-
what's the technical name for the soft spot on a baby's head, and how long does it last?
- anterior fontanelle
- should close by 12-18 months, but can stay open until 3-5 years (though that seems abnormal)
- it's trouble if it's closed at 6 months
-
apgar stands for what?
- appearance (skin color)
- puylse (HR)
- grimace (reflex irritability)
- activity (muscle tone)
- respiration
-
apgar norms
8-9 out of 10
-
if a baby is born at 28-32 weeks there's a big risk of neurologic complications. Name 3 types
- intraventricular hemorrhage --> spastic hemiparesis, quadriparesis, cog defects
- periventricular leukomalacia
- seizures
-
3 types of respiratory complications seen in premature babies
- respiratory distress syndrome (RDS)
- bronchpumlonary dysplasia (BPD)
- apnea
-
describe the apnea seen in premature babies
- lack of breathing for > 20 sec 2/2 system immaturity... may indicate systemic medical problems
- happens in as many as 90% of infants who weigh less than 1000g at birth
-
rel between apnea and SIDS?
none
-
what's an easy tx for apnea
caffein minimizes frequency of apnea episodes
-
what is respiratory distress syndrome? - overview from a website
- breathing disorder, seen in infants > 6 weeks premature / earlier than 28 weeks
- develops in first 24 hrs after birth
- it's due to a lack of surfactant, which would help keep the lungs open
- baby has to work harder to get oxygen if lungs are collapsed, and parts of body may get ischemic
- RDS could be an early phase of bronchopulm displasia (BPD), and some tx for RDS cause BPD
-
RDS nickname
- (respiratory distress syndrome)
- hyaline membrane disease
seen in premies younger than 34 weeks -- the numbers seem to vary, but I guess younger than 34 is a risk, younger than 32 it's pretty likely, younger than 28 it's guaranteed
-
what does surfactant do?
decreases surface tension of smaller airways so alveoli don't collapse
-
when does the surfactant apparatus get made?
- starts at 28 weeks
- fully formed at 32
-
3 treatments for RDS/hyaline membrane disease
- surfactant replacement
- O2
- in some cases, mechanical ventilation
-
what babies get BPD (bronchopulmonary disorder)?
- babies that required supplemental 2 a/o mechanical ventilation
- babies born more than 10 weeks early
- wt less than 2 lbs (about 1,000 grams)
- babies with hx of RDS
-
what happens in BPD?
walls of lung thicken, making O2/CO2 exchange difficult ... actually, I can't tell if this happens because kid has BPD, or if this is one of the things that leads to BPD
-
2 consequences of BPD
- limited physical activity tolerance, which'll lead to dev delays
- chronic upper respiratory problems / chronic lung disease
-
cardiac complications seen in premature babies
- patent ductus arteriosus
- heart murmur
- bradycardia
-
how much tummy time does a baby need? simple answer, and more detailed answer
- 81 minutes per day
- doesn't have to be consecutive
- begin placing infant in prone when a few days old (and awake)
- start w a few min/day, work up to an hour/day by end of 3rd month
- place kid prone after each diaper change and each bath
- play in prone
- roll up a towle and palce the infant prone over it
-
first leading cause of death in infants in first year of life?
sudden infant death syndrome (SIDS)
-
risk factors for SIDS
- prone sleeping
- sleeping on a soft surface
- smoking during pregnancy
- second hand smoke
- overheating
- late or no prenatal care
- young maternal age
- premature birth or low birth weight
- male
-
not getting tummy time can lead to...?
- gross motor delay
- and also contributes to SIDS
-
plagiocephaly
abnormal shape of head
-
plagiocephaly can be due to abnorlal forces on the skull before or after birth. 4 ways to happen pre-birth
- when baby descends into pelvis
- abnormally shaped uterus
- fetus in an odd position
- twins, triplets (it's crowded)
-
resolution of plagiocephaly if it's due to abnormal forces on the skull pre-birth
usually goes to normal shape in about 6 weeks after birth
however, localized occiput flattening at birth might also be a precursor to deformational plagiocephaly
-
risk factors for plagiocephaly (the pre-birth kind)
- assisted vaginal delivery (tongs)
- prolonged labor (baby's stuck in canal longer)
- unusual birth position
- multiparity (more babies inside)
- male gender
-
what causes deformational plagiocephaly?
pressure on occiput of growing skull causing the occiput to flatten
-
where is plagiocephaly most common?
- flattening on right side > left
- boys more than girls
-
name for plagiocephaly if it hits the face?
craniofacial asymmetries (esp in eyes)
-
craniosynostosis
- premature closure/ossification of sutures in skull
- (this is different from plagiocephaly and craniofacial asymmetries)
-
how does prematurity raise the risk of plagiocephaly?
- in the last 10 weeks of pregnancy the cranial bones become stronger and harder
- in NICU on a respirator their heads are maintained in a fixed position
-
developmental delay rel to plagiocephaly
chicken and the egg
-
can torticollis cause plagiocephally
you bet
|
|
