8- Neonatology Flashcards
(91 cards)
Newly born
Infant at time of birth
Newborn
Infant within first few hours of birth
Neonate
Infant within the first month of being born
Antepartum risk factors for resuscitation (8)
- Multiple gestation
- No prenatal care
- Mom is <16 or >35 y/o
- Polyhydramnios or Oligohydramnios
- History of stillbirth
- Post term gestation
- Drug use during pregnancy
- Eclampsia, HTN, Diabetes, Toxemia
Intrapartum risk factors for resuscitation (7)
- Premature labor
- Meconium
- Membrane rupture >24hrs before delivery
- Abnormal presentation
- Prolonged delivery
- Prolapsed cord
- Bleeding
Steps of neonatal resuscitation (5)
1-Dry, warm, stimulate, suction for 30 seconds
2- HR >100 HR w/ central cyanosis, free flow O2 30 seconds
2.5- Poor respirations <100 HR, BVM 40-60/min for 30 seconds
3- HR >60 begin compressions 3:1 and ET
4- No improvement after 30 sec start ALS
5- No signs of life after 10 min, consider termination
Fetal transition
Series of events needed to enable newborn to breath as its delivered
The 3 shunts from adult to newborn
1-Ductus venous
2-Ductus arteriosus
3- Foramen ovale
Weeks of gestation for pre, term and post term delivery
Preterm- Less than 37 weeks
Term- 38 to 42 weeks
Postterm- More than 42 weeks
What causes a newborn to begin its own breathing
Hypoxia and hypercapnia related to partial occlusion of the umbilical cord during normal delivery
NEEDED equipment for newborn delivery (14)
- Bulb syringe
- 5F to 14F suction catheter
- 8F feeding tube with 20 mL syringe
- Pedi BVM
- Laryngoscopes 00, 0, 1
- ET tubes 2 to 4
- EPI (0.1 mg/mL)
- 250 mL D10
- Umbilical catheters 3.5F and 5F
- 1 through 50 syringes
- 26 through 18 g needles
- OPA’s 0, 00, 000
- Plastic wrap
- Warming pad
What is suctioned first in a newborn
MOUTH
What needs to be examined as newborn is delivered
- ABC’s
- APGAR
- Skin discoloration
- Head symmetry
- Eyes
- Umbilical cord
Target O2 sat at 1-10 min for a newborn
1- 60 to 65% 2- 65 to 70% 3- 70 to 75% 4- 75 to 80% 5- 80 to 85% 10- 85 to 95%
How long can you suction a newborn for
No more than 10 seconds
When and how much free flow O2 is applied to a newborn
Cyanotic, pale
5 Lpm
Why would a newborn need an OPA
Bilateral Chantal atresia
Pierre Robin sequence
Macroglossia
Other craniofacial defects
In what case can nasal intubation not be done
Choanal atresia
What is choanal atresia
Bony or membranous obstruction of the back of the nose preventing air flow
Pierre Robin Sequence
Developmental abnormalities including small chin, posteriorly positioned tongue leading to airway obstruction
How to relieve Pierre Robin sequence
OPA, depress tongue dont rotate OPA
Signs of resp distress for BVM use in newborn
Periodic breathing
Intercostal retractions
Nasal flaring
Grunting on expiration
When to use BVM on newborn
Inadequate respiratory effort
HR less than 100 after initial stimulation
Other signs of resp distress
Common causes of respiratory distress in a newborn (11)
- Lung, heart disease
- CNS disorder
- Pneuothorax
- Meconium aspiration
- Premature development
- Shock/Sepsis
- Diaphragmatic hernia
- PERSISTENT PULMONARY HYPERTENSION
- Airway obstruction
- Pneumonia
- Metabolic acidosis