Flashcards in Exam #2 Respiratory Deck (134)
Before born, lungs are not needed.
Less than 32-33 weeks of age, baby does not have sufficient amount of surfactant.
Biggest change in the NICU is the development of surfactant
If less than 34 weeks 1st dose of surfactant is given at birth
Fake surfactant = decrease incidence of -
RDS - Respiratory Distress Syndrome
BPD- Bronchopulmonary Dysplasia
**** Respiratory Distress Syndrome =
Lack of Surfactant
hard alveoli due to constant ventilator causing positive pressure.
lung tissues get pounded until gets tough
Treatment for Apnea of Prematurity
Can give through IV or Orally
Monitor for Toxicity
What is Apnea of Prematurity?
pause longer than 20 seconds
Apnea spells can last so long that they cause bradycardia
Sudden Infant Death Syndrome (SIDS) interventions:
sleep on back
pacifier after 1 month
A + B Spells =
(Apnea and Brady)
How premie tells us they are sick
If alarm goes off, ASSESS FIRST
Infants breathe periodically- breathe, Breathe, Pause
----Happens in Premature babies
Preterm babies =
**** S/S of Caffeine Toxicity
Toddlers and Preschoolers breathe abdominally
use of abdominal muscles to breathe until 5 years old
Infants have irregular breathing patterns and are nose breathers.
they have smaller, less rigid airways
smaller lung size
horizontal, short eustachian tubes in Infants
Immature immune systems
Surfactant was given in clinical trials and had to stop because was unethical.
What is a late sign of respiratory distress?
Assessing Respiratory Status - VISUAL ASSESSMENT =
- work of breathing such as grunting, flaring, retracting
- Rate of breathing
- Chest Movement- is it equal?
- Posture and activity level - Well Flexed alert and awake**
- Sensorium (LOC)
- Level of comfort
- Color- skin and mucus membranes
- pink? sats in the 90's
- Grey? 80's or lower
- Worried about mucus membranes
Assessing Respiratory status - AUSCULTATION
Without the stethoscope you can hear grunting, stridor, or wheezing.
With Stethoscope- inspiratory and expiratory- will usually tell us if it is something in the upper or lower airway
Baby- Listen to Axillae and back
Older listen to front and back
While grunting- baby uses abdominal muscles to push air out.
What are the cardinal signs of respiratory distress?
Restlessness (Huge sign) , Confusion, Anxiety, Irritability
What is the earliest sign of respiratory distress?
What are additional signs of respiratory distress?
grunting, flaring, retracting
What are the signs of Impending Respiratory Failure?
Depressed or slow respirations (Decreased inspiratory breath sounds)
Cyanosis (Central (Mucus membranes)
What are 2 signs that a baby is about to code?
80's o2 sat
Means about to code…,.
O2 Sats falling are a sign of respiratory failure….
dont wait for them to become cyanotic
Why is tachypnea a sign of respiratory distress?
because if you have trouble breathing, you are going to breathe faster to get more air.
pH Less than 7.35
Respiratory Acidosis causes =
need to be ventilated with oxygen
Metabolic Acidosis causes =
Diarrhea, Kidney failure, DKA
pH greater than 7.45