- What does brown adipose tissue do? - It helps insulate, right? - It helps with body temperature, so it generates heat.
That's basically what it does. Okay, what is the first stool called? And when should it happen? - 24 hours.
- 24 hours, and what does it look like? - Mustard, green, yellowish, black, tarry, sticky. It's pretty bad. Okay, but you would hope that they pass that. Okay, what is the one thing in children born with respiratory problems?
They lack... Surfactant. Surfactant.
So if you remember back in the reading it talked about the LS ratio. Yes. And so what do you give them that will increase that surfactant? Isn't it the dextromethazone? Dextromethazone.
Yes ma'am. Okay. So vitamin K injections are given for what reason? Blood. Blood clotting.
So where in the infant do I get it? What size? Vastus lateralis.
Very good. And so we already talked about why we do not do rectal temps, and that's because of... Where was we injecting that at? Where was we injecting the vitamin K? It would be the vastus lateralis in the leg.
And so the question back to the other way is rectal temps, we don't do them because of perforation, right? What is the immediate newborn care that baby's head delivers? Make sure the cords not around its neck.
Suction that airway. Make sure you got a patent airway. And what do you suck first, mouth or nose? Mouth. Very good.
All right, heat loss. If I am, I have an air conditioner that blows across me and I'm under an air vent, that is. That is heat loss by?
Convection. Convection. If I touch cold inanimate objects like the tables and all that good stuff, that is heat loss by? Conduction.
Conduction. When does John disappear in breastfeeding? When does what? John disappear in those that breastfeed after the fifth day.
Okay, talk to me about at-gar scores. When do we do them? One minute, five minutes, and ten minutes.
Ten if needed. And what's the normal score? Eight to ten.
There you go. Eight to ten is normal. And what's that telling you, eight to ten? Yes, it does, but it also tells you the baby is transitioning or adequately transitioning.
What does flaring nostrils, substernal retractions, grunting, snorting, respiratory distress. Very good. How do you maintain an airway after a baby has been fed? How are you going to lay them?
Do you want to put them on their stomach? No, I think Lizard says you're not even going to put them on their stomach anymore. No, say it. I was going to say is that family? Like how you position them?
Yeah, how you position them. Do you set them up? You can set them up, but usually they would tell them to lay flat and on their back, okay, to keep their airway open.
We already talked about that. Let's see. How is the respirations initiated at birth? I don't even think I've read this, but it's chemical, thermal, thermal, and mechanical factors. You said initiated?
Yes, respiratory respirations are initiated at birth by chemical, thermal, and mechanical factors. Got that? Right. What is the process of change in bilirubin called? Conjugation of bilirubin.
Respiratory distress requires what? Suction. And?
What'd you say? Respiratory distress requires what? We know that we're in respiratory distress so what needs to happen after that?
Do I just leave them? I know that they're breathing bad. I just leave them.
I have seen people do that. How about some further evaluation? We'll be appropriate, yes?
Okay, now you are born by C-section which means you don't go through the actual birth now. So you would expect that that baby will have what they call wet lungs, okay? Because they have not pushed out the excess stuff in your lungs.
So when should that go away? Well, let's just do one day, 24 hours. It should decrease or go away. Let's see. When does pathological jaundice occur?
Okay, well we said jaundice in breastfeeding occurs at what day? Okay, so that's okay. Okay, because what it's doing is it's breaking down the red blood cells, the fetal red blood cells, and it's changing over. But if I have pathological things going on, when would you expect that to be seen? Right after birth.
Right after birth or within 24 hours. Because that could mean somehow liver issues. We're not excreting.
It's not doing what it's supposed to do. We already talked about the interior font now. Yes, it closes when?
12 to 24 months. Let's do 18 to 24. Technically, you'll feel it getting smaller and smaller and smaller until about 18 to 24 months it shuts, it closes. The interior font name. So 12 to 24 or 18?
Let's do 18 to 24. Yes. What's that hair called? Okay. What's the eye treatment you do at birth for STIs? Erythromycin.
