Pediatric and Adolescent Medicine 1: Module 2
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Questions and Answers

What is the normal heart rate range for a newborn at rest?

  • 100-165 beats/min (correct)
  • 90-160 beats/min
  • 80-140 beats/min
  • 120-180 beats/min

    • How much does a typical infant's weight change in the first week after birth?

  • Remains unchanged
  • Increases by 10% of birth weight
  • Regains 5-10% of their birth weight
  • Drops up to 5-10% of their body weight (correct)

    • By how much does the head circumference of an infant increase on average per month during the first year?

  • 2 cm/month
  • 3 cm/month
  • 1 cm/month (correct)
  • 0.5 cm/month

    • At what age does an infant typically triple their birth weight?

    <p>One year (A)</p> Signup and view all the answers

    What is the average length of a newborn at term birth?

    <p>51 cm (C)</p> Signup and view all the answers

    What is the primary factor influencing neonatal history?

    <p>Maternal and family history (B)</p> Signup and view all the answers

    What Apgar score range indicates a newborn is at high risk for central nervous system or organ dysfunction?

    <p>0-4 (C)</p> Signup and view all the answers

    Which of the following components is NOT part of the Apgar scoring system?

    <p>Weight (A)</p> Signup and view all the answers

    When should Apgar scores be obtained?

    <p>At 1 minute and 5 minutes after birth (D)</p> Signup and view all the answers

    Which of the following is NOT typically included in a child's history during a pediatric evaluation?

    <p>Travel history (B)</p> Signup and view all the answers

    Which vital sign is considered normal for a newborn?

    <p>Heart rate of 110 bpm (C)</p> Signup and view all the answers

    What does the term 'acrocyanotic' refer to in a newborn?

    <p>Cyanosis of the extremities (C)</p> Signup and view all the answers

    What aspect of history is crucial to obtain before assessing a neonate's developmental status?

    <p>Maternal health history (C)</p> Signup and view all the answers

    Which of the following is NOT a component of a neonatal evaluation?

    <p>Family medical history (D)</p> Signup and view all the answers

    What is the purpose of obtaining an Apgar score?

    <p>To assess the infant's overall well-being and need for immediate care (C)</p> Signup and view all the answers

    Which components are NOT included in the Apgar score?

    <p>Body temperature (C)</p> Signup and view all the answers

    What is the significance of an Apgar score of 5-7 at 1 minute?

    <p>The infant may need some intervention, but is not in immediate danger. (A)</p> Signup and view all the answers

    Which of the following is NOT a component of the Apgar scoring system?

    <p>Head circumference (C)</p> Signup and view all the answers

    A newborn's heart rate is measured at 95 bpm while sleeping. Considering the provided ranges, this would be considered:

    <p>Within the normal sleeping range (C)</p> Signup and view all the answers

    An infant is 3 months old. Approximately what percentage of their birth weight should they have gained, based on the information given?

    <p>Approximately 50% of their birth weight (C)</p> Signup and view all the answers

    A newborn's length is measured at 50 cm at birth. If growth proceeds as expected, what is the approximate expected length at 1 year of age?

    <p>Approximately 75 cm (C)</p> Signup and view all the answers

    An infant's head circumference at birth is measured at 33 cm. Assuming average growth, what would be the approximate head circumference at 6 months?

    <p>Approximately 39 cm (A)</p> Signup and view all the answers

    At a 5 minute Apgar assessment, a newborn displays a heart rate of 92 bpm, respirations of 27 bpm and demonstrates a grimace as the only reaction to stimuli. Based on this, which of the following would be the most appropriate intervention?

    <p>Administer supplemental oxygen and continue to stimulate, as the resp and other vitals are slightly below the normal range. (C)</p> Signup and view all the answers

    Flashcards

    What is the normal respiratory rate for a newborn?

    The number of breaths a newborn takes per minute. It can range from 40 to 60 breaths per minute.

    What is the average weight of a full-term newborn?

