Podcast
Questions and Answers
If an infant is born and their Apgar score is 5, what does this indicate?
If an infant is born and their Apgar score is 5, what does this indicate?
What is the typical range for an infant's heart rate when they are awake?
What is the typical range for an infant's heart rate when they are awake?
Which of the following represents a normal birth weight for an infant?
Which of the following represents a normal birth weight for an infant?
What is the expected weight gain for a four-month-old infant compared to their birth weight?
What is the expected weight gain for a four-month-old infant compared to their birth weight?
Signup and view all the answers
Which of the following is NOT a component of the Apgar score?
Which of the following is NOT a component of the Apgar score?
Signup and view all the answers
A respiratory pause lasting more than 20 seconds is considered:
A respiratory pause lasting more than 20 seconds is considered:
Signup and view all the answers
What is the typical head circumference at birth for a full-term infant?
What is the typical head circumference at birth for a full-term infant?
Signup and view all the answers
What is the expected growth in length for an infant during their first year?
What is the expected growth in length for an infant during their first year?
Signup and view all the answers
During the examination of a newborn's abdomen, what is a key aspect that should be inspected and evaluated?
During the examination of a newborn's abdomen, what is a key aspect that should be inspected and evaluated?
Signup and view all the answers
What is the purpose of the Barlow maneuver during a newborn's physical examination?
What is the purpose of the Barlow maneuver during a newborn's physical examination?
Signup and view all the answers
Which of the following is TRUE about the Babinski reflex in a newborn?
Which of the following is TRUE about the Babinski reflex in a newborn?
Signup and view all the answers
What is the significance of the number of umbilical cord vessels in a newborn?
What is the significance of the number of umbilical cord vessels in a newborn?
Signup and view all the answers
Which of the following conditions in a newborn is a medical emergency that requires immediate attention?
Which of the following conditions in a newborn is a medical emergency that requires immediate attention?
Signup and view all the answers
What is a possible reason for a newborn to have an abnormally small placenta?
What is a possible reason for a newborn to have an abnormally small placenta?
Signup and view all the answers
Which of the following is NOT a common problem associated with newborn jaundice?
Which of the following is NOT a common problem associated with newborn jaundice?
Signup and view all the answers
Which of the following reflexes is known to develop by 28 weeks gestation and disappear by 4 months of age?
Which of the following reflexes is known to develop by 28 weeks gestation and disappear by 4 months of age?
Signup and view all the answers
Which of these following examinations should be done during the immediate period after the newborn's birth?
Which of these following examinations should be done during the immediate period after the newborn's birth?
Signup and view all the answers
A newborn infant has a heart rate of 120 beats per minute while sleeping. What is the most likely explanation for this?
A newborn infant has a heart rate of 120 beats per minute while sleeping. What is the most likely explanation for this?
Signup and view all the answers
An infant who was born at 35 weeks gestation is considered:
An infant who was born at 35 weeks gestation is considered:
Signup and view all the answers
Which of these vital signs is NOT typically assessed during the immediate period after birth?
Which of these vital signs is NOT typically assessed during the immediate period after birth?
Signup and view all the answers
A two-week-old infant presents with episodes of respiratory pauses lasting more than 20 seconds. This is likely indicative of:
A two-week-old infant presents with episodes of respiratory pauses lasting more than 20 seconds. This is likely indicative of:
Signup and view all the answers
Which of these is NOT a possible reason for an infant to have a lower-than-expected Apgar score at 1 minute after birth?
Which of these is NOT a possible reason for an infant to have a lower-than-expected Apgar score at 1 minute after birth?
Signup and view all the answers
A full-term infant weighs 3.1 kg at birth. How would you classify this infant's weight?
A full-term infant weighs 3.1 kg at birth. How would you classify this infant's weight?
Signup and view all the answers
An infant's head circumference is measured at 37 cm at 6 months of age. This measurement is:
An infant's head circumference is measured at 37 cm at 6 months of age. This measurement is:
Signup and view all the answers
A newborn infant with a five-finger Apgar score of 7 at 1 minute after birth and a score of 9 at 5 minutes is considered:
A newborn infant with a five-finger Apgar score of 7 at 1 minute after birth and a score of 9 at 5 minutes is considered:
Signup and view all the answers
During a newborn examination, which reflex is typically considered a 'normal finding' up until the age of one year?
During a newborn examination, which reflex is typically considered a 'normal finding' up until the age of one year?
Signup and view all the answers
A newborn who displays an absence of the Babinski reflex could potentially indicate what kind of issue?
A newborn who displays an absence of the Babinski reflex could potentially indicate what kind of issue?
Signup and view all the answers
What is a possible reason why an infant might exhibit intercostal retractions?
What is a possible reason why an infant might exhibit intercostal retractions?
Signup and view all the answers
What is the significance of a sacral dimple located above the gluteal cleft in a newborn?
What is the significance of a sacral dimple located above the gluteal cleft in a newborn?
