Case 7 - Newborn with resp distress Flashcards Preview

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Flashcards in Case 7 - Newborn with resp distress Deck (27):
1

C-section predisposes to what cause of neonatal resp distress?

TTN (transient tachypnea of the neonate)

2

What counts as prolonged PROM?

≥ 18 hrs

3

RDS occurs as late as __ weeks' gestation.

37

4

DDx for neonate w/ resp distress?

TTN, RDS, pneumothorax, hypoglycemia, CHF, neonatal sepsis, congenital diaphragmatic hernia, severe coarc, maternal drug use, meconium aspiration

5

What are the five components of APGAR?

Appearance/Color, Pulse (0, 100), Grimace/"Reflex Irritability", Activity/Tone, Respirations

6

Define LGA

Large for gestational age (LGA) is defined as weight for gest. age > 90th %ile [REMEMBER: Confirm WGA w/ Ballard exam]

7

Define SGA

SGA = wt for gest age < 3rd (or 10th depending on who you ask) %ile

8

Unique problems of the SGA baby

Temperature instability (hypothermia); Inadequate glycogen stores (hypoglycemia); Polycythemia and hyperviscosity

9

HR and RR in first hour of life?

HR is often 160-180/min, and RR is often 60-80/min

10

If an infant successfully transitions its circulation, what should its HR and RR be at 2 hrs of life?

HR is usually 120-160/min, and RR is usually 40-60/min

11

DDx of blue baby?

Resp: TTN, RDS (Pneumothorax, Diaphragmatic hernia, Choanal atresia, Pulm hypoplasia); Cardiac: Tet, TGA (Truncus arteriosus, Tricuspid atresia, TAPVR, Pulm atresia); Neuro: HIE, Intraventric hemorr, Sepsis/meningitis; ID: Septic shock, Meningitis; Other: Resp depr 2/2 maternal meds, Hypothermia, Polycythemia/hyperviscosity syn

12

(proposed) definition of hypoglycemia in the neonate?

Asymptomatic infants and infants at risk for hypoglycemia: < 35 mg/dL; Symptomatic infants: < 45 mg/dL

13

A diaphragmatic hernia most commonly develops on the ____ side

left

14

Perform screening for Developmental Dysplasia of the Hip (DDH) until what age?

Until child is 18 m/o.

15

Call the doc if the newborn has fewer than ___ wet diapers per day

6 (though keep in mind how good new diapers are)

16

Define AGA.

Within 10–90th percentile on the intrauterine growth curve

17

Risk factors for DDH?

1. Breech (30–50% occur in breech infant); 2. Sex (9:1 female predom); 3. Family hx

18

A - scoring [A]ppearance in APGAR?

2 - all pink; 1 - limbs blue; 0 - all blue or pale

19

P - scoring [P]ulse in APGAR?

2 - HR > 100bpm; 1 - HR < 100bpm; 0 - no HR

20

G - scoring [G]rimace or "reflex irritability" in APGAR?

2 - Good cry or active withdrawal; 1 - Grimace or weak cry; 0 - No response

21

A - scoring [A]ctivity/Tone in APGAR?

2 - Well flexed, or active mov'ts of extremities; 1 - some flexion of extremities; 0 - flaccid

22

R - scoring [R]espiratory effort in APGAR?

2 - Good, crying; 1 - Weak, irregular, or gasping; 0 - absent

23

Which is Ortolani and which is Barlow?

"Ortolani goes out and Barlow pushes back."

24

Risk factors for RDS?

IDM (due to delayed lung maturation); Sibling w/ ho RDS; Male; C-section w/o labor; Perinatal asphyxia

25

Normal inspiratory films in an infant should have ??how many?? intercostal spaces of lung fields on both sides.

8 or more

26

CXR findings of TTN?

1. Perihilar streaking (d/t interstitial fluid and engorged lymphatics); 2. Coarse, fluffy densities that represent fluid-filled alveoli; 3. Fluid in pleural space and fissures

27

CXR findings in RDS?

Air bronchograms and "Ground-glass" (Diffuse reticulogranular appearance of lung fields)