High Risk Newborn Quiz: Altered Gestational Age or Birth Weight

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Questions and Answers

What is the term used to describe infants who fall between the 10th and 90th percentile of weight for their gestational age?

Small for Gestational Age (SGA)

Appropriate for Gestational Age (AGA) (correct)

Preterm Infant

Large for Gestational Age (LGA)

What is one of the most common problems for Small for Gestational Age (SGA) infants?

Respiratory Distress Syndrome

Hypoglycemia (decreased blood glucose) (correct)

Congenital Abnormalities

Jaundice

What is a common problem for Small for Gestational Age (SGA) infants due to their underdeveloped chest muscles and risk of meconium aspiration syndrome?

Feeding difficulties

Retinopathy of Prematurity

Intraventricular Hemorrhage

Birth asphyxia (correct)

What physical characteristic of Small for Gestational Age (SGA) infants may indicate their lack of normal bone growth?

Widely separated skull sutures Signup and view all the answers

What is the term used to describe infants who are above the 90th percentile of weight for their gestational age?

Large for Gestational Age (LGA) Signup and view all the answers

What is a potential consequence of being Small for Gestational Age (SGA) that may have occurred due to lack of oxygen and nourishment in utero?

Cognitive development impairment Signup and view all the answers

What is the most likely cause of respiratory difficulties in some LGA infants at birth?

Increased intracranial pressure from the larger-than-usual head Signup and view all the answers

Which of the following is NOT a common finding in a small-for-gestational-age (SGA) infant?

Enlarged abdomen Signup and view all the answers

What is the most serious type of ABO incompatibility in newborns?

Type B Signup and view all the answers

What is the primary cause of hyperbilirubinemia in newborns?

Abnormal destruction of red blood cells Signup and view all the answers

What is the purpose of using phototherapy in the management of hyperbilirubinemia in newborns?

To convert bilirubin to a more water-soluble form for excretion Signup and view all the answers

What is the purpose of performing an exchange transfusion in the management of hyperbilirubinemia?

To decrease bilirubin levels Signup and view all the answers

Which of the following conditions is associated with large for gestational age (LGA) infants?

Transposition of the great vessels Signup and view all the answers

What is a common characteristic of small for gestational age (SGA) infants?

Wasted appearance Signup and view all the answers

Which of the following is a potential problem for large for gestational age (LGA) infants?

Jaundice Signup and view all the answers

What condition is characterized by overgrowth and associated with large for gestational age (LGA) infants?

Beckwith syndrome Signup and view all the answers

Which of the following is a potential problem for small for gestational age (SGA) infants?

Hypoglycemia Signup and view all the answers

What is a potential birth injury associated with large for gestational age (LGA) infants?

Cephalohematoma Signup and view all the answers

Study Notes

Altered Birth Weight

Infants are assessed after birth to determine weight, height, head circumference, and gestational age to determine immediate needs.
Birth weight increases for each additional week of age.
Infants who fall between the 10th and 90th percentile of weight for their gestational age are considered appropriate for gestational age (AGA).

Small-for-Gestational-Age (SGA) Infants

SGA infants have decreased glycogen stores, making them prone to hypoglycemia (decreased blood glucose, or a level below 45 mg/dL).
SGA infants are at risk for birth asphyxia, meconium aspiration syndrome, and cognitive development impairment due to lack of oxygen and nourishment in utero.
Physical characteristics:
- Below average weight, length, and head circumference
- Wasted appearance
- Small liver
- Poor skin turgor
- Widely separated skull sutures
- Dull, lusterless hair
- Sunken abdomen
- Cord dry and yellow-stained
Laboratory results:
- Elevated hematocrit (Hct)
- Polycythemia
- Prolonged acrocyanosis
- Hypoglycemia (20 mg/dL in term infants, 12 mg/dL in preterm infants)

Management of SGA Infants

Intrauterine transfusions
Induced preterm labor
Phenobarbital
Rh immunoglobulin for ABO incompatibility

Large-for-Gestational-Age (LGA) Infants

LGA infants may have difficulty establishing respirations at birth due to birth trauma and increased intracranial pressure.
Physical characteristics:
- Large head size
- Immature reflexes
- Low scores on gestational age examinations
- Extensive bruising or birth injury (e.g., broken clavicle or Erb-Duchenne)
- Prominent caput succedaneum, cephalhematoma, or molding
Common problems:
- Hyperbilirubinemia (increased serum bilirubin level)
- Hypoglycemia in early hours of life
- Cyanosis (may indicate transposition of the great vessels)

Rh Incompatibility and Hemolytic Disease of the Newborn

Causes:
- Destruction of red blood cells (RBCs) by normal physiological process
- Abnormal destruction of RBCs due to Rh or ABO incompatibility
Results in severe anemia and hyperbilirubinemia
Management:
- Initiation of early feeding
- Phototherapy (quartz halogen, cool white daylight, blue fluorescent)
- Exchange transfusion (if level exceeds 5 mg/dL at birth, 10 mg/dL at age 8 hrs, 12 mg/dL at age 16 hrs, or 15 mg/dL at age 24 hrs)

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Description

This quiz covers the concept of altered gestational age or birth weight in high risk newborns. Learn about assessing infants after birth to determine weight, height, head circumference, and gestational age, and managing their immediate needs promptly.

High Risk Newborn: Altered Gestational Age or Birth Weight

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