    The average weight of a full-term newborn is between 7 pounds 9 ounces and 13 pounds.

    What happens to a newborn's weight in the first week?

    Newborns typically lose 5-10% of their birth weight in the first week, but they should regain it within 7-10 days.

    How much does a baby's head grow in the first year?

    The head circumference of a newborn usually grows about 1 centimeter each month during their first year of life.

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    What is the average head circumference at birth?

    The average head circumference at birth is 35 centimeters.

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    Maternal history

    Information about the mother's health, previous pregnancies, labor and delivery, and her overall health since delivery.

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    Family & genetic history

    Information about the family's medical history and genetic background.

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    Apgar score

    The first assessment of a newborn's physical condition, performed at 1 minute and 5 minutes after birth.

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    Severe depression

    A score of 0-4 on the Apgar scale indicates a newborn is experiencing severe depression, requiring immediate medical attention.

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    Some CNS depression

    A score of 5-7 on the Apgar scale indicates a newborn is experiencing mild depression and may require monitoring.

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    Normal Apgar

    A normal Apgar score at 1 minute and 5 minutes indicates a healthy newborn with no signs of distress.

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    Apgar scoring components

    The newborn's heart rate, respiratory rate, muscle tone, reflex irritability, and skin color are assessed during an Apgar score.

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    Acrocyanotic

    A blue or purple discoloration of the hands and feet, common in newborns.

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    Normal Newborn Heart Rate

    The normal resting heart rate for a newborn baby. It can vary depending on whether the baby is awake, asleep, or crying.

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    Normal Newborn Respiration Rate

    The average number of breaths a newborn takes per minute. It can vary slightly depending on the baby's activity level.

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    Normal Newborn Blood Pressure

    The average blood pressure for a newborn. It can vary depending on the baby's age and health.

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    Average Newborn Weight

    An average full-term newborn usually weighs between 7 pounds 9 ounces and 13 pounds.

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    Newborn Head Growth

    A baby's head circumference usually grows about 1 centimeter each month during their first year of life.

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    What is the purpose of an Apgar score?

    The initial assessment of a newborn's health, performed at 1 and 5 minutes after birth.

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    What are the five components of an Apgar score?

    Heart rate, respiratory rate, muscle tone, reflex irritability, and skin color.

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    What Apgar score identifies the neonate in need of resuscitation?

    A score of 0-4 on the Apgar scale indicates a newborn is experiencing severe distress and requires immediate medical attention.

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    What does "acrocyanotic" mean?

    A bluish or purplish discoloration of the hands and feet, common in newborns.

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    What is maternal history?

    The information gathered about the mother's health before, during and after pregnancy.

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    What details are included in maternal history?

    This includes details of the mother's past pregnancies, labor and delivery, and her overall health since delivery.

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    What is family & genetic history?

    This involves gathering information about the family's medical history and genetic background.

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    Why is maternal history important in neonatal evaluation?

    This aspect of neonatal evaluation considers the mother's health, previous pregnancies, labor and delivery, and her overall health since delivery.

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    Study Notes

    Pediatric and Adolescent Medicine 1: Module 2 - The Neonate

    • Pediatric history taking differs from adult due to the involvement of parents as the historians
    • Key components of pediatric history include:
      • Chief complaint
      • History of present illness (HPI)
      • Past medical history
      • Review of systems
      • Family history
      • Social history
      • Pregnancy and birth history
      • Developmental history
      • Feeding history
      • Vaccine history
    • Neonatal history heavily relies on maternal and family history
    • Maternal history, family & genetic history, previous pregnancies/outcomes, labor & delivery, general history of the infant & mother since delivery are important elements.
    • Neonatal evaluation components: Apgar score, vitals, age/length/weight, and physical exam

