The Biophysical Profile uses Ultrasound to determine fetal well being. These five parameters are assessed: Amniotic Fluid Tone Respiratory Movement Body Movement Non Stress Test

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The Biophysical Profile uses Ultrasound to
determine fetal well being. These five
parameters are assessed Amniotic FluidTone
Respiratory Movement Body Movement Non Stress
Test
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Physical Assessment

• Caput Succedaneum- crosses the suture lines, can
  occur with a vertex delivery, hemorrhagic edema.
• Cephalohematoma- will not cross the suture lines,
  due to traumatic delivery and is contained to one
  area.

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PHYSICAL ASSESSMENT

• A FULL TERM INFANT THAT IS SGA IS AT RISK FOR
  POLYCYTHEMIA DUE TO CHRONIC HYPOXIA IN UTERO
• MORE RBCS ARE PRODUCED TO COMPENSATE FOR LACK
  OF OXYGEN.

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PHYSICAL ASSESSMENT

• ERYTHEMA TOXICUM- YELLOW OR WHITE MACULAR PAPULAR
  RASH. THIS IS A NORMAL NEWBORN RASH WHICH WILL
  RESOLVE SPONTANEOUSLY.
• THIS RASH WOULD NEVER BE FOUND ON THE PALMS OF
  HANDS OR SOLES OF FEET (THIS TYPE OF RASH CAN BE
  INDICATIVE OF SYPHYLLIS)

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Alpha-fetoprotein (AFP)

• THE CONCENTRATION IS LOW IN DOWN SYNDROME BUT
  ELEVATED IN NEURAL TUBE DEFECTS.

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• LATE DECELERATIONS- A FALL IN HEART RATE AT THE
  BEGINNING OF THE UTERINE CONTRACTION, AND
  RETURNING TO BASELINE AFTER THE CONTRACTION HAS
  ENDED.
• ASSOCIATED WITH INCREASED INCIDENCE OF FETAL
  COMPROMISE.

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THERMOREGULATION

• NEONATES CONSERVE HEAT THROUGH NON-SHIVERING
  THERMOGENESIS, WHICH CONSISTS OF THE METABOLISM
  OF BROWN ADIPOSE TISSUE.
• BROWN ADIPOSE TISSUE BEGINS FORMING AT 26-28
  WEEKS GESTATION.

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THERMOREGULATION

• INSENSIBLE WATER LOSS IS WHAT IS LOST THROUGH THE
  SKIN AND RESPIRATORY SYSTEM, AND WE ARE UNABLE TO
  MEASURE.
• THE MORE PRETERM THE NEONATE IS THE MORE WATER
  THEY LOSE IN THIS MANNER.

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FLUID AND ELECTROLYTES

• INFANTS WITH RDS AND BPD TEND TO HAVE THIRD
  SPACING OF FLUID WITH EDEMA DUE TO INJURY TO THE
  CELLS WHICH CAUSE FLUID TO LEAK.
• THE INJURY IS DUE TO EXPOSURE TO OXYGEN AND
  POSITIVE PRESSURE VENTILATION.

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DEVELOPMENTAL

• SELF REGULATION IS WHEN A NEONATE ATTEMPTS TO
  MAINTAIN A BALANCED STABLE STATE EXAMPLES OF
  SELF REGULATORY STRATEGIES INCLUDE-
• 1. FOOT BRACING AGAINST A BOUNDARY
• 2. GRASPING HANDS TOGETHER OR HAND TO MOUTH OR
  HAND TO FACE
• 3. SUCKING
• 4. GRASPING BLANKET OR TUBING

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DEVELOPMENTAL

• THERE ARE TWO DIFFERENT STATES THE NEONATE CAN BE
  IN SLEEP AND AWAKE STATE THE AWAKE STATE
  CONSISTS OF THE INFANT BEING - ACTIVE ALERT,
  QUIET ALERT AND CRYING.
• THE BEST TIME TO INTERACT WITH THE NEONATE IS
  WHEN THEY ARE IN THE QUIET ALERT STATE.

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NUTRITION

• NEONATES DEVELOP THE ABILITY TO COORDINATE
  SUCKING, SWALLOWING AND BREATHING AT 31-34 WEEKS.

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CARDIAC

• CONGENITAL HEART DEFECTS THAT HAVE AN INCREASE IN
  PULMONARY BLOOD FLOW ARE
• PDA
• VSD
• ASD
• AV CANAL

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CARDIAC

• OBSTRUCTIVE DEFECTS THAT CAUSE PULMONARY VENOUS
  CONGESTION ARE
• COARCTATION OF THE AORTA
• AORTIC STENOSIS

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CARDIAC

• MATERNAL FACTORS THAT PREDISPOSE NEONATES TO
  CONGENITAL HEART DEFECTS ARE
• LUPUS
• MATERNAL DIABETES
• RUBELLA

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LINE PLACEMENT

• UMBILICAL ARTERY CATHETERIZATION IF PLACEMENT
  IS LOW CATHETR SHOULD BE BETWEEN THE 3RD AND 4TH
  LUMBAR SPACE.
• IF PLACEMENT IS HIGH CATHETER SHOULD BE BETWEEN
  THE 6TH -10TH THORACIC SPACE.

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X-RAYS

• DUODENAL ATRESIA IS ASSOCIATED WITH DOWN
  SYNDROME.
• CLASSIC APPEARANCE ON ABDOMINAL X-RAY WILL REVEAL
  A DOUBLE BUBBLE.

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PHARMACOLOGY

• TOLERANCE TO A MEDICATION IS WHEN THE INFANT
  REQUIRES AN INCREASE IN DOSE TO ACHIEVE THE
  DESIRED EFFECT.
• DEPENDANCE TO A MEDICATION IS WHEN THE INFANT
  NEEDS REGULAR ADMINISTRATION OF THE MEDICATION
  FOR PHYSIOLOGICAL WELL BEING.

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GI SYSTEM

• OMPHALOCELE- HERNIATION THROUGH THE UMBILICUS,
  COVERED BY A SAC. ASSOCIATED WITH OTHER
  ANOMALIES SUCH AS SGA, SKELETAL OR CHROMOSOMAL.
• GASTROSCHISIS- HERNIATION OCURS TO THE RIGHT OF
  THE UMBILICUS AND IS NOT USUALLY ASSOCIATED WITH
  OTHER ANOMALIES.

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BILIRUBIN

• INDIRECT BILIRUBIN ALSO KNOWN AS UNCONJUGATED IS
  FAT SOLUBLE AND MUST BE BROUGHT TO THE LIVER TO
  BE CHANGED TO WATER SOLUBLE.
• DIRECT BILIRUBIN ALSO KNOWN AS CONJUGATED IS
  WATER SOLUBLE AND IS READY TO BE EXCRETED IN THE
  BILE AND INTO THE STOOL.

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GI SYSTEM

• AT BIRTH THE ABDOMEN IS FLUID FILLED, WITHIN 30
  MINUTES IT BEGINS TO FILL WITH AIR.
• WITHIN 8 HOURS THE LARGE INTESTINE SHOLD BE
  FILLED WITH AIR, IF NOT THIS COULD INDICATE AND
  OBSTRUCTION.