OB final - Newborn 1

Question 1

when is meconium suctioning done

Answer 1

when infant is pale, limp and have no respiratory effort or tone
healthy babies just get bulb suction

Question 2

which way do you milk the umbilical cord

Answer 2

towards the baby

Question 3

components of apgar

Answer 3

heart rate
respiratory effort
muscle tone
reflex irritability
color

Question 4

normal newborn vitals

Answer 4

• pulse: 110-160 (can go to 80 during sleep & 180 during crying)
• temp: 97.7-99.5
• res: 30-60

Question 5

changes in respiration: mechanical

Answer 5

during the birth process, the fetal chest is compressed and squeezes fluid out
c section babies are more prone to fluid in the lungs & moms who had quick labor

Question 6

changes in respiration: chemical stimuli

Answer 6

the first breath is triggered by increased pCO2 and decreased pH and pO2 triggers brain respiratory center to breath, this is a natural result of a normal vaginal birth

Question 7

changes in respiration: thermal stimuli

Answer 7

• decrease in environmental temp after birth
• newborn responds w/ increase in respirations
  avoid prolonged exposure to cold

Question 8

changes in respiration: sensory stimuli

Answer 8

• lights
• sounds
• gravity
• touch

Question 9

periodic breathing

Answer 9

when the baby pauses in respiration for up to 20 seconds & that is considered normal

Question 10

apneic breathing

Answer 10

when breathing breaks are greater than 20 seconds & is considered abnormal

Question 11

transient tachypnea of the newborn

Answer 11

progressive respiratory distress noted by at least 6 hours of age until 72 hours in more severe cases caused by
- LGA, late preterm, maternal over sedation, maternal bleeding, prolapsed cord, breech birth, maternal DM, C sections

Question 12

transient tachypnea treatment

Answer 12

• chest xray
• oxyhood
• IV fluids or feeding tube

Question 13

what can stimulate development of surfactant in the alveoli

Answer 13

• giving mother betamethasone
• rupture of membranes

Question 14

respiratory distress is treated by

Answer 14

• oxygen therapy
• surfactant administration
• thermoregulation
• ECMO

Question 15

newborn circulation

Answer 15

• enhances perfusion of body systems
• increased systemic vascular resistance
• decreased pulmonary vascular resistance
• closure of ductus arteriosus so that blood goes from the aorta to the pulmonary artery
• closure of the ductus venosus which forces perfusion to the liver

Question 16

when should the foramen ovale close after birth

Answer 16

within 2 hours

Question 17

at birth blood pressure is “” and is “” around 3 hours of age

Answer 17

highest, lowest

Question 18

convection heat loss in babies

Answer 18

loss of heat from warm body surface to the cooler air temps

Question 19

radiation heat loss in babies

Answer 19

heat is transferred from the heated body surface to a cooler surface or object not in direct contact with the baby

Question 20

evaporation heat loss in babies

Answer 20

loss of heat when water turns to vapor

Question 21

conduction heat loss in babies

Answer 21

loss of heat to a cooler surface by direct content

Question 22

causes of heat loss

Answer 22

• large surface area to body mass ratio
• decreased subQ fat
• increase body water content
• immature skin leading to increase evaporative water & heat losses
• poorly developed metabolic mechanism for responding to thermal stress
• altered skin blood flow

Question 23

why are preterms are at an even higher risk for thermoregulation issues

Answer 23

• lack a flexed posture for preserving heat
• very thin skin w/ capillaries close to the surface

Question 24

S/s of hypothermia

Answer 24

• acrocyanosis
• hypoglycemia
• transient hyperglycemia
• bradycardia
• tachypnea
• res distress
• decreased activity/lethargy
• feeble cry & poor feed
• decrease wt gain

Question 25

S/s of hyperthermia

Answer 25

- tachy - apnea - warm extremities, flushing, perspiration - dehydration - lethargic - poor feeding - irritability - weak cry

Question 26

consequences of hypertermia

Answer 26

- hypotension & dehydration - seizures & apnea - hypernatremia - res distress

Question 27

mgt of hyperthermia

Answer 27

- adjust environmental conditions - move baby away from source of heat - allow air temp if not already - breastfeed frequently

Question 28

when does brown fat begin to form and stay until

Answer 28

26-28 weeks gestation and used until 3-5 weeks after birth for temp regulation

Question 29

cephalohematoma

Answer 29

a collection of blood that results from ruptured blood vessels between the cranial bone and the periosteum membrane **bleeding does not cross the sutures, which is a distinguishing factor**

Question 30

what is a risk for babies with cephalohematoma

Answer 30

they have an increased risk for jaundice because the blood is going to have to break down so they're going to have increased bilirubin + risk for anemia and hypotension

Question 31

caput succedaneum

Answer 31

soft tissue swelling that is in a localized soft area of the scalp and it does cross the sutures

Question 32

transient strabismus

Answer 32

cross eyed -> not treated at birth

Question 33

doll eyes

Answer 33

if you turn the baby, their eyes will go in the opposite direction d/t underdeveloped head eye coordination

Question 34

epstein pearls

Answer 34

small cysts in the mouth that are harmless and will go away

Question 35

how do you dx tethered cord syndrome and what does it cause

Answer 35

**sacral dimple on exam then xray** can lead to weakness, numbness, and bladder/bowel problems

Question 36

phimosis

Answer 36

small opening of the foreskin that cannot be retracted causing urination problems

Question 37

hydrocele

Answer 37

fluid surrounding testes and scrotum

Question 38

cryptorchidism

Answer 38

failure of the testes to descend

Question 39

when do stork bites heal

Answer 39

by age 2

Question 40

nevus flammeus (port wine stain)

Answer 40

a capillary angioedema that is below the epidermis which is non elevated and looks red/purple on the face and it does not go away

Question 41

strawberry mark

Answer 41

a capillary human genomia that is newly formed in enlarged capillaries in the dermal and sub dermal layers. they are raised, dark red and rough **type of birthmark that grows rapidly but later may shrink and resolves spontaneously**