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Questions and Answers
According to the content, what is the primary purpose of obtaining an Apgar score?
According to the content, what is the primary purpose of obtaining an Apgar score?
When should Apgar scores be obtained? (Select all that apply)
When should Apgar scores be obtained? (Select all that apply)
Which of the following is NOT a component of the Apgar score?
Which of the following is NOT a component of the Apgar score?
What Apgar score indicates a newborn requires immediate resuscitation?
What Apgar score indicates a newborn requires immediate resuscitation?
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What are normal vital signs for a newborn?
What are normal vital signs for a newborn?
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Based on the content provided, what does "acrocyanotic" mean?
Based on the content provided, what does "acrocyanotic" mean?
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Which of the following is considered a normal respiratory rate for a newborn?
Which of the following is considered a normal respiratory rate for a newborn?
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Which aspect of the content is NOT directly related to neonatal evaluation?
Which aspect of the content is NOT directly related to neonatal evaluation?
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Based on the provided information, what is the most likely reason for the neonate's low heart rate at 5 minutes?
Based on the provided information, what is the most likely reason for the neonate's low heart rate at 5 minutes?
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Calculate the expected head circumference of a neonate at 6 months of age if the head circumference at birth was 35 cm.
Calculate the expected head circumference of a neonate at 6 months of age if the head circumference at birth was 35 cm.
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Which of the following statements about a neonate's growth is NOT accurate?
Which of the following statements about a neonate's growth is NOT accurate?
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A neonate's average length at birth is approximately 51 cm. Based on the content, what is the expected length of a 4-year-old child?
A neonate's average length at birth is approximately 51 cm. Based on the content, what is the expected length of a 4-year-old child?
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A neonate's heart rate can be up to 180 beats per minute while crying. Comparing the neonate's vital signs at 5 minutes to the normal ranges provided, which of the following statements is true?
A neonate's heart rate can be up to 180 beats per minute while crying. Comparing the neonate's vital signs at 5 minutes to the normal ranges provided, which of the following statements is true?
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Flashcards
Newborn Heart Rate
Newborn Heart Rate
Normal heart rate for newborns ranges from 100-165 bpm when awake.
Newborn Respiratory Rate
Newborn Respiratory Rate
Normal respiratory rate for newborns is 40-60 breaths/min.
Newborn Weight Changes
Newborn Weight Changes
Infants typically double their birth weight by four months and triple it by one year.
Head Circumference Growth
Head Circumference Growth
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Infant Length Growth
Infant Length Growth
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Pediatric History
Pediatric History
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Neonatal History
Neonatal History
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Apgar Score
Apgar Score
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Apgar Components
Apgar Components
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Normal Apgar Score
Normal Apgar Score
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Acrocyanosis
Acrocyanosis
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Newborn Vital Signs
Newborn Vital Signs
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History Components
History Components
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Study Notes
Pediatrics and Adolescent Medicine 1, Module 2: The Neonate
- Pediatric history taking differs from adult, due to the parent acting as the historian
- Key elements of pediatric history taking 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, and vaccine history
- Neonatal history heavily relies on maternal and family history, encompassing maternal history, family and genetic history, previous pregnancies and outcomes, labor and delivery, general history of the infant since delivery, and general history of the mother since delivery
- Neonatal evaluation components include Apgar scores, vital signs, sex, and a physical exam with age, length, and weight assessment
Neonatal Apgar Scoring
- Apgar scores are used to assess the health of newborns immediately after birth
- Apgar scores are typically taken at 1 minute and 5 minutes after birth
