Infant Scoring and Assessment Quiz

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Questions and Answers

What is the correct placement for ointment application in the eyes?

Around the eyes to provide a protective barrier.

Inside the lower lids from inner canthus to outer. (correct)

Inside the upper lids and close the eyes.

On the surface of the eyeball while holding it open.

What should be done with excess ointment after application?

Gently wipe it away after 1 minute. (correct)

Leave it on to absorb into the eye.

Rub it into the skin around the eye.

Rinse it off with water immediately.

What is a significant consideration for neonatal units regarding noise levels?

Loud environments can enhance sensory development.

Neonates have a weak response to auditory stimuli.

Neonates exhibit an autonomic response to auditory stress. (correct)

High noise levels can promote sleep.

Which of the following is NOT a recommended practice for eye ointment application?

Applying ointment while the eyes are open. Signup and view all the answers

Why is it important to manage noise levels in neonatal units?

To protect neonates from excessive auditory stress. Signup and view all the answers

Which condition is characterized by an inability to digest protein due to a deficiency of a liver enzyme?

Phenylketonuria (PKU) Signup and view all the answers

What is the first symptom that typically appears in infants with PKU?

Poor feeding effort Signup and view all the answers

Which of the following is NOT typically included in newborn genetic screening tests?

Maternal alcohol syndrome Signup and view all the answers

Which enzyme deficiency is associated with medium-chain acyl-CoA dehydrogenase disorder?

Autosomal recessive Signup and view all the answers

What is the primary medication used for eye prophylaxis in newborns?

Erythromycin eye ointment Signup and view all the answers

Which benefit of Kangaroo Care can significantly affect the weight gain of an infant?

Decreased episodes of apnea Signup and view all the answers

What is the primary risk of incorrect placement of skin temperature probes on an infant?

Overheating the infant leading to hyperthermia Signup and view all the answers

What criterion must be met for an infant to be considered in a neutral thermal environment (NTE)?

Minimal use of energy to maintain normal body temperature Signup and view all the answers

Which of the following is NOT a benefit of Kangaroo Care to the mother?

Improvement in maternal physical health Signup and view all the answers

What is a significant institutional benefit of implementing Kangaroo Care?

Reduced morbidity and mortality rates Signup and view all the answers

Which area is commonly recommended for placing a skin temperature probe for an infant in a supine position?

Over the liver Signup and view all the answers

What is the optimal room temperature for the effective use of radiant heat devices?

Above 25°C Signup and view all the answers

What is a potential consequence of placing an infant under radiant heat warmers for an extended period?

Dehydration Signup and view all the answers

What is the primary component of colostrum produced by mothers in the first few days after birth?

High in protein and antibodies Signup and view all the answers

What are the caloric needs for a full-term infant for adequate growth?

100 to 120 cal/kg/day Signup and view all the answers

What is the predominant carbohydrate found in breast milk?

Lactose Signup and view all the answers

What can increase the caloric needs of a neonate?

Thermal stress or cold stress Signup and view all the answers

What is the recommended daily calorie intake for a premature infant per kilogram of body weight?

110 to 160 cal/kg/day Signup and view all the answers

How does mixing formula incorrectly affect kidney health in infants?

There is no chance of causing kidney damage Signup and view all the answers

What is the most likely cause of transient tachypnea of the newborn (TTN)?

Fluid retention in the lungs Signup and view all the answers

Which symptom is NOT commonly associated with respiratory distress syndrome (RDS)?

Poor feeding due to increased respiratory rate Signup and view all the answers

Which intervention is part of the management for TTN?

Monitoring oxygen saturation levels Signup and view all the answers

What laboratory finding is indicative of TTN in a neonate?

Hypoxia on arterial blood gas analysis Signup and view all the answers

Which factor is NOT a risk associated with the development of respiratory distress syndrome (RDS)?

Being born at term Signup and view all the answers

What is a symptom of moderate birth asphyxia related to body temperature?

Hypothermia Signup and view all the answers

Which action is indicated for severe birth asphyxia management in an infant?

Providing supplemental oxygen Signup and view all the answers

Which of the following is NOT part of the minimum neonatal resuscitation equipment?

