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Blue coloring of hands ans feet
Acrocyanosis
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Infants weight falls between 90th ad 10th percentile for gestational age
Appropriate for gestational age
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Edema of the newborn scalp which is present at birth, may cross suture lines and is caused by head compression against the cervix
Caput succedaneum
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Collection of blood between the periosteum and the skull of a newborn; appears several hours to a day after birth, does not cross suture lines, and is caused by the rupturing of the periostealbridging veins due to friction ans pressure durin l and d
Cephalhematoma
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Surgical removal of the prepuce or foreskin which covers the glans penis
Circumcision
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Excessive heat loss
Cold stress
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Loss of heat by the direct contact with a cooler object
Conduction
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Loss of heat by movement of air
Convection
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Failure of one or both testes to descend
Cryptorchisism
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Congenital chromosomal abnormality also called trisomy 21
Down syndrome
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Placement of the urinary Meatus on top of the penis
Epispadias
-
Small, whitish yellow epitheal cysts found on the hard plate
Epsteins pearls
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Pink rash with firm, yellow white Palouse or pustules found on the chest, abd, or butt of a new born
Erythema toxcum neonatorum
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Loss of heat when water is changed to a vapor
Evaporation
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Watery first milk from the breast, high I lactose, like skim milk, and effective in quenching thirst
Foremilk
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Placement of the greater toe farther from other toes
Hallux varus
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Follows foremilk, is higher in fat content leads to weight gain and more satisfying
Hindmilk
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Fluid around the testes in the scrotum
Hydrocele
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Excess bilirubin in the body
Hyperbilirubinemia
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Placement of the urinary Meatus on the underside of the penis
Hypospadias
-
Severe neurological damage resulting from a high keel of bilirubin
Kernicterus
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Fine hair covering the fetus body
Lanugo
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Infants weight falls above the 90th percentile for gestational age
Large for gestational age
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Fetal material stored in the fetal intestines
Meconium
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Saclike protrusion along the vertebral column filled with CSF and meninges
Meningocele
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Pearly white cysts on the face
Milia
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Shaping the fetal head to adapt p the mothers pelvis during labor
Molding
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Large patches of bluish skin on the buttocks of dark skinned infants
Mongolian spots
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Saclike protrusion along the vertebral column that is filled with spinal fluid, meninges, nerve roots and spinal cord
Myelomeningocele
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First few hours after birth where in the newborn makes changes to and stabilizes response and circulatory functions
Neonatal transition
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Environment in which the newborn can maintain internal body temperature with min oxygen consumption and metabolism
Neutral thermal environment
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Large reddish purplish birthmark usually found on te face or neck and does not blanch with pressure
Nevus flammeus
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Birthmark of enlarged superficial blood vessels, elevated and red in color
Nevus vascularis
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Metabolism of brown ft process of unique to the newborn
Nonshivering thermogenesis
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Inflammation of the newborns eyes that results from passing through the birth canal when a gonorrheal or chlamydial infection is present
Opthalmia neonatorum
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Condition where in the opening in the foreskin is so small that it canny be pulled back over the glans
Phimosis
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Blood tinged mucus discharge from the vagina
Of a newborn caused by the withdrawal of maternal hormones
Pseudomenstruation
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Loss of heat by transfer to cooler near objects but not through direct contact
Radiation
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Infants weight falls below the 10th percentile for gestational age
Small for gestarional age
-
Failure of the vertebral arch to close
Spina bifida occulta
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Fusion on two or more fingers or toes
Syndacryly
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A congenital deformity in which the foot and ankle are twisted inward and cannot be moved to a midline position also known
As club foot
Talipes equinovarus
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Birthmark of dilated capillaries that blanch with pressure also called stork bite
Telangiectasic nevi
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How may the ears seem?
Irregular and against the head
-
What are perocious teeth?
Teeth at birtg we remove to prevent aspirarion
-
What may the baby secrete?
Witches milk and engorged breats and last 2 weeks
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When is pseudomenstruation appear?
First week causes bu withdrawl of maternal hormones
-
-
This interstates with urination
Phimosis and ceyptorchidism
-
This disappears without treatment?
Hydrocele
-
Where is syndacrtly found?
On the 2nd and 3rd toe
-
Reflexes in newborns?