Signup and view all the answers
A newborn exhibiting tachypnea with a respiratory rate greater than 60 breaths per minute could be a sign of what?
A newborn exhibiting tachypnea with a respiratory rate greater than 60 breaths per minute could be a sign of what?
Signup and view all the answers
When assessing a newborn's heart murmur, what is considered a 'normal' finding if it occurs after the first 24 hours of life?
When assessing a newborn's heart murmur, what is considered a 'normal' finding if it occurs after the first 24 hours of life?
Signup and view all the answers
What is the typical developmental timeframe for the rooting reflex in a newborn?
What is the typical developmental timeframe for the rooting reflex in a newborn?
Signup and view all the answers
A newborn infant presents with a heart rate of 120 beats per minute while sleeping. What is the most likely explanation for this?
A newborn infant presents with a heart rate of 120 beats per minute while sleeping. What is the most likely explanation for this?
Signup and view all the answers
A newborn infant has a five-finger Apgar score of 7 at 1 minute after birth and a score of 9 at 5 minutes. This infant is considered:
A newborn infant has a five-finger Apgar score of 7 at 1 minute after birth and a score of 9 at 5 minutes. This infant is considered:
Signup and view all the answers
Which of these reflexes is typically considered a 'normal finding' up until the age of one year?
Which of these reflexes is typically considered a 'normal finding' up until the age of one year?
Signup and view all the answers
During a newborn examination, what is the significance of finding only one artery and one vein in the umbilical cord?
During a newborn examination, what is the significance of finding only one artery and one vein in the umbilical cord?
Signup and view all the answers
What is the significance of a small placenta in a newborn?
What is the significance of a small placenta in a newborn?
Signup and view all the answers
Which of the following findings during a newborn examination could indicate spina bifida?
Which of the following findings during a newborn examination could indicate spina bifida?
Signup and view all the answers
What is the significance of a newborn displaying intercostal retractions during breathing?
What is the significance of a newborn displaying intercostal retractions during breathing?
Signup and view all the answers
Which of the following is considered a normal finding in a newborn's physical exam?
Which of the following is considered a normal finding in a newborn's physical exam?
Signup and view all the answers
Which of the following is a possible concern regarding abnormal findings in the newborn's extremities?
Which of the following is a possible concern regarding abnormal findings in the newborn's extremities?
Signup and view all the answers
What is a potential consequence of a cervical plexus palsy in a newborn?
What is a potential consequence of a cervical plexus palsy in a newborn?
Signup and view all the answers
Which of these would be considered a 'normal' finding in a newborn's vital signs?
Which of these would be considered a 'normal' finding in a newborn's vital signs?
Signup and view all the answers
A newborn infant is assessed at 1 minute after birth with an Apgar score of 5. What is the most likely interpretation of this score?
A newborn infant is assessed at 1 minute after birth with an Apgar score of 5. What is the most likely interpretation of this score?
Signup and view all the answers
A newborn infant exhibits intercostal retractions during breathing. What is the most likely reason for this?
A newborn infant exhibits intercostal retractions during breathing. What is the most likely reason for this?
Signup and view all the answers
An infant is brought to a checkup at 4 months of age. What is the expected weight gain compared to their birth weight?
An infant is brought to a checkup at 4 months of age. What is the expected weight gain compared to their birth weight?
Signup and view all the answers
Which of the following is a potential consequence of a cervical plexus palsy in a newborn?
Which of the following is a potential consequence of a cervical plexus palsy in a newborn?
Signup and view all the answers
What is a potential concern regarding abnormal findings in the newborn's extremities?
What is a potential concern regarding abnormal findings in the newborn's extremities?
Signup and view all the answers
Study Notes
Pediatric Exam 1: Newborn Assessment
-
Age Classifications:
-
Neonate: 1-28 days old
-
Infant: 0-1 years old
-
History:
-
Heavily reliant on maternal and family history
-
Includes maternal history, family history, genetic history, previous pregnancies/outcomes, labor/delivery details
-
Apgar Score:
-
Purpose: Evaluate CNS depression and immediate intervention need
-
Components: Appearance, Pulse, Grimace, Activity, Respiration
-
Scoring: 0-2 points per component; 0-4 = severe CNS depression, 5-7 = some CNS depression, 8-10 = normal
-
Timing: 1 minute and 5 minutes after birth; repeat every 5 minutes until score of 8 or above.
