Neonatal A&P

Question 1

Each vital sign is consistent with the term newborn EXCEPT:
a. heart rate 140 bpm
b. respiratory rate 40 bpm
c. systolic blood pressure 90 mmHg
d. diastolic blood pressure 40 mmHg

Answer 1

c. systolic BP 90 mmHg

Question 2

The neonatal period encompasses the first _________ of life

Answer 2

28 days of life

Question 3

The infant period lasts from

Answer 3

29 days to one year

Question 4

Newborn BP is

Answer 4

70/40

Question 5

Newborn RR is

Answer 5

40-60

Question 6

Newborn HR is

Answer 6

140

Question 7

1 year old BP is

Answer 7

95/60

Question 8

1 year old HR is

Answer 8

120

Question 9

1 year old RR is

Answer 9

40

Question 10

3 year old BP is

Answer 10

100/65

Question 11

3 year old HR is

Answer 11

100

Question 12

3 year old RR is

Answer 12

30

Question 13

12 year old BP is

Answer 13

110/70

Question 14

12 year old HR is

Answer 14

80

Question 15

12 year old RR is

Answer 15

20

Question 16

Select the statements that MOST accurately reflect the CV system in the newborn. (select 2)
a. heart rate is the primary determinant of blood pressure
b. phenylephrine is a first-line treatment for hypotension
c. stress is more likely to activate the parasympathetic system
d. hypotension is defined as a systolic BP <70 mmHg

Answer 16

a. heart rate is the primary determinant of BP
c. stress is more likely to activate the parasympathetic nervous system

Question 17

Neonates consume _______ as much oxygen and produce _______ as much CO2 than the adult on a weight-adjusted basis

Answer 17

2x; 2x

Question 18

_________ is the primary determinant of cardiac output and systolic blood pressure in the neonate.

Answer 18

Heart rate

Question 19

______ is relatively fixed in the neonate

Answer 19

stroke volume

Question 20

The best way to support BP in the neonate is _________ because

Answer 20

increasing heart rate because of the non-compliant left ventricle sensitive to increased afterload

Question 21

What is more mature in the neonate SNS or PNS?

Answer 21

PNS is more mature

Question 22

Neonates respond to the stress of laryngoscopy with

Answer 22

bradycardia

Question 23

Although the neonate has an immature SNS, ____ activates the SNS

Answer 23

pain

Question 24

What predisposes the neonate to intracerebral hemorrhage?

Answer 24

hypertension
immature cerebral autoregulatory response
frail cerebral vasculature

Question 25

It’s metabolically more efficient for neonates to increase _____________ than it is to increase ___________

Answer 25

respiratory rate; tidal volume

Question 26

Do neonates have the frank-starling relationship?

Answer 26

yes, but it is underdeveloped

Question 27

Hypotension is defined as _______ in the newborn

Answer 27

<60 mmHg

Question 28

Hypotension is defined as _________ in the 1 year old

Answer 28

<70 mmHg

Question 29

Hypotension is defined as _________ if patients older than 1 year

Answer 29

70+ (child’s age in years x2) mmHg

Question 30

In the setting of hypovolemia and bradycardia, ______ is favored over ________

Answer 30

epinephrine over atropine

Question 31

Do neonates have a baroreceptor reflex?

Answer 31

it is poorly developed and reflex fails to increase HR in the setting of hypovolemia

Question 32

What is the normal tidal volume in a neonate?

Answer 32

6 ml/kg

Question 33

Which statement MOST accurately describes the infant airway? (select 3)
a. glottic opening is positioned more cephalad
b. vocal cord position at C1-C2
C. C shaped epiglottis
d. epiglottis is floppy
e. right and left mainstem bronchi take off at same angle
f. vocal cords have anterior slant

Answer 33

a. glottic opening is positioned more cephalad
e. right and left mainstem bronchi take off at same angle
f. vocal cords have anterior slant

Question 34

Describe the pediatric patients tongue.

Answer 34

large tongue relative to the volume of the mouth

Question 35

vocal cords of the pediatric patient take on

Answer 35

an anterior slant

Question 36

Describe the pediatric patient’s epiglottis

Answer 36

U or omega shape epiglottis that’s longer and stiffer

Question 37

The laryngeal position of the pediatric patient is at

Answer 37

C3-C4

Question 38

What is the narrowest fixed region of the airway in the pediatric patient?

Answer 38

cricoid ring

Question 39

What is the narrowest dynamic region of the airway of the pediatric patient?

Answer 39

vocal cords

Question 40

The subglottic airway shape in the pediatric patient is

Answer 40

funnel shaped

Question 41

Infants up to 5 months of age are preferential

Answer 41

nose breathers

Question 42

The mainstem right bronchus of the pediatric patient is

Answer 42

less vertical (takes off at 55 degreed from midline

Question 43

Bilateral choanal atresia in the infant may require

Answer 43

emergency airway management if the infant is unable to mouth breathe

Question 44

Infants/pediatric patients are more likely to obstruct the

Answer 44

upper airway due to the tongue being closer to soft palate

Question 45

The anterior slant to the infants vocal cords makes it

Answer 45

more difficult to visualize and pass an ETT as it can get stuck in the anterior commissure

Question 46

Resistance to ETT insertion beyond the vocal cords is likely at the

Answer 46

cricoid ring

Question 47

What intubating position is recommended for infants?

Answer 47

head on bed with shoulder roll

Question 48

The sniffing position in the infant will

Answer 48

place the glottic opening in a more anterior position