Newborn Nursery

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Author:
docdewaal
ID:
90881
Filename:
Newborn Nursery
Updated:
2015-07-27 13:24:22
Tags:
Newborn Nursery Neonatology
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Description:
Review of Common Conditions Found in the Newborn Nursery
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  1. What is the definition of anemia in the term newborn?
    Anemia (in infants >34weeks gestation) is defined as a venous Hgb <13g/dl or capillary Hgb <14.5g/dl

    • The normal values are:
    • -Hgb: 14-20g/dl
    • -Hct: 38-55% (AMC lab)
  2. What is "physiologic anemia of infancy?"
    In healthy term infants, hemoglobin values remain unchanged until the 3rd week of life and then decline, reaching a nadir of 11g/dl at 8-12 weeks (2-3 mo).

    In preterm infants, the nadir may reach 7-9g/dl at 4-8 weeks (1-2 mo) **NOTE DIFFERENCE**
  3. Should a mother with HCV breastfeed her infant?
    • Hepatitis C virus (HCV), a small, single-stranded RNA virus, is a member of the Flavivirus family, and its transmission from mother to infant via human milk never has been documented.
    • Both the American Academy of Pediatrics and the Centers for Disease Control and Prevention advise that maternal HCV infection is not a contraindication to breastfeeding.
    • However, HCV-positive mothers who have bleeding or cracked nipples should consider deferring breastfeeding until the skin is healed.
  4. What is the differential for an infant who fails to pass urine in the first 24 hours?
    • "Is it pre-renal, renal, or post-renal?"
    • Prerenal causes:
    • -Sepsis
    • -Congestive heart failure
    • Intrinsic renal disease: 
    • 1. Parenchyma (acute tubular necrosis, cortical necrosis, or autosomal recessive polycystic kidney disease)
    • 2. Vasculature (renal vein thrombosis)
    • Postrenal failure:
    • -Posterior urethral valves
    • -Prune-belly syndrome
    • -Neurogenic bladder
    • -Obstruction of a single kidney
  5. What are the features of prune-belly (Eagle-Barrett) syndrome (PBS)
    • Abdominal muscle deficiency
    • Severe urinary tract abnormalities
    • Bilateral cryptorchidism in males
  6. What is the definition of micropenis in the newborn?
    • SPL less than 1.8 cm (2.5 standard deviations less than normal) are considered to have micropenis and would require additional workup to determine the cause. 
    • SPL is performed by placing a tongue blade at the dorsal base of the penis and gently pushing down to the pubic symphysis while extending the penis along the length of the blade.
    • The length of the penis can be accurately assessed by drawing a horizontal line on the tongue blade just above the glans of the stretched penis and subsequently measuring the distance from the end of the blade to the marked line.
  7. How does NYS currently detect CF in NB screening (2015)
    • NYS uses a combination of IRT/DNA mutation analysis to screen newborns for CF.
    • IRT is a pancreatic enzyme precursor found in the blood, and the concentration is elevated in babies with CF since pancreatic ducts are partially blocked leading to abnormal enzyme drainage.

    IRT can also be elevated in premature infants, or infants with stressful deliveries.

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