndrome

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9
Q

What are the symptoms of TTN?

A
  • ‘Wet lungs’
  • Rapid, difficult breathing
  • Grunting
  • Cyanosis
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10
Q

What causes ‘wet lungs’?

A

Most common in a CS because the fluid is not forced out of the lungs like it would be in a SVD

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11
Q

What is the management for a baby with TTN?

A
  • Refer to paed
  • Infection screen to exclude pneumonia
  • X-ray to exclude other problems
  • Antibiotic therapy?
  • NNU
  • Usually resolves itself
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12
Q

What causes RDS?

A

Deficiency of surfactant

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13
Q

What factors increase the risk of RDS?

A
  • Preterm
  • Perinatal hypoxia
  • Infants of diabetic mothers
  • Pre-labour LSCS
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14
Q

What factors decrease the risk of RDS?

A
  • Stress in utero and narcotic addiction

- Steroids to mothers at risk of pre-term delivery

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15
Q

What are the signs of RDS?

A
  • Tachpnoea/ increased RR
  • Grunting
  • Nasal flaring
  • Sternal/ intercostal recessions
  • Peripheral/ central cyanosis
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16
Q

What is the treatment for RDS?

A
  • Surfactant via ET tube
  • Oxygen with ventilation if needed
  • Maintain temperature
  • Biochemical balance
  • Nutrition
  • NICU
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17
Q

What does cyanosis when breathing indicate?

A

Congenital heart problems

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18
Q

What does cyanosis with apnoea indicate?

A

Investigate cause

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19
Q

What does grey colouring indicate?

A

Shocked and very sick babies

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20
Q

What does Jaundice indicate?

Study These Flashcards
A

Infection if pathological

21
Q

What is mild Hypothermia?

Study These Flashcards
A
  • 36.0-36.4
  • Skin to skin and hat
  • Ensure baby has fed
  • Full set of obs and repeat after 1 hr
  • Refer if worried
22
Q

What is moderate Hypothermia?

Study These Flashcards
A
  • 32.0-35.9
  • Follow trust policy for warming and feeding
  • Check blood sugar level
  • Paediatric referral
23
Q

What is severe Hypothermia?

Study These Flashcards
A
  • <32.0

- Paediatric emergency

24
Q

What may contribute to sickness in Hypothermic babies?

Study These Flashcards
A
  • Sepsis
  • Underfeeding/ Hypoglycaemia
  • Intercranial bleeding
  • Baby must be warmed slowly if true Hypothermia
25
What are some concerning behaviours of a baby?
- Hypotonia (floppy) - Hypertonia (tense) and clenched fists - Not moving when awake - Persistent failure to attach to breast - Persistent head retraction
26
What are the common causes of Hypotonia?
- Down's syndrome - Cerebral injury - Hypoglycaemia/ Hyponatraemia - Infection - Maternal drugs crossing the placenta - Congenital conditions
27
What is Hyponatraemia?
Decreased sodium concentration
28
When is Hypotonia expected?
In babies <34/40
29
What should be considered if a baby consistently cries?
- Hunger - Wind/colic - Important to understand that some babies do cry alot
30
What are some signs that a baby is in pain?
- Grimace - Avoidance of moving - Cries when disturbed/ handled
31
What should be considered if a baby has a shrill, high-pitched cry?
- Mild encephalopathy | - Cri du Chat (chromosomal condition)
32
What eye movements are abnormal?
Eye rolling or crossing
33
Describe neonatal fits
- Brief jerking/ twitching of a single limb - Sometimes very rapid - Momentary changes in respiration, eye movement, drooling or lip smacking
34
What are some common causes of neonatal fits?
- Encephalopathy - Cerebral haemorrhage/ oedema from trauma - Infection - Metabolic disorders - Structural abnormalities in the brain - Drug withdrawal - Toxins
35
Give 4 examples of anti-convulsants
1. Phenobarbital 2. Clonazepam 3. Diazepam 4. Phenytoin
36
What are 2 common neurological problems?
1. Intracranial haemorrhage - resulting from birth injury/ perinatal asphyxia (subdural, intraventricular, subarachnoid) 2. Hypoxic-Ischaemic Encephalopathy syndrome - graded into mild (grade 1), moderate (grade 2) and severe (grade 3)
37
What is therapeutic Hypothermia and why is it used?
- Protects brain following severe perinatal asphyxia | - Cool within 6 hours of birth to 33-35 for 72 hrs and then warm up slowly
38
What should be considered if a baby does not demand feeds?
- Affected by maternal medication/ drugs? | - Jaundice
39
What should be considered if a baby is too tired to suck?
- Preterm? - Prolonged crying or disturbance? - Underfed or sick?
40
What are the signs of dehydration?
- Dry mouth - Dry, wrinkled, inelastic skin - Little darker urine and infrequent stools - Sunken fontanelle and eyes - Tachycardia, hypotension and greyish pallor - Excessive weight loss
41
When is vomiting common and why?
In 1st 2 weeks due to posseting, oesophageal reflux or swallowed blood at birth
42
What is posseting?
Bringing up milk after a feed
43
When should a baby be referred for vomiting?
- Persistent - Not keeping down any milk - Contains bile (obstruction or cerebral problem) - Combined with diarrhoea (gastroenteritis)
44
What are the obvious signs of infection?
- Eyes - Paronychia - Mastitis - Rashes - Umbilical - Thrush - Cuts/ abrasions - Unpleasant smell
45
What is Paronychia?
Infection under the nails
46
When should a woman be screened for Group B Strep?
- Prev. baby with GBS - Discovery of GBS through bacteriology investigation during pregnancy - Preterm birth - Prolonged ROM - Suspected maternal infection - Pyrexia
47
What does IAP stand for?
Intrapartum Antibiotic Prophylaxis
48
When should IAP be given for GBS?
- Prev. GBS pregnancy - Current GBS pregnancy - Pyrexia in labour
49
What IAP is used for GBS?
3g Benzylpenicillin at beginning of labour and then 1.5g Benzylpenicillin every 4 hrs

Appreciating Complex Midwifery Care (14 decks)

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