Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RB Y3 3 Reproduction & Sexual Health > The Newborn Infant > Flashcards

The Newborn Infant Flashcards

1
Q

what structure allows foetal bood to bypass the liver, and what vessel does it join into

A

the ductus venosus

joints into the IVC - drains into RA of heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what structures in the heart allow the blood to bypass the lungs

A
  • the foramen ovale between the RA and LA allows blood to flow straight from RA to LA, then LV and out aorta
  • if any blood escapes the FO and flows into RV and then out pulmonary artery, the patent ductus arteriosus will allow it to enter the aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

by which gestational age does the foetus have lungs that function well enough (dont need steroids if delivered)

A

36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when does the baby start producing surfactant, and what does this do

A

from around 24 weeks, it reduces alveolar surface tension stopping the smaller alveoli from collapsing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does vaginal delivery help lung preparation for the outside world

A

it squeezes the fluid out of the lungs

if eg C section, there will be delayed clearance of lung fluid and transient tachypnoea/resp distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are O2 sats expected to be when thebaby is born

A

they will intially be around 70% and will increase to around 90% over teh first 10 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

hwat colour is the baby when born

A

blue, turns pink as oxygenated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what changes happen in the lungs after birth

A

the lungs before were a very high pressure system (unfavourable.). PVR drops and SVR rises, driving blood through lungs

FO and DA close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what causes closure of teh FO, and what is left behind

A

the pressure in LA > RA - forcing FO shut

fossa ovalis remains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what kept the DA open in utero, and what now causes it to shut

A

it was kept open by the placental PG

after birth, there are no more PG and high O2 tension causes the smooth muscle in it’s walls to constrict

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the closed DA called in children/adults

A

ligamentum arteriosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what murmur would a PDA cause

A

machine like murmur below the left clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do you manage a PDA

A

IV NSAIDs - indomethacin or ibuprofen (anti COX action inhibits PG production and causes closure).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what does the ducuts venosus become

A

the ligamentum teres (round ligament) in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why are neonates particularly prone to rapid heat loss

A
  • covered in fluid when born
  • have a high surface area : volume ratio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 4 mechanisms by which neonate can lose heat

A
  • radiation
  • evaporation of fluid
  • conductive - contact with cold surface
  • convection - air flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how do babies warm themselves up? they cant shiver

A
  • non shivering thermogenesis
  • stored brown fat breaks down in response to catecholamines - heat is generated through ATP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

where is the brown fat found in babies

A

between scapula, around organs, sternum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

does NST work immediately from birth?

A

no, takes around 12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the negative consequences of hypothermia, and NST

A

it increases metabolic rate

  • so uses a lot of O2 = resp rate increases to get more O2 = cant meet demands = anaerobic metabolism and hypoxia
  • uses lots of glucose - depletes glycogen stores and results in hypoglycaemia
  • hyopglycaemia leads to decreased surfactant proudction and pulmonary vasoconstriction - resp distress
  • = HYPOXIA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what necessary precuations must be taken to keep baby warm

A

good delivery room temperature, dry baby immediately, swaddle (hat), skin to skin contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what extra precuations must be taken for premature babies or to rewarm hypothermic babies

A
  • put in polyethene bag
  • blankets/clothes, heated mattress, prewarmed incubator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the normal weight range for a newborn baby

A

2.5-4kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

neonatal vital signs

A
  • Resp rate: 40-60, signs of work of breathing may be attributable to circulatory adaptation
  • HR: 120-140
  • Cap refill: 2-3 seconds
  • Colour: Pink/blue/white
  • SaO2: Around 65-70% when born, increase to 90% in first 10 minutes
25
Q

what benefit does crying hav on lung developmen

A

it helps to push fluid out of the lungs

26
Q

what are the benefits of delayed cord clamping

A

better outcome for baby = higher haematocrit, Hb levels, better blood flow to vital organs

avoids anaemia and hypovolaemia

27
Q

when shoudl the cord be cut (delaeyd cord clamping)

A

when it stops pulsating - 30-60 seconds

28
Q

what is a normal Apgar score

A

8/8

29
Q

outline Apgar score

A
30
Q

why is skin to skin recommended s highly

A

it is assoicated with improved bonding and higher breast feeding rates

it keeps the baby warm

31
Q

mother is worried because baby is not feeding much, 18 hours old?

