Relationship

Environment

Flexibility

Part of Health Maintenance

Increase in functions related to the body & mind

1.  Physiologic jaundice

2.  Breast Feeding Jaundice

3.  Breast Milk Jaundice

Physiologic Jaundice

Baby should not be:

Inactive

Floppy

Present with disturbed appetite

This type of Jaundice:

occurs 72 hrs after birth, 3rd day

no floppiness, inactivity, disturbed appetite present

only see coloring

breast milk babies have a higher incidenc than bottle

This type of Jaundice is caused by not enough feedings, occurs 1st wk, more than 72 hrs.

Tx: more frequent feedings & longer feeding intervals

Breast Feeding Jaundice

Remember:  Dehydrated

How many lbs or kg should they weight?

9-10 month-1 year

5 yr old

10 yr old

9-10 month- 1 year:  triple birth wt

5yr: 20kg

10yr:  30kg

How tall are they suppose to be?

birth

1 yr

3yr

birth:  20 inches

1 yr:  30 inches

3 yr:  3 feet

Head circumference?

Birth

 increase up to 2 yrs

rest of their life

Birth:  35 cm

 increase up to 2 yrs:  1 cm per month for 2 yrs

rest of their life:  10 cm

Gross motor

Language

Fine motor-adaptive

Personal-Social

T/F

Denver Development also looks at IQ?

False

not done

Toxoplasma

Rubella

CMV

Herpes

Syphyllis

Neuromuscular

&

Physical Maturity

Tense

Flexed

Floppy

Soft

Flexible

Mobile

Newborn sex characteristics

breast & genitalia

breast budding-do not squeeze nipple

males-testes descending

female-distinct labia majora & minora

Less lines

thin skin

Hard time opening eyes

Keep the eyes shut

Epicanthal folds-Down Syndrome

Response:

Alert

responds to voice

responds to pain only

unresponsive

APGAR??

When is this administered?

A: appearance (skin color)

P:  pulse rate

G: grimace (reflex activity)

A:  activity

R:  respirations (breathing)

Done at immediate birth and 5 minutes later.

Higher the score the better!

Cyanosis

Nasal flaring

Intercostal retractions

Grunting

Quality of crying

Apnea

Normal HR & RR for a newborn?

How is a temperature taken?

HR:  120-160

RR:  30-60

Temperature:  Rectal

What type of birth mark is this?

Flat freckle

This type of birthmark is:

uniformly pigmented macule/patch

0.5-1.5 cm & no significant consequence

Neurofibromatosis

More than 6 cafe au lait spots

This occured due to a vaccum extraction.

Tissue is on top of the head.

Cylinder shape

Feels like a ping pong ball when pressed on bone?

if not resolved after 2 yrs of life, leads to what?

Cranotabes

Vitamin deficiency, bone is not developing

Leads to Rickets

If red reflex not present in newborn??

2 conditions

Congenital Cataract-Rubella

Retinoblastoma-tumor, familial, urgent

Fetal Alcohol Syndrome

Dysmorphic features

Palate-hard & soft

natal teeth

Epstein pearls

T/F

Normal to enlarged breast in both genders in the neonate?

True

will resolve on its own

Placenta

2 arteries

1 vein

Stronger stream- Left ventricle

Weaker stream- pulmonary area, but this is closed off

This congenital heart disease has:

Wide split S2

spontaneously closure in 90% (esp if < 3mm)

ASD

Atrial Septal Defect

This congenital heart disease has:

Holosystolic Murmur

spontaneous closure in 30-50%

Surgical repair is needed if growth & heart failure present

This congenital heart disease has:

Machine-like murmur in intercostal space 2

Bounding peripheral pulse

Wide pulse pressure

This congenital heart disease is:

 present in 10%

female:male 2/1

Usually asx, becomes sx w/ other defects & later in life

Atrial Septal Defect

ASD

This congenital heart disease affects:

more male infants

present 20-60% of CHD

if defect small-asx

larger defect- leads to Pulmonary HTN & CHF (FTT)

Ventricular Septal Defect

VSD

This congenital heart disease is:

mostly problematic in premmies

mostly females

Maternal rubella possible cause

L to R shunt b/w aorta & pulmonary artery

Patent Ductus Arteriosus

PDA

YES

due to site of erythropoiesis, needs to be large

What is this?

epi or hypospadias

YES

due to hormones from mom

Hip dyspasia is:

present when

more common in

present when:  during breech deliveries

more common in:  female newborns

What are these tests & how are they performed?

Ortolani test

Barlow test

BOTH test for  hip dysplasia

Ortolani test:  place hip & knee 90 degree flexion & abd, will feel click

Barlow test:  place thumb in inner thigh & push back

Describe these conditions:

Metatarsus varus

Talipes varus

Talipes equinovarus

Metatarsus varus:  adduction of the metatarsal

Talipes varus:  club foot (looks like a club)

Talipes equinovarus:  club foot

Describe the primitive reflexes:

Palmar grasp

Plantar reflex

root reflex

Moro reflex

 Fencer's position

Palmar grasp:  baby grasp what is put in hand

Plantar reflex:  baby moves foot away from shin (plantar flex)  & toes curl down

root reflex:  move head toward the side their cheek was touched

Moro reflex:  baby get started with sudden change of position

 Fencer's position:  baby walks if feet touch down on surface

In the mouth, if whitish covering noted:

what is it

&

 what does it indicate

Canidida albicans

immature immunity

If exudate present on the tonsils:

what type of exudate present

&

what is the most common organism

Whitish, yellow, gray

EBV

YES

very important part of the exam

part of the developing immunity

they are working hard

Normal to be Enlarged

Should not be Tender

ASD: SEM inpulmonic area w/ wide split of S2

VSD: Pansystolic murmur on LSB w/ thrill

PDA:  continous, diastolic + systolic

Congenital heart disease where there is a

right to left shunt

What are causes of Precocious Puberty?

Endocrine & CNS system

CNS tumor

Gonadal tumor

Congenital adrenal hyperplasia

Constitutional

malnutrition

Chronic disease

Chromosomal disease

Eating disorder-anorexia

Age 11-17 yrs

Height spurt

Penis/Testes

Sexual maturity rating/ pubic hair

age 11-15 yrs

Height spurt

Menarche

Breast

Sexual maturity/pubic hair

Scoliosis

&

Kyphosis