Neonatal Assessment & Resuscitation Ch. 9

Question 1

How many shunts does the fetus circulatory system use?

Answer 1

3

Question 2

What are shunts?

Answer 2

●These are small passages that direct blood that needs to be oxygenated.

Question 3

What is the purpose of these shunts in the fetal circulatory system?

Answer 3

●The purpose of these shunts is to bypass the lungs and liver. That’s because these organs will not work fully until after birth.

Question 4

Which shunt in the fetus circulatory system bypasses the lungs?

This shunt moves blodd from the ____ ____ of the heart to the ____ _____.

Answer 4

a)The shunt that bypasses the lungs is called the foramen ovale. This shunt moves blood from the right atrium of the heart to the left atrium.

Question 5

What moves the blood from the pulmonary arter to the aorta?

Answer 5

b)The ductus arteriosus moves blood from the pulmonary artery to the aorta.

Question 6

Why might preterm infants and infants requiring ceserean delivery without labor have a greater amount of residual liquid after deivery?

Answer 6

Preterm infants and infants requiring cesarean delivery without labor may have greater amount of residual liquid after delivery owing to a reduced catecholamine surge at delivery that promotes sodium channel transport; this residual lung liquid leads to difficulty in initiation and maintenance of normal breathing patterns, and is the cause of transient tachypnea of the newborn.

TTN –> transient tachypnea of the newborn

Question 7

TTN is caused by?

TTN –> Transient Tachypnea of the Newborn

Answer 7

benign, self limited condition that can present in infants of any gestational age, shortly after birth caused by delay of fluid clearance from the lungs

Question 8

Why is the first breath in a neonate important?

Answer 8

First breath occurs approximately 9 seconds after delivery. This first breath is important because it establishes the neonate’s functional residual capacity. (FRC)

Question 9

Where do catecholamine have an imprtant role in?

Answer 9

●Catecholamines have an important role in the following areas:

(1) the production and release of surfactant,
(2) the transition to active sodium transport for absorption of lung fluid,
(3) the mediation of preferential blood flow to vital organs during the period of stress that occurs during every delivery, and
(4) thermoregulation of the neonate.

Question 10

What is an alternative method to eliminate heat lossfrom eveaporation ?

Answer 10

An alternative method to eliminate heat loss from evaporation is to provide an occlusive wrap rather than drying the infant.

Question 11

What is recommended to minimize heat loss for infants born at less than 28 weeks gestation?

Answer 11

For infants born at less than 28 weeks’ gestation, the use of polythene wraps or bags is recommended to minimize heat loss.

Question 12

Neonatal Assessment

APGAR

What are the times they are done at?

What is the parameters?

Answer 12

Apgar score done a 1, 5 and 10 minute interval post delivery

Parameters are:

1. Heart Rate
2. Respiratory Rate
3. Muscle Tone
4. Reflex
5. Irritability and color

Know How to Calculate APGAR score*

Question 13

What does the APGAR score mean?

Answer 13

Used to assess newborn and guide resuscitative efforts.

5 parameters are evealuated at 1 & 5 minutes.

The score at 1 minute correlates with fetal acid base status.

5 minute score can be predictive of neurological outcome.

Normal = 8-10

Moderate Distress = 4-7

Impending Demise =0-3

Question 14

Meconium Aspiration Syndrome Treatment ?

Answer 14

Treatment involves the use of PPV and is associated with a 5% to 20% incidence of pneumothorax from pulmonary ark leaks.