- Apgar scores consist of 5 components: appearance, pulse rate, grimace, activity, and respiration
- Infants receiving scores of 0-3 at either time point require resuscitation
Apgar Scoring
- 8-10 at 1 minute and 5 minutes = normal infant
- 5-7 at 1 minute and 5 minutes = some central nervous system (CNS) depression
- 0-4 at 1 minute and 5 minutes = severe CNS depression; high risk for CNS/organ dysfunction
Newborn Vital Signs
- Normal heart rate (awake): 100-165 beats/min
- Normal heart rate (asleep): 90-160 beats/min
- Normal heart rate (crying): up to 180 beats/min
- Normal respiratory rate: 40-60 breaths/min
- Normal blood pressure (systolic): 67-84 mmHg
- Normal blood pressure (diastolic): 35-53 mmHg
- Normal temperature: 36.5°C to 37°C axillary
Infant Growth
- Infants double their birth weight by 4 months and triple it by one year
- Full-term average weight: 3.5-6 kg (7 lb 9 oz-13 lb)
- Weight may decrease by 5-10% in the first week, then should be regained within 7-10 days
- Average length at birth: 51 cm (20 inches)
- Average growth: 10 inches during the first year and 2 inches per year between age 4 and puberty
Brain and Head Circumference
- Brain weight doubles in 4-6 months and triples by one year
- Average head circumference at birth: 35 cm
- Increases approximately 1 cm per month during the first year
- Head circumference is usually 1-2 cm larger than chest circumference at birth
Classification by Gestational Age and Weight
- Preterm: <37 weeks
- Term: 37-42 weeks
- Postterm: >42 weeks
- Classifications by weight: - Extremely low birth weight (ELBW): <1000 grams - Very low birth weight (VLBW): <1500 grams - Low birth weight (LBW): <2500 grams - Normal: ≥2500 grams
- Other classifications: Small for gestational age (SGA), appropriate for gestational age (AGA), Large for gestational age (LGA)
- SGA: <10th percentile
- AGA: 10-90th percentile
- LGA: >90th percentile
Newborn Screening - New Mexico
- The New Mexico Newborn Screening panel covers over 45 disorders
- Main categories include amino acids, endocrine, fatty acid oxidation, hemoglobin, organic acids, and bilirubin
Newborn Screening Timing
- Healthy infants: timing of screening depends on specific tests, but typically occurs soon after birth
- NICU infants: timing of screening depends on specific tests, but typically occurs soon after birth
- Hearing screening: recommended time frames vary, but typically involve 1 month, 3 months, and 6 months
- Congenital heart disease screening: methods and timing vary based on facilities and infants' health status
Common Newborn Problems
- Jaundice (often not problematic if appearing after 24 hours)
- Hypoglycemia (<40 mg/dL in first 0-4 hours or <45 mg/dL 4-24 hours)
- Respiratory distress (tachypnea >60 breaths/min, intercostal retractions, grunting, cyanosis)
- Birth trauma (e.g., broken clavicle)
- Maternal drug use
- Prematurity
- Multiple births
- Infections
- Murmurs (often benign but needing evaluation if persistent or concerning)
Prematurity Problems
- Physiological handicaps caused by tissue and organ immaturity, impacting sucking, swallowing, breathing, temperature regulation, and development
- Apnea (pause > 20 seconds or shorter cyanotic/bradycardia)
- Hyaline membrane disease (common in preemies)
- Chronic lung disease, often due to high oxygen requirements, immature lungs, inflammation, and ventilation trauma
- Patent ductus arteriosus (PDA), continuous machine-like murmur, cyanosis, and respiratory distress
- Necrotizing enterocolitis, immature GI tract, abdominal distention, bloody stools, diarrhea, and confirmed by pneumatosis intestinalis
- Retinopathy of prematurity (ROP), abnormal vasculature of the immature retina, and may lead to retinal detachment
Normal Newborn Examination
- Vital signs
- Appearance
- Appropriate size for gestational age?
- Head, neck, and clavicles examination
- Chest examination
- Heart and lung auscultation
- Palpate femoral pulses
- Abdominal examination
- Genitalia and anus examination
- Back and spine examination
- Eyes, ears, and mouth examination
- Extremities evaluation
- Newborn reflexes
Normal Head Features
- Fontanels (soft spots) sizes
- Sutures
- Common bruising may be present after birth
- Normal head shapes
Abnormal Head Shapes
- Plagiocephaly (asymmetrical head shape)
- Brachycephaly (shortened head)
- Scaphocephaly (long head)
Other Abnormal Features
- Cleft lip
- Ambiguous genitalia
- Closed rectum
- Polydactyly
- Sacral dimple
Primitive Reflexes and Examination Maneuvers
- Three basic primitive reflexes to examine newborns include rooting, sucking, and Moro reflex
- The Babinski reflex involves toes fanning outward and great toe dorsiflexing
- Barlow and Ortolani tests are used to examine hip stability and possible dislocation
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Description
Explore the key elements of pediatric history and neonatal assessment in this quiz. Focus on neonatal Apgar scoring, essential history taking, and evaluation methods. Perfect for students and professionals in pediatric health care.