A

wont feed much for first

24 hours - reassure

32
Q

what extra precuations are taken if mother is known to be at high risk of hep B infection

A

baby is given an immediate vaccination instead of waiting for routine one at 2 months

33
Q

what extra precuations are taken if mother is known to have HIV

A

post exposure prophylaxis - drug infusion started within 4 hours of delviery and continued for 4 weeks

combination drug if DVL, monotherapy if UVL

34
Q

what ART drug is used for HIV in babies

A

zidovudine (NRTI)

35
Q

what extra vaccines does the mother during prengancy get to protect the baby

A

pertussis vaccine from 16 weeks gestation and influenza vaccine

36
Q

what NHS intiative has been put in place to keep babies warm and healthy

A

newborn snuggle bundle

37
Q

within what time frame should the newborn physical examination be carried out

A

72 hours

38
Q

what resp rate and heart rate would you expect on examination

A

resp 30-60

heart 100-150

39
Q

if a baby is at high risk of hip problems, what is done

A

US of hips

eg breech birth

40
Q

what 4 things does the heel prick test test for

A

sickle cell

cystic fibrosis

inherited metabolic diseases

congenital hypothyroidism

41
Q

which sleeping position is recommended for baby

A

on back

42
Q

what is the greatest risk factor for neonatal death

A

prematurity

43
Q

does previous preterm births put you at risk of more

A

yes, increases risk a lot

44
Q

LOW ADMISSION TEMPERATURE IS AN INDEPENDENT RISK FACTOR FOR NEONATAL DEATH

A
  • low BMI, minimual muscle activity
  • less brown fat
  • les subcutaenous fat
  • large surface area : volume ratio
45
Q

the premature baby has an increased risk of nutritional compromise, how is this managed?

A

parenteral nutrition initially

46
Q

what is hypoxic ischaemic encephalopathy

A

brain and organ damage that occurs due to hypoxia, range in severity

47
Q

how will the baby with HIE present

A

signs of hypoxia and low Apgar score at birth

later in lfie it will have developmental delay, epilepsy, cognitive issues etc

48
Q

management of HIE

A

active resuscitation

cooling treatment - this changes chemical processes in the brain so that less damage is done. can use cooling mat

49
Q

what glucose concentrations are considered to be hypoglycaemia in term and preterm infants

A

<2.2 and <1.7 respectively

50
Q

what commonyl causes transient hypoglycaemia in babies

A

LBW/premature - dont have enough glycogen stores.

51
Q

which drug that is used in obstetric management can cause transienet hypoglycaemia in baby

A

labetalol

52
Q

why will the baby of a diabetic mother be hypoglycameia

A

in order to adapt to high blood glucose levels from mother baby pancreas beta cells undergo hyperplasia - hyperinsulinaemia

53
Q

how does a hypoglycaemic baby present

A

many asymptomatic

sweating, tachycardia, lethargy, neurological signs

54
Q

management of hypoglycaemic baby

A

IV/gel dextrose

55
Q

what is the cause of most early onset neonatal ifnections

A

tend to be acquired intrapartum - most are group B strep

56
Q

what are TORCH infections

A

ones that are known to produce congenital defects

toxoplasmoa, others, rubella, CMV, herpes/hepatitis

57
Q

when would you screen for GBS?

A

no screening even on maternal request

58
Q

managment of GBS

A

benzylpenicillin ABx

59
Q
A

RB Y3 3 Reproduction & Sexual Health (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions