Newborn and Neonatal Care Part 2

Flashcards covering key concepts from the 'Newborn and Neonatal Care Part 2' lecture, including neonatal statistics, maternal and newborn history, physical examination components, APGAR scoring, anthropometric measurements, common newborn conditions, Ballard Score, and essential newborn care practices and legislation.

What percentage of under-5 mortality in the Philippines is accounted for by newborn deaths?

48%

What is the neonatal mortality rate in the Philippines per 1000 live births?

14/1000 live births

What are the primary causes of newborn deaths in the Philippines?

Prematurity, Asphyxia, Congenital anomalies, Infection/sepsis, Pneumonia.

What demographic information about the mother is important in maternal history during birth?

Age, parity, and gravidity.

What work-ups are typically done during prenatal care that are relevant to maternal history?

CBC plt, urinalysis, Group B Streptococcus screening, HbsAG, test for syphilis, ultrasound, oral glucose tolerance test.

What aspects of an infant's history does 'Newborn History' concentrate on?

Infant’s birth, growth and development, and any potential concerns or issues since birth, including maternal health before, during, and after pregnancy.

What maternal age and reproductive factors are included in prenatal history?

Mother’s age and reproductive history.

What key observations are noted in postnatal history immediately after birth?

APGAR Score, need for immediate resuscitation, presence of cyanosis, pallor or jaundice, signs of respiratory distress, feeding difficulties, congenital anomalies, birth injuries, anthropometric measurements.

What is noted regarding membrane rupture during the peripartum period?

Premature rupture of membrane (>18 hours prior to delivery).

When should an initial physical examination of a newborn infant ideally be performed?

Within 24 hours of birth.

What is the typical heart rate range for a newborn in the first 15-30 minutes after birth?

Immediately tachycardia to 160-180 bpm with gradual drop to 100-120 bpm.

What is a common gastrointestinal event that occurs in the next 60-90 minutes after birth?

Usually passage of meconium.

What are the primary physiological parameters measured by the APGAR score?

Color, Respirations, Heart rate.

What neurological parameters are measured by the APGAR score?

Muscle tone, Reflex tone.

An APGAR score of what range at 5 minutes indicates a normal condition for a newborn?

8-10.

What APGAR score requires immediate resuscitation?

0-3.

What is the normal core temperature range for a stable newborn?

36.5-37.5 degrees Celsius.

What is the normal heart rate range for a stable newborn when active?

120-160 bpm.

What anthropometric measurements provide essential insights into a newborn's growth, development, and overall health?

Weight, length, head, and abdominal circumference.

What is the normal head circumference range for Filipino babies?

33-35 cm.

How is chest circumference measured in a newborn?

Tape is placed around the chest at the level of the nipples, recorded midway between inspiration and expiration, without pressing tightly.

What does it mean if an infant is classified as Large for Gestational Age (LGA)?

The infant's weight is in the 90th percentile for neonates of the same gestational age.

What is the most common cause of a newborn being Large for Gestational Age (LGA)?

Maternal diabetes.

What does it mean if an infant is classified as Small for Gestational Age (SGA)?

The infant's birth weight is below the 10th percentile.

What are some causes of Small for Gestational Age (SGA)?

Anything restricting uteroplacental blood flow, smoking, DM (diabetes mellitus), PIH (pregnancy-induced hypertension), infections.

What distinguishes Symmetric Small for Gestational Age (SGA)?

Onset early in gestation, with brain size corresponding to body size.

When should the Ballard Score typically be performed?

As soon as possible after initial stabilization or within 12 hours of life.

What two main parts comprise the Ballard Score?

Neuromuscular maturity and Physical maturity.

What physical findings are associated with prematurity in infants?

Thin, translucent skin; reduced muscle tone; and immature reflexes.

What is Acrocyanosis?

Benign bluish discoloration of the hands and feet in newborns due to immature circulation in small blood vessels of the extremities.

What is Vernix Caseosa?

A greasy white substance that covers the skin, providing a moisture barrier.

What are 'Mongolian Spots'?

Flat, bluish-gray patches typically found on the lower back and buttocks of newborns.

What is the typical shape and closing time of the anterior fontanel?

Diamond-shaped, closes between 9-18 months.

What is the key differentiating factor between Cephalhematoma and Caput Succedaneum?

Cephalhematoma does not cross the suture line, while Caput Succedaneum crosses the suture line.

What chest observation might suggest Turner syndrome?

Widely spaced nipples with a shield-shaped chest.

What is the normal umbilical cord composition?

2 arteries and 1 vein.

What are the two types of Brachial Palsies mentioned and which nerve roots are affected?

Erb-Duchenne palsy (C5-C6) and Klumpke palsy (C7-C8, T1).

What are the core principles of Essential Intrapartum and Newborn Care (EINC)?

Immediate & thorough drying, skin-to-skin contact, properly timed cord clamping, and non-separation of mother and baby for early initiation of breastfeeding.

What ophthalmic ointment is applied to newborns' eyes to protect against gonococcal ophthalmia neonatorum?

Erythromycin (0.5%) or tetracycline (1.0%) sterile ophthalmic ointments.

What injection is given to all infants shortly after birth to prevent hemorrhagic disease of the newborn?

Intramuscular injection of 0.5-1 mg of water-soluble Vitamin K1 (phytonadione).

What vaccines and screenings are typically administered/performed upon delivery for newborns in the Philippines?

Hepatitis B vaccine, BCG Vaccine, Hearing Screening, and Newborn Screening.

Which Philippine legislation is known as the 'Milk Code'?

Executive Order 51.

Which Philippine legislation mandates rooming-in and breastfeeding?

Republic Act 7600 (Rooming-In and Breastfeeding Act).