Moro, rooting, sucking, extrusion, palmar grasp, stepping, tonic neck
-
If rooting doesn't occur what shud u do and wen shud it disappear?
Rub side of the face or chin, 3-4wks
-
When sucking doesn't happen what to do and when does it go away?
Touch the lip, 10 mo
-
When extrusion doesn't happen and wen disappear?
Touch tip of tongue, 4 mo
-
Palmer grasp? Disappear?
The baby shud grasp finger when touch palm, 4 mo and if they dont grab could mean frontal lobe lesion
-
Stepping and when stop?
Holding hands of baby and standing up to see if they step ther feet, 3 mo
-
Tonic neck or fencing?
Turnin neck to one side, extremities on that side extend on the opposite side they flex, 6-8 wks
-
Upon birth of the fetus head what is suctioned?
Oropharynx 1st abd nasopharynx next
-
Compression of the fetal chest during birth causes increased intrathoracic pressure
Mechanical
-
What is absorbed with the first day after birth?
Alveolar fluid
-
Gaseous changes occur when the umbilical cord is clamped, mild asphyxia results and stimulates resp?
Chemical
-
Prolong asphyxia causes what?
CNS resp depressant
-
Neonate enters an environment about 20 degree cooler than the uterine environment, this change stimulates respirations
Thermal
-
Birth leads to auditory, visual and tactile stimuli
Sensory
-
Ductus arteriousus does what?
Reverses blood floe, resulting in more blood through pulmonary arteries
-
Closure of the ducts arteriousus happens when?
24 hra and permanent in 3-4 wks
-
When does the foramen ovule close? And permanent?
Within minutes ans permanebt in appx 3 mo
-
What does the ducts venosus do?
Stops blood flow when cord is clamped an causes blood the blood to flow to the liver like adults
-
How is heat production increased in the infant?
Increased by metabolic rste, muscular activity, crying, metabolism of brown fat
-
How does the neonate maintain the heat?
Staying in a flexed position
-
How does hypoxia occur?
Metabolism of brown fat
-
With prolonged cold stress this causes what?
Resp distress
-
Resp distress may also result in?
Hypoglycemia, metabolic acidosis and jaundice
-
What is the apgar score for?
Assess cardiopulmonary status, given immedistely after birth
-
When is the apgar score need no intervention?
8 or more
-
What does is mean with apgar score of 4-8?
Gentle stimulation and o2 administration is needed
-
Apgar score of 0-4?
Needs resusitation
-
Where and when are bands placed?
Asap after birth that are matching for mother and infant and on the infant ankle and wrist
-
When is vit k given and how?
-
When is vit k start to synthesize? Why?
8 days after birth to prevent hemorrhage
-
When is the hep vaccine given?
12 hrs and requires consent
-
What is used to treat ophthalmia ?
Erythromycin ointment or tetracycline ointment
-
When is the cord clamped and cut?
When pulsating stops
-
What do we teach ab umbilical cord?
To put alcohol on it several times daily to dry it out.
-
Norm weight for neonate?
5lb 8oz - 8lb 13oz
-
What is neonate temp?
97.6-98.9
-
Heart rate of neonate?
120-140
-
-
-
-
Blue coloring of hands and feet
Acrocyanosis
-
Edema is normal where on neonate?
Eyes, back of hands, legs, feet, labia/scrotum
-
Head circumference?
13-14in
-
Eye color is noted when?
3 mo
-
Chest measurements?
12-13 in
-
When can jaundice appear?
With in 24 hr and resolves in few weeks
-
Bruising related to diff delivery
Ecchymosis
-
When does petechiae show?
RT difficult delivery
-
Baby acne, sebaceous glands, resolve with normal hygiene
Milia
-
Molding reolves when?
2-3 days
-
Caput succedaneum resolves?
2-3 days
-
Cephalhematoma resolves?
3-6 days
-
When does stanismus eyes disappear?
3-4mo
-
Baby can be have what in mouth?
Percocious teeth, epsteins pearls, resolves in wks
-
Chest may appear how?
Engorged, witches milk
-
Respiration of quiet sleep?
100-120
-
First period of rest?
30 min, alert active, best bonding, sucking strong
-
Second period of rest?
