NMS Medicine: Medicine: Newborn Assessment Flashcards


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NMS Medicine
Chapter 1
updated 10 years ago by jgaversa5
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1

how many infants are born each year in US

4 million

2

how many newborns need resuscitation

10%

3

what are the major physiological events at birth

lung expansion/cry
umbilical cord clamping and sudden increase in BP
decrease in pulmonary vascular resistance
transition from fetal to adult ciruclaiton (FO close, DA close)

4

when are APGAR scores assessed

1, 5, 10 minutes of life

5

what is the a in apgar

appearance (color)

6

what is the p in apgar

pulse (heart rate)

7

what is the g in apgar

grimace (irritability)

8

what is tha a in apgar

activity (muscle tone)

9

what is the r in apgar

respirations

10

what is a 0 in a

blue/pale

11

what is a 1 in a

pink body, blue exterior

12

what is a 2 in a

completely pink

13

what is a 0 in pulse

absent

14

what is a 1 in pulse

slow (< 100/min)

15

what is a 2 in pulse

>100/min

16

what is a 0 in grmiace

no response

17

what is a 1 in grimace

grimace

18

what is a 2 in grimace

cough/sneeze

19

what is a 0 in activity

limp

20

what is a 1 in activity

some flexion

21

what is a 2 in activity

active movments

22

what is a 0 in respirations

absent

23

what is a 1 in respirations

slow, irregular

24

what is a 2 in respirations

good, crying

25

what types of situations could apgars be misleading in

preterm infants, meconium deliveries

26

what is a meconium delivery

...

27

what are the key things in the newborn physical exam

vital signs
"measurements"
genreal appearance

28

what are the vital signs

temp
resp
BP
HR

29

what is important about the "measurements" in newborns

head circumference
length
weight
gestational age

30

what is improtant about gneral appearance of newborns

activity
color
obvious abnormalities

31

what should you notice about the newborn's skin

color
rashes
nevi

32

what types of colors could be see on newborn skin

plethora
jaundice
pallor
cyanosis
bruising
mottling

33

what is a newborn's skin like if it is described as "plethora"

flushed

34

what would a baby's skin be like if it were jaundinced

yellow hue

35

what is a baby that has "pallor" in the skin like

pale

36

what is "mottling" in a baby'e skin like

marble like pattern when the baby gets cold

37

what is another name for nevi

birthmarks

38

what is erythema toxicum

card image

blotchy red spots on the skin[4] with overlying white or yellow papules or pustules

disappear on their own

39

what type of rashes could be seen on newborn skin

milia
erythma toxicum
candida albicans
acne neonatorum

40

what types of nevi could be seen on newborn skin

macular hemangiomata
port wine stain
mongolian spot

41

what is of note in newborn heads

anteiror and posterior fontanelles
modling
caput succedaneum
increased IC pressure
craniosynostosis

42

what is improtant in newborn neck

clavicle intact
thyroglossal duct
hematomata

43

what is important in newborn face

symmetry (damage to facial nerve)
obvious dysmorphology

44

what is important in newborn ears

abnormal shape and/or position

45

what is important in newborn eyes

red reflex
scleral color
Brushfield's spots
conjunctivitis

46

what is important in newborn nose

assessment of patency of nares

47

what is important in newborn mouths

ranula
epstein's pearls
mucocele
natal teeth
macroglossia
copious saliva
thrus

48

what is important in newborn chest

breath sounds: asymmtery, quality, tachypnea
pectus excavatum
breast tissue

49

what is important in newborn heart

murmurs: ASD, VSD, PDA, TOF, coarctation
pulses and perfusion

50

what is improthatn in newborn abdomen

auscultaiton
palpation
anomalies (gastroschissi, omphalocele)

51

what is importnat in newborn umbilicus

3 vessel cord

52

what is important in newborn male genitalia

hypospadias, epispadias, chordee, testicles, herna

53

what is important in newborn female genitalia

muscoal tag, vaginal bleeding, clitoromegaly

54

what is important in newborn anus and rectum

patency and position

55

what is improtant in newborn extremities

syndactyly
polydactyly
simian crease
clubfoot

56

what is important in newborn spine

sacral dimple
abnormal pigmentation

57

what is important in newborn hips

dislocation

58

what is important in newborn nervous system

muscle tone
reflexes
crenial nerves
movemetnt

59

what is "preterm"

earlier than 38 weeks

60

what is "term"

38-41+6

61

what is "post term"

over 42

62

whatis small for gestational age

less than 2 SD below mean or <10%

63

what is large for gestational age

greater than 2 SD above mean or >90%

64

what is new ballard score best performed at for infants less than 26 week gestation

<12 hrs of life

65

what i the new ballard score best performed at for more mature infants

<96 hrs of life

66

within how many weeks of gestational age is the new ballard score activate

2 weeks

67

what are the criteria of new ballard score

6 neuromusclar
6 phsyical

68

what is routine newborn care in terms of monitoring

monitoring temp, HR, resp rate, feeding vol/freq/tolerance, urine output, meconium, daily weights, initial blood glucose and hematocirt

69

what types of things should you watch for newborn eye care

prophylaxis for gonococcal ophthalmia neonatorum

70

what would you treat gonococal ophthalmia neonatorum with

AgNO3 or erythromycin within an hour of delivery

71

what does vitamin K prevent

hemorrhagic disease of newborn within 1 hour of birth

72

what are some general things to pay attention to with the newborn

cord care
circumcision
hep B vaccine
hearing screeing
newborn screening
discharge planning

73

what things are included in the newborn screen

phenylketoniuria
galactosemia
hypothyroidism
homocystinuria
maple syrup urine disaes
sickle cell disaese/hemoglobinopathies
cystic fibrosis

74

what are the things to set up with discharge planning

newborn screen
return visit
back to sleep
carseat safety

75

from lecture

...