Laser surgery equipment Signup and view all the answers

What indicates respiratory distress in a moderately asphyxiated infant?

Elevated heart rate Signup and view all the answers

What complication is linked with severe birth asphyxia, requiring careful monitoring?

Cerebral edema Signup and view all the answers

Which type of IV fluids are typically used for neonatal resuscitation?

Dextrose 10% in water Signup and view all the answers

What is a possible sign of hypoglycemia in a moderately asphyxiated newborn?

Hypotonia Signup and view all the answers

Which drug is essential for resuscitation equipment in the neonatal unit?

Epinephrine Signup and view all the answers

What characteristic indicates severe bradycardia in a newborn?

Heart rate below 100 beats per minute Signup and view all the answers

Which monitoring equipment is essential for assessing oxygen levels in a neonate?

Pulse oximeter Signup and view all the answers

What percentage of total daily calories should lipids ideally supply?

40-52% Signup and view all the answers

What is the primary reason preterm infant formulas contain higher protein content than term formulas?

To support increased growth requirements. Signup and view all the answers

Which of the following is NOT a risk associated with circumcision?

Decreased muscle growth. Signup and view all the answers

What mechanism does a fetal distress signal represent during birth asphyxia?

Increased fetal heart rate. Signup and view all the answers

How long should the Plastibell remain in place after circumcision before it generally falls off?

3-4 days Signup and view all the answers

Which of the following accurately describes how medium-chain triglycerides (MCTs) benefit premature infants?

They are absorbed without pancreatic lipase or bile salts. Signup and view all the answers

What Apgar score is generally indicative of an infant experiencing birth asphyxia at birth?

4 or less Signup and view all the answers

What is a common symptom of birth asphyxia observed in infants within the first hour after birth?

Overly alert state Signup and view all the answers

What should be done to the glans during circumcision to promote healing?

Cover with petrolatum gauze. Signup and view all the answers

What is a consequence of inadequate oxygen delivery to the fetus during birth asphyxia?

Switch to anaerobic metabolism. Signup and view all the answers

Study Notes

Infant Scoring Criteria

Scoring assesses infants' awake or sleep states, looking at multiple areas of response.
Habituation: Ability to reduce response to repetitive stimuli.
Visual and Auditory Orientation: Response to stimuli, fixation, and tracking objects.
Motor Activity: Evaluation of body tone during various activities.
Variations: Observations of changes in color, state, activity, alertness, and excitement.
Self-Quieting Activities: Frequency and speed of calming behaviors, such as sucking or focusing.
Social Behaviors: Capacity to engage physically and emotionally with caregivers.

Phenylketonuria (PKU)

Inborn metabolic disorder due to a deficiency in the enzyme converting phenylalanine to tyrosine.
Symptoms of PKU may present before 3 months, including vomiting, poor feeding, and irritability.
Untreated infants may develop eczema and have musty-smelling urine.
Strict dietary management is necessary to limit phenylalanine intake to prevent intellectual disability.
Mandatory screening for PKU within 7 days of birth across all states.

Newborn Genetic Disease Screening

Genetic disease screenings differ by state; approximately 1 in 200 newborns may have chromosomal abnormalities.
Common screenings include:
- Biotinidase Deficiency
- Congenital Adrenal Hyperplasia
- Congenital Hearing Loss
- Congenital Hypothyroidism
- Cystic Fibrosis
- Galactosemia
- Homocystinuria
- Maple Syrup Urine Disease
- Medium Chain Acyl-CoA Dehydrogenase Deficiency
- Phenylketonuria
- Sickle Cell Disease
- Tyrosinemia

Eye Prophylaxis

Most states require eye prophylaxis for newborns, but parents may refuse if prenatal care was adequate.
Common medications include erythromycin ointment, tetracycline ointment, and silver nitrate drops, with erythromycin being preferred.
Application technique involves spreading ointment on lower eyelids with minimized irritation.

Benefits of Kangaroo Care

Infant Benefits: Improves temperature regulation, calms stress, promotes weight gain, and enhances mother-infant bonding.
Maternal Benefits: Increases milk production, confidence in infant care, and opportunities for teaching by nursing staff.
Institution Benefits: Facilitates earlier hospital discharge and reduces morbidity and mortality.

