Flashcards in Case 7 - Newborn with resp distress Deck (27):
C-section predisposes to what cause of neonatal resp distress?
TTN (transient tachypnea of the neonate)
What counts as prolonged PROM?
≥ 18 hrs
RDS occurs as late as __ weeks' gestation.
DDx for neonate w/ resp distress?
TTN, RDS, pneumothorax, hypoglycemia, CHF, neonatal sepsis, congenital diaphragmatic hernia, severe coarc, maternal drug use, meconium aspiration
What are the five components of APGAR?
Appearance/Color, Pulse (0, 100), Grimace/"Reflex Irritability", Activity/Tone, Respirations
Large for gestational age (LGA) is defined as weight for gest. age > 90th %ile [REMEMBER: Confirm WGA w/ Ballard exam]
SGA = wt for gest age < 3rd (or 10th depending on who you ask) %ile
Unique problems of the SGA baby
Temperature instability (hypothermia); Inadequate glycogen stores (hypoglycemia); Polycythemia and hyperviscosity
HR and RR in first hour of life?
HR is often 160-180/min, and RR is often 60-80/min
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
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
(proposed) definition of hypoglycemia in the neonate?
Asymptomatic infants and infants at risk for hypoglycemia: < 35 mg/dL; Symptomatic infants: < 45 mg/dL
A diaphragmatic hernia most commonly develops on the ____ side
Perform screening for Developmental Dysplasia of the Hip (DDH) until what age?
Until child is 18 m/o.
Call the doc if the newborn has fewer than ___ wet diapers per day
6 (though keep in mind how good new diapers are)
Within 10–90th percentile on the intrauterine growth curve
Risk factors for DDH?
1. Breech (30–50% occur in breech infant); 2. Sex (9:1 female predom); 3. Family hx
A - scoring [A]ppearance in APGAR?
2 - all pink; 1 - limbs blue; 0 - all blue or pale
P - scoring [P]ulse in APGAR?
2 - HR > 100bpm; 1 - HR < 100bpm; 0 - no HR
G - scoring [G]rimace or "reflex irritability" in APGAR?
2 - Good cry or active withdrawal; 1 - Grimace or weak cry; 0 - No response
A - scoring [A]ctivity/Tone in APGAR?
2 - Well flexed, or active mov'ts of extremities; 1 - some flexion of extremities; 0 - flaccid
R - scoring [R]espiratory effort in APGAR?
2 - Good, crying; 1 - Weak, irregular, or gasping; 0 - absent
Which is Ortolani and which is Barlow?
"Ortolani goes out and Barlow pushes back."
Risk factors for RDS?
IDM (due to delayed lung maturation); Sibling w/ ho RDS; Male; C-section w/o labor; Perinatal asphyxia
Normal inspiratory films in an infant should have ??how many?? intercostal spaces of lung fields on both sides.
8 or more
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