    Neonatal Apgar Scoring

    • Apgar score purpose: assesses the newborn's immediate health after birth
    • Apgar scores are obtained at 1 minute and 5 minutes after birth
    • The Apgar score consists of 5 components:
      • Appearance (color)
      • Pulse rate
      • Grimace (reflex irritability)
      • Activity (muscle tone)
      • Respiration
    • An Apgar score of 0-3 at either 1-minute or 5-minute indicate a need for resuscitation
    • Normal 1 minute Apgar Score: 8-10
    • Normal 5-minute Apgar Score: 8-10
    • 5-7 points on the 1-minute scale suggest some CNS depression, while 0-4 points signal severe CNS depression

    Newborn Vital Signs

    • Heart rate: 100-165 beats/minute (awake), 90-160 beats/minute (sleeping), up to 180 beats/minute (crying)
    • Respiratory rate: 40-60 breaths/minute
    • Blood pressure (BP): 67-84 mmHg (systolic), 35-53 mmHg (diastolic)
    • Temperature: varies

    Newborn Growth

    • Infants typically double their birth weight by 4 months and triple it by 1 year
    • Full-term average birth weight: 3.5-6 kg (7lb 9oz-13 lb)
    • Weight loss of up to 5-10% in the first week is acceptable, and should be regained within 7-10 days
    • Average length at term birth: 51 cm (20 inches)
    • Growth pattern: 10 inches in the first year and 2 inches per year until puberty
    • Brain weight doubles by 4-6 months and triples by 1 year
    • Average head circumference at birth: 35cm
    • Head circumference typically increases by ~1cm per month in the first year.

    Newborn Classification by Gestational Age and Weight

    • Classification based on gestational age (<37 weeks, 37-42 weeks, >42 weeks) and weight (<1000 grams, <1500 grams, <2500 grams, ≥2500 grams).
    • Additionally classified by percentile (<10th, 10-90th, >90th) based on gestational age with weight categories.

    Newborn Screening

    • Over 45 disorders are screened for in New Mexico's Newborn screening panel.
    • Screening tests include Amino Acid, Endocrine, Fatty Acid Oxidation, Hemoglobin, Organic Acid, Bilirubin (and other) tests
    • Newborn screening timing:
      • All infants: 1 day old; 2 and/or 3 day old
      • NICU infants: 1, 2, and/or 3
    • Timing of hearing tests: 1 month, 3 months, and 6 months
    • Timing of critical congenital heart disease screening: pulse ox levels (in addition to other tests and methodologies)

    Newborn Problems

    • Common problems include jaundice, hypoglycemia, murmurs, respiratory distress
    • Additional factors contributing to these problems include birth trauma, maternal drug use, prematurity, and multiple births (and infections)

    Newborn Examination

    • All vital signs are to be checked
    • Assess general appearance and size appropriateness for gestational age
    • Inspect the head, neck, clavicles, and chest
    • Auscultate the heart and lungs, palpate femoral pulses
    • Inspect the abdomen
    • Inspect genitalia, and anus, spine and back
    • Evaluate extremities
    • Check for newborn reflexes

    Normal vs Abnormal Newborn Features

    • Normal features include fontanelles, sagittal suture, coronal suture, possible bruising
    • Abnormal features include unusual head shapes (plagiocephaly, brachycephaly, scaphocephaly) , cleft lip, ambiguous genitalia, low-set or deformed ears, broken clavicles, tongue tie

    Newborn Reflexes and Hip Maneuvers

    • Three basic primitive reflexes to check for in newborns are:
      • Stepping reflex
      • Moro reflex
      • Sucking reflex
    • A reflex in which toes fan out and the great toe dorsiflexes upon plantar surface stroke: Babinski reflex
    • Hip examination maneuvers (Barlow and Ortolani) are used to screen for hip dislocations or subluxations in newborns

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    Pediatrics and Adolescent Medicine 1 Module 2: The Neonate PDF

    Description

    This quiz covers key aspects of pediatric history taking and neonatal evaluation. Emphasis is placed on the importance of maternal and family history in understanding a neonate's health, including the Apgar scoring system for immediate post-birth assessment. Test your understanding of these vital components in pediatric medicine.

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