Thermoregulation Monitoring

Temperature probes need correct placement to avoid inaccurate readings and ensure appropriate heat delivery.
Probes should avoid bony areas and regions with dense brown adipose tissue to prevent temperature misinterpretation.
A neutral thermal environment conserves energy and maintains normal body temperature without metabolic adjustments.

Nutritional Needs for Infants

Calories: Caloric intake varies by age, weight, and health, with full-term infants needing 100-120 cal/kg/day and preterm infants needing 110-160 cal/kg/day.
Macronutrients: Essential proportions:
- Carbohydrates: 40-50% of total calories, primarily lactose.
- Fats: Around 40-52% of total calories with emphasis on medium-chain triglycerides (MCT) for preterm infants.
- Proteins: Less than 5% of total daily calories, with higher requirements for preterm infants.

Circumcision Overview

Surgical procedure involving the removal of the penis foreskin; current prevalence in the U.S. is around 50%.
Pros include reduced risk of infections and certain diseases, while cons involve potential complications and pain.
Local anesthesia is recommended during the procedure; post-operative care emphasizes healing and prevention of irritation.

Respiratory Issues in Newborns

Birth asphyxia affects gas exchange, leading to oxygen deprivation and subsequent fetal distress.
Symptoms of moderate birth asphyxia include hypothermia, hypoglycemia, and lethargy.
Transient Tachypnea of Newborn (TTN): Commonly follows cesarean delivery, resolving within 3 days with symptoms like tachypnea and respiratory distress.
Respiratory Distress Syndrome (RDS): Common in preterm infants, characterized by inadequate surfactant production leading to severe respiratory issues and potential complications.

Neonatal Pneumonia

Caused by intrauterine infections or nosocomial infections; symptoms often resemble those of respiratory distress.
Treatment includes antibiotics and supportive care, focusing on thermoregulation and blood glucose maintenance.

Meconium Aspiration Syndrome (MAS)

Occurs when meconium is aspirated before, during, or after birth, leading to respiratory complications.
Symptoms include tachypnea, cyanosis, and potential long-term respiratory issues; treatment involves suctioning and supportive therapies.### Hyperbilirubinemia Overview
Hyperbilirubinemia indicates an excess of bilirubin in the blood leading to jaundice.
Evaluated via direct (conjugated) and indirect (unconjugated) bilirubin levels.

Types of Bilirubin

Direct/conjugated bilirubin: Elevated due to bile duct blockage, hepatitis, or liver damage.
Indirect/unconjugated bilirubin: Increased with hemolytic anemias and transfusion reactions.

Types of Hyperbilirubinemia

Physiologic Hyperbilirubinemia:
- Common in newborns; usually benign.
- Caused by immature liver function and increased RBC hemolysis.
- Newborn RBCs have shorter lifespans, leading to more bilirubin.
- Onset: 24-48 hours post-birth; peaks at 72 hours for full-term or 5 days for preterm infants.
- Declines within a week; phototherapy indicated for bilirubin levels ≥18 mg/dL.
Hemolytic Hyperbilirubinemia:
- Triggered by Rh blood group incompatibility; onset within the first 24 hours.
- Preventive treatment options include RhoGAM® prenatally or post-natal exchange transfusion.
- Can also result from ABO incompatibility, but usually only requires phototherapy.
Breast-feeding Associated Jaundice:
- Linked to inadequate caloric intake during early breastfeeding; onset at 2-3 days.
- Slower stool excretion leads to rising bilirubin levels.
- Increased feeding frequency with caloric supplements often sufficient; phototherapy for bilirubin levels 18-20 mg/dL.
Breast Milk Jaundice:
- Occurs when components in breast milk affect bilirubin breakdown and reabsorption in the gut.
- Characterized by infrequent stools; onset between 4-5 days, peaking at 10-15 days.
- Jaundice may last for several weeks; treatment involves stopping breastfeeding for 24 hours.

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Description

This quiz explores the various scoring methods used to evaluate infants based on their awake or sleep states. Topics include habituation, response to visual and auditory stimuli, and overall motor activity. Test your understanding of infant assessment techniques and their implications.