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Flashcards in Sick Infants Deck (31)
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1
Q

What is the time period for classifying a new baby as a neonate?

A

Up to 28 days

2
Q

What are the components of the APGAR score?

A
Appearance
Pulse
Grimace
Activity
Respirations
3
Q

What is a normal APGAR score?

A

8 or 10

4
Q

How is appearance scored on APGAR?

A

Blue or pale = 0
Blue in extremities = 1
No cyanosis = 2

5
Q

How is pulse scored on APGAR?

A

Absent = 0
Less than 100 = 1
More than 100 = 2

6
Q

How is grimace scored on APGAR?

A

No response = 0
Feeble cry when stimulated = 1
Cry or pull away when stimulated = 2

7
Q

How is activity scored on APGAR?

A

No activity = 0
Some flexion = 1
Flexed arms and legs that resist extension = 2

8
Q

How is respiration scored on APGAR?

A

No respiration = 0
Weak, irregular, gasping = 1
Strong cry = 2

9
Q

What is a normal respiratory rate for a neonate?

A

40-60 breaths/min

10
Q

What are the 4 main causes/groups of causes of a sick term infant?

A

Congenital abnormality
Metabolic disorder
Birth-related
Infection

11
Q

List the main bacterial infections that affect neonates

A
Group B Strep.
E. coli
Listeria
Staph. aureus
Staph. epidermidis
12
Q

List the main viral infections that affect neonates

A

Cytomegalovirus
Parovirus
Herpes virus
Enterovirus

13
Q

What is hydrops foetalis?

A

Accumulation of fluid in at least 2 compartments (ascites, pleural effusion etc.)

14
Q

When is a baby classed as preterm?

A

Born before 37 weeks gestation

15
Q

When is a baby classed as post-term?

A

Born after 42 weeks gestation

16
Q

List some risk factors for preterm birth

A
Smoking, alcohol, drugs
Poor socioeconomic status/poverty
Complications, maternal disease
Twin pregnancy
Teenage mother
IVF conception
17
Q

What are the physiological differences between a preterm and term infant?

A

Get colder quicker
Fragile lungs
Less effective breathing
Little reserve

18
Q

The cord should be clamped immediately in a preterm baby. True/False?

A

False

Can wait a minute to allow placental transfusion if baby is OK and can be kept warm

19
Q

How can a neonate be kept warm?

A

Wrap clothes
Plastic bag under a radiant heater
Skin-skin care
Prewarmed incubator

20
Q

List the main medical concerns in a preterm infant

A
Hypothermia
Sepsis
Undernutrition
Respiratory distress
Patent ductus arteriosus
Interventricular haemorrhage
Necrotising enterocolitis
21
Q

How does hypothermia lead to hypoxia?

A

Increased metabolism decreases O2 supply

22
Q

How does hypothermia lead to hypoglycaemia?

A

Increased metabolism increases glucose uptake and usage of glycogen stores

23
Q

How does hypothermia lead to respiratory distress?

A

Brown fat metabolism causes release of fatty acids which decreases surfactant production, requiring more work for breathing

24
Q

For preterm infants, gestational correction is done for plotting growth charts. How is gestation corrected?

A

Number of weeks early = 40 weeks minus gestational age

25
Q

What is the pathophysiology behind respiratory distress syndrome?

A

Surfactant deficiency causes alveolar collapse and decreased residual capacity, requiring more effort to breathe

26
Q

List clinical features of respiratory distress syndrome in neonates

A
Tachypnoea
Grunting
Intercostal recession
Nasal flaring
Cyanosis
27
Q

How is neonatal respiratory distress managed?

A

Steroid
Surfactant
Ventilation (invasive/non-invasive)

28
Q

When does intraventricular haemorrhage occur typically in neonates?

A

First day of life

Insult is present by 72 hours

29
Q

What is the most common neonatal surgical emergency?

A

Necrotising enterocolitis

30
Q

List clinical features of necrotising enterocolitis

A

Lethargy
Gastric residue
Bloody stool
Sepsis

31
Q

List long-term complications of premature birth

A

Neurodevelopmental dysfunction
Growth issues
Chronic medical conditions

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