Chapter 41 - Chapter 41 Neonatology Neonate an infant from...

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Chapter 41: Neonatology Neonate - an infant from the time of birth to one month of age. Newborn - a baby in the first few hours of its life Prenatal - time from before birth Gestation - time from conception to birth General Pathophysiology Assessment, and Management Epidemiology Antepartum - before the onset of labor. Intrapartum - occurring during childbirth Postpartum - occurring after birth o About 80% of newborns weighing <1500g (5lb. 5oz.) at birth require resuscitation. Pathophysiology Factors that stimulate the baby’s 1 st breath include: o Mild acidosis o Initiation of stretch reflexes in the lungs o Hypoxia o Hypothermia Reality: Mamallion Reflex Persistent fetal circulation - condition in which blood continues to bypass the fetal respiratory system, resulting in ongoing hypoxia. Primary Apnea - after birth the period of time when the newborn has initial asphyxia and the newborn can be stimulated to increase response Secondary Apnea - the infant takes several last deep gasping respirations and becomes unresponsive. Congenital Anomalies Diaphragmatic hernia - protrusion of abdominal contents into the thoracic cavity through an opening in the diaphragm. Meningomyelocele - herniation of the spinal cord and membranes through a defect in the spinal column. Omphalocele - congenital hernia of the umbilicus. Choanal atresia - congenital closure of the passage between the nose and pharynx by a bony or membranous structure. Cleft palate - congenital fissure in the roof of the mouth forming a passageway between oral and nasal cavities. Cleft lip - congenital vertical fissure in the upper lip. Pierre Robin Syndrome - unusually small jaw, combined w/a cleft palate, downward displacement of the tongue, and an absent gag reflex. APGAR - +2 Good Response, +1 Some Response, 0 No response =<10 Appearance Pulse rate Grimace Activity Respiratory effort
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APGAR is done at 1 & 5 minutes 7-10 score an active and vigorous newborn, needs only remote care.
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