-
Abnormal Score (0-7): High risk for CNS/organ depression
-
Scoring Details:
-
Appearance: 0 = blue/pale, 1 = body pink, extremities blue (acrocyanotic: peri-oral, hands, feet), 2 = pink
-
Pulse: 0 = none, 1 = <100 bpm, 2 = >100 bpm
-
Grimace: 0 = none, 1 = grimace, 2 = cries
-
Activity: 0 = limp, 1 = some activity, 2 = active
-
Respiration: 0 = absent, 1 = slow/irregular, 2 = strong cry
-
Normal Respiration: 40-60 breaths/minute
-
Vitals:
-
Heart Rate: Awake 100-165 bpm, Crying up to 180 bpm, Sleeping 90-160 bpm
-
Blood Pressure: Systolic 67-84, Diastolic 35-53
-
Temperature: 36.5°C to 37°C (axillary)
-
Growth:
-
Weight: Full-term average 7 lb 9 oz (3.5-6 kg); expected 5-10% weight loss in the first week, regained in 7-10 days; double birth weight by 4 months, triple by 1 year
-
Length: Full-term average 20 inches (51 cm); about 10 inches of growth in the first year; 2 inches per year until puberty
-
Head Circumference: 35 cm at birth; increases 1 cm/month in the first year
-
Gestational Age Classification:
-
Preterm: Less than 37 weeks
-
Term: 37-42 weeks
-
Postterm: Greater than 42 weeks
-
Low birth weight: Less than 2,500 grams (5.5 lb)
-
Normal birth weight: Greater than or equal to 2,500 grams (5.5 lb)
-
Apnea: Respiratory pause lasting >20 seconds, most common in <34 week gestation, onset before 2 weeks of age. Treated with caffeine
-
Percentiles:
-
Less than 10th%: small
-
10th-90th%: normal
-
Greater than 90th%: large
Physical Exam
- General Appearance: Size appropriate for gestational age? Inspect and palpate
- Head: Inspect and palpate for deformities
- Neck & Clavicles: Inspect and palpate
- Chest: Inspect and auscultate
- Back & Spine: Inspect for deformities (e.g., sacral dimple, spina bifida)
- Eyes: Inspect
- Ears: Inspect
- Nose: Inspect
- Throat: Inspect, looking for tongue tie
- Mouth: Inspect; look for feeding challenges, or cleft lip
- Genitalia: Inspect for abnormalities; vaginal discharge and mucous normal.
- Anus: Inspect for closed rectum; sacral dimple above the gluteal cleft (Spina Bifida)
- Abdomen: Inspect and evaluate
- Extremities (Hands & Feet): Inspect for abnormalities (polydactyly, hip dysplasia)
Hip Examination:
- Ortolani: Flex the hip and knees, gently abduct the hip
- Barlow: Flex and adduct the hip, then apply pressure to the knee
Reflexes
- Sucking: Present by 14 weeks gestation; assessment of feeding
- Moro: Present by 28 weeks gestation; disappears by age 3 months
- Babinski: Present until 1 year old; absence could indicate CNS issues.
- Palmar Grasp: Present by 28 weeks; disappears by 4 months
- Rooting: Helps in feeding
Umbilical Cord & Placenta
- Cord Vessels: Usually 2 arteries and 1 vein; variations possible (1-6%)
- Placenta: Examine for size, membranes, vessels, and infarcts/clots (abruption) on the maternal side. Small placentas are frequently associated with smaller infants.
Screenings
- General Population Screenings: Genetic (2 screenings immediately after birth, repeated 1.5-2 weeks in NICU and 3 before discharge/28 days) and Neonatal Metabolic Screening (NM) (24-48 hours after birth, NICU repeat 1.5-2 weeks, 3 tests before discharge or day 28) with 6 categories: amino acids, fatty acid oxidation, organic acids, hemoglobin, endocrine, bilirubin, and others. Genetic and NM screenings (initial and repeats) must be done within this timeframe.
- Hearing Screening: Common at age 1 month, 3 months, 6 months
- Critical Congenital Heart Disease: Possible pulse oximetry, SCID if indicated
Common Newborn Problems
- Jaundice: Usually not pathologic if after 24 hours, well perfused, palpable and symmetrical pulses, and stable.
- Murmurs: Grade 1-3/6, soft heard at left upper/midsternal border, often louder first 24 hours. Not necessarily abnormal, unless present before 24 hours (potential valve problems). Do not discharge infants with murmurs before 24 hours of life (must rule out valvular problems)
- Hypoglycemia: Should rise to normal levels within 0-4 hours; <40 mg/dL at 4-24 hrs, <45 mg/dL
- Respiratory Distress: Tachypnea (>60 bpm), Intercostal retractions, Grunting, Cyanosis
- Birth Trauma: Possible bruising, fractures (clavicle, humerus, femur), and cervical plexus palsies. Maternal drug use is a serious concern and prevents discharge.
- Prematurity: Physiological challenges like difficulty with sucking, swallowing, and breathing.
- Apnea: Respiratory pause lasting >20 seconds, most common in <34 week gestation, onset before 2 weeks of age. Treated with caffeine. Consider apnea a respiratory pause lasting >20 seconds.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz focuses on the assessment of newborns in pediatric exams. Key topics include age classifications, history taking, Apgar score evaluation, and vital signs monitoring. Understanding these components is essential for effective newborn care and evaluation.
