Neonatal A&P

Question 1

neonatal period is when?

Answer 1

0-28days

Question 2

infant period is when?

Answer 2

28 days to 1 year

Question 3

newborn vital signs

Answer 3

BP 70/40
HR 140
RR 40-60

Question 4

1yr vital signs

Answer 4

BP 95/60
HR 120
RR 40

Question 5

3yr vital signs

Answer 5

BP 11/65
HR 100
RR 30

Question 6

12yr vital signs

Answer 6

BP 110/70
HR 80
RR 20

Question 7

primary deterimant of CO and BP in neonates

Answer 7

HR

Question 8

what is stress likely to cause and why?

Answer 8

bradycardia because lots of PNS activity, stress causes bradycardia that decreases CO

Question 9

HoTN definiton in newborn

Answer 9

SBP <60

Question 10

why is it hard for neonate to overcome increased afterload?

Answer 10

poor cardiac contractility

Question 11

oxygen and CO2 production in a neonate

Answer 11

2x the oxygen consumption (6ml/kg/min) and 2x the CO2 production

Question 12

most effecient way for neonate to increase MV?

Answer 12

by increasing RR, not TV

Question 13

SV is realtively what in neonate?

Answer 13

fixed

Question 14

what is the big risk of pain in a neonate?

Answer 14

pain activates SNS > HTN.

immature cerebral autoregulatory response and fragile cerebral vasculature pre-dispose neonate to intracerebral hemorrhage.

Question 15

BP formula

Answer 15

BP = HR x SV x SVR

Question 16

HoTN definitions by age group

Answer 16

neonate SBP < 60
1yr SBP < 70
>1yr SBP 70 + (age x 2)

Question 17

pediatric airway things to know

Answer 17

prefferential nose breathing up to 5 months
large tongue
short neck
u shapped epiglottis
long stiff epiglottis (hard to displace)
vocal cords have ant slant
larynx at C3-C4
neonates have ^ alveolar ventilation from ^ RR

Question 18

type 1 fibers

Answer 18

slow twich

Question 19

type 2 fibers

Answer 19

fast twitch

Question 20

neontes have more type 1 or type 2 fibers?

Answer 20

type 2 so they fatigue easily

Question 21

neonats and adults have the same ammount of?

Answer 21

dead space adn tidal volume

Question 22

who has highest risk of post-op apnea?

Answer 22

former pre-term infants < 44 weeks

Question 23

what can decrease tisk of apnea after GA?

Answer 23

caffeine 10mg/kg

Question 24

how are lung compliance and chest wall compliance affected by neonatal period?

Answer 24

decreased lung compliance (fewer alveoli)

increased chest wall compliance (more cartilage)

Question 25

how do lung neonatal lung volumes change on per weight basis?

Answer 25

decreased FRC, VC, TLC increased RV and closing capacity increased resistance to airflow from small airways TV is the same as adult Deadspace is same as an adult

Question 26

how do chagnes in airway diamater affect the neonate?

Answer 26

minor decrease in airway diameter (edema or secrtions) significantly increases WOB

Question 27

how is water loss affected by neonatal period?

Answer 27

high insensible water loss where evaporation is most significant source of heat loss.

Question 28

in the first few days of life, the neonate is an obligate?

Answer 28

Na looser. after first few days then neonte can retain Na better than excret it

Question 29

when does GFR increase?

Answer 29

increases substantially in 1st few weks of life, but doesnt reach adult levels until 8-14 months of age

Question 30

when does neonate acheive full renal tubular concentrating ability?

Answer 30

around two years

Question 31

when is TBW the highest?

Answer 31

at birth and decreaes with age

Question 32

ECF is highest when?

Answer 32

at birth and decreaes with age

Question 33

ICF is highest when?

Answer 33

lowest at birth and increases with age

Question 34

should you routinely use glucose containing solutions in the neonate?

Answer 34

No, unless neonate is at risk of hypoglycemia

Question 35

s/s of hypoglycemia are present when < 72hrs old?

Answer 35

BP <30-40

Question 36

s/s of hypoglycemia are present when >72hrs old

Answer 36

BG <40

Question 37

CO in neonate is higher or lower?

Answer 37

higher

Question 38

volume of distribution for water soluble drugs in the neonate is

Answer 38

higher

Question 39

plasma protein concentration in the neonate

Answer 39

lower

Question 40

neonatal hepatic function is

Answer 40

immature

Question 41

renal function in neonate

Answer 41

immature

Question 42

neonatal BBB

Answer 42

immature

Question 43

MAC is what in neonate

Answer 43

higher

Question 44

Sux dose in neonate

Answer 44

increase to 2mg/kg because of extra ECF

Question 45

how does NDNMB dose change in neonate?

Answer 45

stays teh same

Question 46

what is the risk of sux use in kids < 8?

Answer 46

risk of hyperkalemia from undiagnosed muscular dystrophy

Question 47

priority tx in sux induced hyperkalemia?

Answer 47

IV calcium

Question 48

what paralytics can be given IM?

Answer 48

sux and Roc

Question 49

indicators of recovery from NMBs

Answer 49

TOF ratio > 0.9 and max inspiratory force > -25

Question 50

what are some subjective signs that correlate with adequte NMB recover in teh neonate?

Answer 50

grimaces, elbow and hip flexion, brining kneeds to chest,

Question 51

10ml/kg of PRBC will raise Hgb by?

Answer 51

1-2g/dL