4-6 hrs, awake and alert, v/s fluctuations,
-
what is rooting reflex? and if not present what can it determine?
stroking skin at one corner of infants mouth, the infant should turn head toward it, disppears 3-4 mo and cant indicate frontal lobe lesion
-
what is the sucking reflex? occurs when?
touching newborns lips, occurs up to 10 mo
-
if a mother is on barbiturates while breastfeeding what can this cause the baby to do?
it causes no sucking reflex in the baby due to CNS depression
-
extrusion reflex? when does it disappear?
when tip of the tongue is touched or depressed, the infant should force the tongue outward, disppears 4 mo of age
-
Palmar grasp? when does it disappear? and if not applicapable what is indicated?
when a finger is placed across the pal, the infants fingers flex and grasp, 4 mo it should be in affect and can indicate frontal lobe lesions.
-
plantar grasp?
when the infants leg is held in one hand and the planted surface of the foot is touhed below the toes with the other hand and the toes will curl downward, last until 8 mo of age. if absent with one foot obstructive lesions are suspected, with both feet neurological alterations such as cerebral palsy
-
tonic neck? or fencing?
lay baby supine and which ever way you face jaw the legs and arms should extend while the other side should flex, last 6 mo, if after cerebral damage is suspected. may not happe until 6-8 wks
-
moro relfex?
when lying supine or semisitting with head 30 degree, you slap a side and the affected side the baby should extend and make a "C" while other side adducts with embracing motion, disappears 4-6 mo and if doesnt, could mean brain damage
-
gallant reflex?
when baby is prone with hands under abd and nurse strokes side of spine and baby should turn buttom and legs that way, if no repsonse spinal cord lesions suspected, present till 2 mo
-
stepping reflex?
newborn held under arm with feet placed on firm surface, infant should lift alternate feet as if walking, disappears 3 mo of age
-
Babinskis reflex?
when stroking the plantar surefave lateral heel area upward the greater toe should dorsiflex while other toes fan out, present after baby has mastered walking
-
crossed extension reflex?
supine holding one leg extended with the knee pressed down and stimulating the bottom of that foot, the other leg should flex, adduct and extend , present in 4 wks of birth
-
placing reflex?
infant held under arms from behind then brought to a standing position, touching the dorsum of one foot to the edge of the table, the affected leg will lift on the table, breech babies and cerebral cortex diff may not respond
-
quiet sleep?
resp regular 100-120, stimuki wont alter newborn state
-
active sleep?
resp rapid, irregular, sucking, stretching, face movement
-
when must the gestational age be determined?
first 4 hrs after birth
-
on a baby assessment what should be assessed first and what for?
posture, should be flexed and for neuromuscular maturity
-
umbillicus assessment?
2 arteries 1 vein
-
what decreases SIDS?
pacifier
-
what type of bath for first 10 days?
sponge bath
-
when can tub baths be used?
after cord falls off
-
how do we circumcise?
only full term babies, put 20% sucrose analgesic on pacifier, new ointment every 24-48 hrs
-
is light bleed ok for circumcision?
yes! may apply 4x4 if needed
-
how many wet diapers after circumcision
6-10
-
signs of hunger?
fussy, wide awake, sucking on hands, rooting
-
position for feeding?
cradle, foot ball, side lying or across the lap hold
-
physiologic jaundice?
appears after 24 hours caused by fetal bllod cells recycling
-
pathologic jaundice?
appears prior 24 hrs, can be avoided with rhogam shot or lead to kernicterus (retardation)
-
should we increase fluids for babies with jaundice?
YES
-
who is associated with RDS?
preterm infants and surfactant deficiency
-
what is noted with nasal flaring and grunting?
Transient tachypnea of newborn, shortly after birth.
-
how should cleft lip babies sleep?
side lying
-
sac containing csf and meninges? how to treat this?
meningocele, and surgery, no long term effects
-
sac containing csf, meninges, nerves, spinal cord, how to treat?
myelomeningocele amd may cause paralysis
-
symptoms of trisomy 21?
short low set ears, broad neck, tansverse palmar crease, slanted eyes
-
what are down syndrome babies at increased risk for?
cardiac anomolies, GI defect, endocrine disorders and leukemia
-
Talipes Equinovarus or club foot?
where foot and ankle turn inward, may be able to correct and wear cast
-
what is necessary for production of surfactant?
lecithin
-
when do withdrawl symptoms begin after birth for infant of substance abuse?
6-48
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