the newborn Flashcards
what are some signs of respiratory distress in a newborn?
tachypnoea >60breaths per minute
central cyanosis - babies should be PINK not BLUE
increased WOB
noisy breathing
what are some causes of respiratory distress in a TERM newborn?
- pneumonia (most severe)
- wet lung/ transient tachypnoea of newborn
- meconium aspiration
- chronic heart disease
- space occupying lesions
when should we expect a newborn to pass urine/meconium post birth?
All newborn infants should pass urine within 24 hours and meconium within 48 hours.
what is the main role of the guthrie heel prick test and when is it performed?
To pick up congenital metabolic disorders
such as CF, PKU and congenital hypothyroidism (TSH)
performed usually from day 3-5 post birth
what is the point of doing an agpar score and when do we do it? what score is normal?
Seeing how well the newborn adapts to extrauterine environment.
performed at 1min and 5min post delivery. Agpar score of 8-10 is normal.
why do we give newborns vitamin K injection?
Without enough vitamin K a baby is at risk of developing a rare disorder called Vitamin K Deficiency Bleeding or VKDB, which can cause them to bleed into their brain. This condition can also lead to death.
when do we do a full newborn exam?
day 3 post delivery
what is the medical name for tongue tie?
ankyloglossia
what imaging might we need to ix neonatal encephalopathy?
cranial ultrasound, MRI and EEG.
what are common causes of hypoxic ischaemic encephalopathy of the newborn?
cord prolapse
placental abruption
what is the mainstay treatment of hypoxic ischaemic encephalopathy of the newborn?
Whole body hypothermia (33 to 34°C) for up to 72 hours is used in the neonatal intensive care setting as a key treatment of moderate or severe HIE. The time-critical period to commence treatment is in the first 6 hours, hence recognition (and if not already, transfer to a tertiary setting) is important.
what are some causes of seizures in the newborn?
Hypoxic-ischaemic encephalopathy Metabolic imbalance: hypoglycaemia, hypocalcaemia, hyponatraemia, hypomagnesaemia Infection: meningitis and encephalitis Anatomical brain abnormalities Intracranial haemorrhage Inherited metabolic disorders Neonatal drug withdrawal
tell me about breastfeeding jaundice?
Breast milk jaundice is a prolonged unconjugated hyperbilirubinaemia common in breastfed babies.
The jaundice peaks in the second week but resolves only very slowly and may last up to 3 months
The infant is healthy and thriving.
Breast milk jaundice is thought to be due to factors in breast milk that cause increased enteric absorption of bilirubin.
what do you think if you see a newborn with persistent drooling after birth?
oesophageal atresia
how might we manage neonates at risk of hypoglycaemia? when do they go to the special care nursery?
Admit to special care nursery if born from a mother with poorly controlled diabetes, birthweight less than 2500 or macrosomia or signs of illness (e.g. resp distress)
feed within 1 hr post delivery and monitor BSLs.
feed every 4 hourly
BSL less than 2.6= hypoglycaemia
Other options include administering buccal glucose gel if hypoglycaemia present or IV dextrose
