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Apex Review > Neonatal A&P 3 > Flashcards

Neonatal A&P 3 Flashcards

1
Q

Potential complications of massive transfusion in the neonate include all of the following EXCEPT:
a. metabolic acidosis
b. metabolic alkalosis
c. hypocalcemia
d. hypokalemia

A

d. hypokalemia

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2
Q

Erythrocyte transfusion triggers vary on

A

the patient’s age (how much Hgb F they have) & underlying cardiopulmonary disease

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3
Q

FFP is indicated for

A

coagulopathy
massive transfusion
emergent warfarin reversal

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4
Q

FFP is not indicated for

A

expansion of intravascular volume

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5
Q

Platelet transfusion is recommended for

A

invasive procedures to maintain the platelet count above 50,000 mm3

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6
Q

Complications associated with massive transfusion include

A

alkalosis
hypothermia
hyperglycemia
hypocalcemia
hyperkalemia

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7
Q

When RBCs are stored, the cell membrane becomes

A

dysfunctional, which allows potassium to leak

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8
Q

Transfusion should be guided by

A

ongoing blood loss
anticipated blood loss
baseline Hgb/Hct
signs of inadequate oxygenation and end-organ dysfunction

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9
Q

For children less than 4 months of age with severe cardiopulmonary disease, the transfusion trigger would be

A

<13 g/dL

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10
Q

For the child less than 4 months of age presenting for major surgery or with moderate cardiopulmonary disease, the transfusion trigger would be

A

<10 g/dL

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11
Q

Dose of erythrocytes for children less than 4 months of age is

A

10-15 mL/kg

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12
Q

10 mL/kg will raise hgb by

A

1-2 g/dL

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13
Q

Dose of FFP is

A

10-20 mL/kg

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14
Q

Dose of platelets is obtained from apheresis is

A

5 mL/kg

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15
Q

Dose of platelets if pool platelet concentrate is

A

1 pack/10 kg

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16
Q

The risk of hyperkalemia during blood transfusion is reduced by

A

administering washed or fresh cells that are less than 7 days old

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17
Q

What type of blood should be given to immunocompromised patients?

A

irradiated blood (prevents graft vs. host)

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18
Q

At what age should you follow transfusion practice guidelines of the ASA task force on blood component therapy in a healthy child?

A

4 months and older

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19
Q

A 3 kg term neonate requires emergency exlap for necrotizing enterocolitis. her preoperative hematocrit is 50%. What is the maximum allowable blood loss to maintain a hematocrit of 40%?
a. 40 mL
b. 55 mL
c. 70 mL
d. 85 mL

A

b. 55 mL

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20
Q

What is the maximum allowable blood loss equation?

A

MABL= EBV x (Hct starting- Hct target)/ Hct starting

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21
Q

Normal newborn Hgb is

A

14-20 g/dL

22
Q

Hemoglobin of a 3 month old is

A

10-14 g/dL

23
Q

normal hemoglobin for a 6-12 month old is

A

11-15 g/dL

24
Q

Normal hemoglobin for an adult female is

A

12-16 g/dL

25
Q

Normal hemoglobin for an adult male is

A

14-18 g/dL

26
Q

Estimated blood volume of a premature neonate is

A

90-100

27
Q

EBV of a term neonate is

A

90-100

28
Q

EBV of an infant is

A

75-80

29
Q

EBV of a year old is

A

70-75

30
Q

The newborn’s kidney tends to:
a. excrete sodium
b. reabsorb sodium
c. reabsorb water
d. reabsorb glucose

A

a. excrete sodium

31
Q

Compared to the adult, the neonatal kidney has

A

a decreased perfusion pressure
a decreased GFR
& a decreased diluting and concentrating ability

32
Q

GFR improves substantially in the__________________ but does not reach adult levels until

A

first few weeks of life but does not reach adult levels until 8-24 months of age

33
Q

The neonate is an obligate __________________– in the first few days of life

A

sodium loser

34
Q

Renal tubular function continues to improve after birth, but it does not achieve full concentrating ability until

A

~2 years of age

35
Q

Describe fluid balance in neonates.

A

do a poor job conserving water so they’re intolerant of fluid restriction but they’re unable to excrete large volumes of water so they don’t do well with fluid overload either

36
Q

Neonates have a high degree of

A

insensible fluid loss

37
Q

The most significant source of water loss for neonates is

A

evaporation

38
Q

Why is so much body fluid lost through the skin of neonates?

A

surface area to body weight ratio is four times higher than the adult
immature skin is thinner and more permeable to water

39
Q

The total body water for a premature neonate is approximately:
a. 65%
b. 75%
c. 85%
d. 95%

A

c. 85%

40
Q

Total body water is highest in _________________ and decreases _____________

A

premature newborns and decreases as the child ages

41
Q

The following are highest at birth and decrease with age

A

total body water
extracellular fluid

42
Q

The following are lowest at birth and increase with age

A

intracellular fluid

43
Q

Signs of dehydration in the neonate include

A

sunken anterior fontanel
weight loss
lethargy
dry mucus membranes
increased hematocrit

44
Q

The premature neonate total body water is

A

85%

45
Q

The neonate total body water is

A

75%

46
Q

A higher ICF as the child ages provides a

A

volume reserve in times of intravascular volume loss making them more capable of adjusting to theses conditions when compared to the neonate

47
Q

Calculate the hourly maintenance rate for a child who weighs 15 kg.

A

50 mLs

48
Q

Routine use of _____________- is not recommended unless the neonate is at risk for __________-

A

glucose-containing solutions; hypoglycemia

49
Q

If less than 72 hours old, signs of hypoglycemia develop if the serum glucose is

A

<30-40 mg/dL

50
Q

If older than 72 hours, signs of hypoglycemia develop if serum glucose is

A

<40 mg/dL

Apex Review (224 decks)

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