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# Mometrix Scoring correlates to the child's awake or sleep state. Infants are scored according to response in many areas, including: - Habituation: Ability to diminish response to repeat stimuli. - Visual and auditory orientation: Ability to respond to stimuli, fixate, and follow a visual object....

# Mometrix Scoring correlates to the child's awake or sleep state. Infants are scored according to response in many areas, including: - Habituation: Ability to diminish response to repeat stimuli. - Visual and auditory orientation: Ability to respond to stimuli, fixate, and follow a visual object. - Motor activity: Assessment of body tone in various activities. - Variations: Changes in color, state, activity, alertness, and excitement during the exam. - Self-quieting activities: Frequency and speed of self-calming activities, such as sucking on their hand, putting their hand to their mouth, and focusing on an object or sound. - Social behaviors: Ability to cuddle, engage, and enjoy physical contact. ## ROUTINE NURSING CARE ### PKU Phenylketonuria (PKU) is an inborn error of metabolism that results from a deficiency of the liver enzyme that changes phenylalanine to tyrosine (phenylalanine is a product that results when protein is digested). These infants are unable to digest protein. The symptoms of this disorder will show up sometime before 3 months if not caught in a screening. The first symptoms will be vomiting, poor feeding effort, and irritability. Later, if not treated, the infant will develop eczema and will have urine that smells musty. Once this condition is diagnosed, the infant must be put on a strict diet that restricts phenylalanine. Extensive family training must take place to educate the family about the diet. If the infant does not follow this diet restriction, intellectual disability will result. PKU screening within 7 days of birth is required in all 50 states. ## SCREENING FOR GENETIC DISEASES Screening of the newborn to detect genetic diseases varies somewhat from one state to another. Because about 1 in 200 newborns has chromosomal abnormalities, screening is an important tool although many birth defects are not genetic in origin, such as defects caused by maternal alcohol abuse or vitamin deficiency. Screening tests include the following: - Biotinidase deficiency (autosomal recessive). - Congenital adrenal hyperplasia (autosomal recessive). - Congenital hearing loss (autosomal recessive, autosomal dominant, or mitochondrial). - Congenital hypothyroidism (autosomal recessive or autosomal dominant). - Cystic fibrosis (autosomal recessive). - Galactosemia (autosomal recessive). - Homocystinuria (autosomal recessive) - Maple syrup urine disease (autosomal recessive). - Medium-chain Acyl-CoA dehydrogenase (autosomal recessive). - Phenylketonuria (autosomal recessive). - Sickle cell disease (autosomal recessive). - Tyrosinemia (2 types are autosomal recessive; third type is unclear). ## EYE PROPHYLAXIS Most states mandate eye prophylaxis for the newborn although a number of studies suggest that parents can safely choose to refuse this prophylaxis if the mother has had prenatal care and screening for STDs. However, most pediatricians still support prophylaxis. Medications used for prophylaxis include erythromycin eye ointment, tetracycline eye ointment, or 1% silver nitrate drops. Erythromycin is usually the drug of choice because it is active against both gonococcal and chlamydial infections. Silver nitrate is rarely used now even though it is effective because it can cause eye irritation.