ISSUES UNIQUE TO THE NEWBORN

1. A newborn has an APGAR score of 5 at one minute and 9 at five minutes. What are the components of the APGAR score? How is the APGAR scored used?
2. A 6-hour-old infant born at term is persistently tachypneic with respiratory rates in the 80’s. What additional information would be helpful in evaluating the infant? Discuss the diagnostic considerations and initial approach to the evaluation of this child.
3. A full-term infant appears yellow at 48 hours of age. The total bilirubin is 13 mg/dl. What components of the history, physical examination, and laboratory data would be helpful in your evaluating this child?
4. An otherwise thriving 14-day-old infant appears yellow. What additional history and evaluation would be important in assessing this infant?
5. A 24-hour-old infant has not yet stooled. Discuss the possible explanations and your concerns.
6. The mother of a newborn infant asks your advice about why she should breast-feed her infant. She will need to return to work in 8 weeks and wonders if she should just bottle feed. How would you Council her?
7. A term newborn weighs 4800 grams. What components of the history and physical examination would be helpful in your assessment? What immediate complications might this infant experience?
8. A mother with no prenatal care and a history of known substance abuse has just delivered a baby. What special medical and social concerns do you have about caring for this infant?
9. The parents of a newborn boy ask your opinion about whether the baby should be circumcised. What should you consider in Counciling these parents?
10. Outline the anticipatory guidance you would give the parents of a healthy, full-term first born infant at the time of discharge home from the newborn nursery.
11. The breast-feeding mother of a 4-week-old infant is concerned that her baby is not gaining enough weight. Her mother-in-law has encouraged her to start formula supplements. The baby’s birth weight was 7lb 8oz. His current weight is 9lb. How would you evaluate this infant and Council the mother? What cultural beliefs might be important to discuss?
12. A full term newborn weighs 2000 grams. What factors might have contributed to this infant’s small size? How do you assess the maturity of this infant?
13. A term female is delivered via c-section because of frank breech presentation. What features of the history and physical examination would support your concern about development hip dysplasia in this child?