Scruggs, Karen
Description
Product Description This reference provides a rapid review of current diagnosis and therapy for children. In outline format, it is a concise review fo
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r the pediatrics clerkship, national board examination, or specialty board review. It is designed for pediatricians, family physicians, and students of pediatrics. Excerpt. © Reprinted by permission. All rights reserved. Neonatology Normal Newborn Care I. Prenatal pediatric visit A. The prenatal pediatric visit usually takes place during the third trimester of the pregnancy. Maternal nutrition, the hazards of alcohol, cigarette smoking and other drugs to the unborn baby; and the dangers of passive smoking should be discussed. Maternal illnesses and medications should be reviewed. B. Information about the benefits of breast feeding or information about infant formula is provided. The use of car seats, safety of cribs, and issues regarding circumcision of boys should be discussed. Prenatal Pediatric Visit Discussion Issues Maternal History General health and nutrition Past and present obstetric history Maternal smoking, alcohol, or drug use Maternal medications Infectious diseases: Hepatitis, herpes, syphilis, Chlamydia rubella Maternal blood type and Rh blood groups Family History Newborn Issues Assessment of basic parenting skills Feeding plan: Breast feeding vs formula Car seats Circumcision of male infant II. Delivery A. Neonatal resuscitation 1. All equipment must be set up and checked before delivery. The infant who fails to breath spontaneously at birth should be placed under a radiant warmer, dried, positioned to open the airway, mouth and nares suctioned, and gentle stimulation provided. 2. The mouth should be suctioned first to prevent aspiration. Prolonged or overly vigorous suctioning may lead to bradycardia and should be avoided unless moderate-to-thick meconium is present in the airway. 3. The infant born with primary apnea is most likely to respond to the stimulation of drying and gentle tapping of the soles of the feet. The infant who fails to respond rapidly to these measures is experiencing secondary apnea and requires positive pressure bag ventilation with oxygen. 4. Adequate ventilation is assessed by looking for chest wall excursions and listening for air exchange. The heart rate should be assessed while 6 Normal Newborn Care positive pressure ventilation is being applied. If the heart rate does not increase rapidly after ventilation, chest compressions must be started by an assistant. If the infant fails to respond to these measures, intubation and medications are necessary. Epinephrine can be administered via the endotracheal tube. Apgar scores are used to assess the status of the infant at 1 and 5 min following delivery. Apgar Scoring System
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