Okay. What is that cheesy covering called? White cheese. White cheese or pot juice, but it's called vernix.
Yes. Okay. And let's see. Ortolini, tell me about that.
What's that? - Shoot, that was the hips. - Yeah, the hips.
What happens with hips? If I have a positive or a negative sign. - Then they have a broken hip or a dislocated hip. - Dislocated, and what are you gonna feel when you do that?
- A popping. - A pop or a click, okay? And usually what you will see, just like that picture I showed you with the dislocation of the shoulder, you know, it had extra creases.
Well, with a dislocated hip, you're going to see the same thing on the thigh. You're going to see extra creases. One leg might be longer than the other.
It might be, you know, laying straight out rather than pulled up from its body. So that's how you would tell that. Let's see. What is the best way to prevent a preterm birth? Prenatal care.
Adequate and early prenatal care. That's perfect. What on the soles of the feet show the greatest maturity?
Creases. Peeling and cracking of the skin is what it says. But creases, yes, is correct.
Arithema toxinatorium. Is it benign or is it cancerous? Benign. Mongolian spots, we already talked about it. Do, when, where?
Usually, sometimes these disappear, sometimes they don't. Discharge planning occurs when? At admission. Okay, so once they're admitted, admission, admitted, discharge occurs.
Because you start teaching, because their stay nowadays are very short. Pregnant ladies usually get M.O. with everything good and click well. Sutures, stitches, staples and all. How do you deal with an apneic episode?
What do you do to the baby? They are just laying there. They are not breathing. Okay, what do you do before you do CPR? - Start a room.
- In a baby. You're doing CPR. - Take a breath.
- Flip 'em. - Flip 'em. - Flip what? - Chest. - Foot.
- Foot. Why do you not shake 'em? - Shake the baby.
- Because why? Because you're rattling her brain. Okay, and where is that brain tissue going to come out?
There. There. Out there in your fine nail, it's going to bulge. So that's why you don't shake babies like we do adults in CPR. You flick their foot.
So that's the way you can get a response with a baby in an apneic situation. That's the first thing you'll do is flip their foot. Because if they wake up, what do they do?
They flex. They flex their foot back. They jerk away from it.
Okay. How will you know that you have a meconium aspirate pneumonia? They got wet lungs. What else?
Fecals. They can. Wet lungs.
What's going to be on their fingers? Dinosus. Not necessarily. I've just... No capillary refill.
Okay, you're gonna see this. If I had meconium aspiration, it usually occurs in utero, right? And I suck all that fluid in. I got wet lungs.
We know that. But what's this baby gonna look like? It's gonna be covered in meconium.
Yeah, it's gonna be covered. Usually, you'll see their fingers stained. Meconium color. Let's see. We already talked about the APGAR score.
Is it normal for a newborn to lose weight in the first three days? Yes. Why?
They're out for the supernatant. Okay, there's another reason. They're passing all that extra body fluid off.
So you would expect them to lose weight, but after three days you expect that baby to gain weight. When you're doing phototherapy, what is the most important thing to do with the baby? Make it.
They gotta be naked, yes. It's almost like if I sat here and stuck a laser pointer in your eyes. Cover their eyes. Cover their eyes because you could cause blindness.
So we don't want that. How long are iron stores from the mother good in the baby? Isn't it for like the first year? First three to six months?
Six months. Six months. And you need to know all your weights for LGA and SGA, those charts I covered too fast. And then there's true-false questions. LGA babies are always post-birth?
No. Yes. False. No, I think I've covered it before. Can you repeat that last board about the weights?
Which ones we haven't known? The weights for LGA and SGA. That was those charts and things I told you.
Here's the tables and the pink. Page 830. Yeah. And I think I put it on the PowerPoint.
You said the iron was good for how long? Yeah. Okay, so 9.30 next week again.
First thing we're going to do is take a test. And after we take a test, we're going to review our math and then we're going to review