Whats that bug
One of the common causative agents responsible for sepsis
GBS
Symptoms are purulent and profuse exudate, swelling of the eyelids
Gonorrhea. Ceftriaxone 25-50 mg/kg, max 125 mg, IV/IM x 1
You suspect NAS on your 3 day old patient because you have observed poor suck swallow when feeding. Your concern for this infant is
Poor weight gain. Failure to Thrive
There are other concerns but think about the current state.
The 3 universal features that make a provider suspect Down's syndrome are
What are the Risk factor for SIDS
Multifactorial
Vulnerable infant/Trigger event/Critical development period
The largest risk for neonatal exposure is if primary or recurrent infection in mother
HSV
Infection diagnosed by PCR/DNA culture or blood culture and treatment
HSV. Acyclovir, 20 mg/kg per day IV divided Q 8 hours as soon as suspected
You are observing a neonate of a mom that took SSRI's and is a smoker. The infant has poor suck and swallow, high pitch cry and nasal stuffiness. Finnegan is 6. You advise mom that
baby is showing no current signs of withdrawal but will need to continue to monitor.
When evaluating developmental impairment in children with DS appear you are aware that milestones occur
2x slower than normal
What is the most important thing to focus on as a provider caring for a newborn suspected to have FAS
Nutrition
Early detection is crucial
Can form a membrane from the conjunctiva to the exudate
Chlamydia
Treat both conjunctivitis and pneumonia the same way
Erythromycin 50 mg/kg/d PO in four divided doses for 14 days
Finnegan scoring needs to be done on a newborn suspected of NAS
Every 4 hours
You are doing a newborn exam on your patient who has down's syndrome. The cardiac exam and pulseoxytometry are normal. What else does your patient need prior to discharge?
An echocardiogram
When is the most common time to see withdrawal symptoms on an infant who's mother used opioids in pregnancy
48-72 hours
The infection is often confused with chemical reaction from the prophylactic treatment
Gonorrhea
You have a 4 day old with mucopurulent discharge from the eyes. You suspect Chlamydia but the results of your cultures are not back. Baby is otherwise asymptomatic. Your next course of action is.
Wait for the results.
Treat suspected Chlamydia pneumonia empirically but not conjunctivitis alone.
Also symptoms of chlamydia conjunctivitis are unusual before 5 days of age unless PROM
Treatment of NAS is
Supportive care/Nonpharmacological
Common murmurs found in infants with DS include
ASD/VSD
The symptom that is less indicative of sepsis in a premature infant
Temperature
Preferred antibiotic treatment for confirmed GBS infectin of the newborn
Penicillin G.
Best as it does not affect microbiome.
If suspected but the cultures are not back then Ampicillin and Gentamycin
Can cause irreversible brain damage and is considered a teratogen
Alcohol
Diagnosis for Down's Syndrome must be done by
Chromosomal confirmation
Ellie was born after a prolonged labor with rupture of membranes > 24 hours, maternal fever. She is having a hard time latching and seems a little tired after the long labor. She will likely need
Blood cultures, Urine culture and CSF to r/o sepsis.