76

what will the OB do in terms of taking care of the child

provide respiration support, that's it

77

what should the newborn's HR be

over 100

78

if you don't have a newborn HR over 60 what will be provided

chest compressions and then if it continues they will get epinephrine

79

what is given to reverse the effects on the baby of the mom's pain meds

narcan (sometimes)

80

can a baby's temperature be both too high and too low

yep

81

what can be an underlying cause if the heart rate is too slow

coarctation of aorta, etc other things

82

what should you do first after checking the general appearance of the child

heart and lungs

83

what could make a baby large for gestational age

maternal diabetes

84

what could make a baby small for gestational age

bad placental connection

CMV or other TORCH viruses

85

what will a mottling baby look like

irregular and splotchy in color

86
card image

do you fix cavernous hemangiomas if you see them

no they resolve themselves

87

where would a stork bite mark be

on the back of the neck

88

what would be a serum jaundice level to watch

over 20 mg/dL

89

what would you do for a serum jaundice over 20 mg/dL

observation
bili blanket
phototherapy

90

what will the bili blanket do

provide light that helps convert wavelength of light to a more excretable form

91

do all babies get jaundice

yes

92

where does jaundice start and where does it go

starts in face and moves down body

93

what ia newborn jauncie due to

baby's liver not being good enough to get rid of bilirubin well yet

94

what should the baby's diet be like if he/she has jaundice

a lot so it can poop a lot to get it out

95

what is milia

keratin filled cyst on skin or roof of mouth

96
card image

what is this

milia

97
card image

what is this

erythema toxicum

98

what is erythema toxicum

blotchy red spots on skin with overlying white or yellow papules or pustules, benign

99

what is a macular hemangioma

vascular malformation, benign for most part but not if in wrong place

100

what is a port wine stain associated with

telangiectasic symptoms

101
card image

is a port wine stain permanent

yes

102
card image

what is this

macular hemangioma

103
card image

what is this

mongolian spot

104

what is acrocyanosis

blue hands or feet

105

is acrocyanosis normal

yep

106

is the forceps mark something to worry about

no, actually much better than vaccuum bruise actually

107

what is molding from

big baby head going through small space

resolves in a couple of days

108

what happens to cephalohematoma

gets absrobed like a bruise

109

is there an underlying skull fracture in cepahlohematoma

no

110

what does cephalohematoma put baby at risk for

baseline jaundice persistence

111

is it common to have damage to clavicles with difficult delivery

yes very, can be felt with crepidice

112

are hematomas usually ok in newborns

yes but watch for respirations

113

what should be watched for in the face

extra ear attachments
preauricular skin tags could indicate hyperplasia or some tissues around this

114

what should the newborn's eyes be checked for

retinoblastoma or cataracts

115

why do baby's eyes appear to be crossing

nose is so wide

116

is red reflex in newborn's eye normal

yes

117

is pseudostrabismus normal in newborn

yes

118

what should be checked for in the mouth of newborns

extra teeth or palate abnormalities

119
card image

do epsteins pearls go away

yes

120

do mucoceles go away

yes

121
card image

what is this

mucocele

122

what is a labial/lingual frena

tongue tie

123

if the tongue tie is narrow, what happens to it

clipped in nursery

124

if tongue tie is deep, what happens to it

sent to dentist

125

what is important for lingual frena

makes the mother very sore from breastfeeding

126

why are natal teeth important

can be aspirated, dangerous

127

what does thrush look like

adherent white plaques on tongue

128

can yeast get into the breast

yes from thrush and it hurts the baby

129

whats a main thing for people to worry about in newborn's chest

pneumothorax

130

why is it hard to hear heart abnormalities in newborn

because HR so high

131

if a baby's abdomen is flat what could be underlying issue

diaphragmatic hernia

132

is gastroschisis or omphalocele associated with midline abnormality

omphalocele

133

what are the vessels in the umbilicus

2 umb arteries
1 vein

134

where do newborns get IV

right from umbilicus

135

why are no babies with penile abnormalities circumcised

might need the skin for repair

136

what is a very important thing to recognize in babies sexual organs

any abnormalities

137

what is chordee

penis is tethered at the body

138

what do you do for an undescended testicle

brought down after a few weeks because of the increased incidence of cancer

139

is it pretty normal for there to be vaginal bleeding

yes

140

if baby doesnt poop for 24 hours what could they have

meconium plug
patent anus

141

do babies with polydactyly get plastic surgery pretty young

yes because this is bony tissue

142
card image

what is simian crease associated with

trisomy 21

143

is bowing of the legs normal in newborns

yes

144

what are the feet like in newborn and preterm babies

term: normal
preterm: slick

145

what happens to babies with clubfoot

serial casting for many weeks after born and repaired after they straighten out

146

what can sacral dimple be a sign of

underlying spina bifida

147

do most babies with sacral dimple have spina bifida

no

148

what will happen if you can dislocate the baby's hip easily

orthopedic surgery right away to fix; big lawsuit thing if you miss this

149

what is the device for correcting an easily dislocateable baby hip

puts head of femur in anterior part of acetabulum

150

what are some good indications that the baby may have easily dislocatable hips

asymmetric gluteal folds and dysplasia

151

what will baby feel like if it does not have great muscle tone

floppy

152

what will the flexibility and folding of tissues be like in a more preterm baby

more flexible

more pronounced rugae in scrotum in a normal baby

153

how much weight can baby lose in first week

10%

154

why are babies given vitamink K

turns on clotting factors in baby so they dont bleed during circumcision and stuff

155

how is the newborn hearing screening done

measures brainstem response to what they are hearing

156

what are some important things to remember in discharge in the carseat

watch the airways!