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Flashcards in Neonates Deck (36)
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1

What is the compression to ventilation ratio for newborn resuscitation?

3:1

2

How long should cord clamping be delayed for following complete delivery?

Cord clamping should be delayed for at least 1 minute

3

Should you attempt to aspirate meconium from the nose and mouth of an unborn infant while the head is still on the perineum?

NO

4

What are the 3 fetal ducts which should close/ constrict in the perinatal period?

Ductus venosus

Foramen ovale

Ductus arteriosus

5

What happens to circulating prostaglandin levels after birth?

Circulating prostaglandins drop

6

What does the ductus arteriosus become?

The ligamentum arteriosus

7

What does the ductus venosus become?

The ligamentum teres

8

Why does persistent pulmonary hypertension of the newborn occur?

The ductus arteriosus remains open, causing shunting of blood from the RV to the descending aorta, causing hypertension

9

What are the management options for persistent pulmonary hypertension?

Ventilation and oxygen

Nitric oxide

Sedation

Inotropes

ECLS

10

What factors make newborns susceptible to heat loss and hypothermia in the first few hours of life?

Wet when born

Large surface area

No shivering

Main source of heat production is the breakdown of brown fat (this is not efficient in the first 12 hours of life)

11

Why are small for dates/ preterm babies most susceptible to hypothermia?

They have lower stores of brown fat, little subcutaneous fat and a large surface area

12

Describe the changes in glucose homeostasis in newborns

Drop in insulin, increase in glycogen

Mobilisation of hepatic glycogen stores for gluconeogenesis

Ability to use ketones as brain fuel

13

Why does physiological anaemia occur in newborns?

Adult Hb is synthesised more slowly than fatal Hb is broken down

14

Why does physiological jaundice occur?

Liver enzyme pathways are present but immature

Breakdown of fetal Hb causes a rise in unconjugated bilirubin

15

What is considered a normal weight for a neonate?

2.5kg to 4kg

Large for gestational age >4kg
Small for gestational age <2.5kg

16

When is considered term?

37- 41 weeks

17

What is the apgar score used for?

The apgar score is a measure of perinatal adpation scored out of 10

Normal is >8

18

What does APGAR stand for?

Alertness, pulse, grimace (reflexes), activity (muscle tone), respiration

19

What respiratory bacterial infection are neonates at risk of?

Group B streptococcus infection

20

What is hydrops fetalis?

Widespread oedema

21

What is potter's syndrome?

Kidney failure causes oligohydramnios (lack of amniotic fluid) which causes abnormal features in the newborn

22

How does respiratory distress syndrome present?

Tachypnoea
grunting
nasal flaring
intercostal recessions
cyanosis

23

What is the underlying pathology behind RDS?

Surfactant deficiency and structural abnormalities

24

When does retinopathy usually present in newborns?

6-8 weeks following delivery

25

When does necrotising enterocolitis present?

After the baby has had its first milk as there is then substrate in the bowel - this will be within the first couple of weeks of life

26

How does necrotising enterocolitis present?

Causes an infection in the bowel wall which can involve necrosis and abscess formation

Feeding intolerance, abdominal distension, blood stools

May be fatal or result in small gut syndrome

27

What is meconium ileus?

Blockage to the passage of meconium through the bowel due to poor quality of the meconium

28

When and how does meconium ileus present?

Presents in the first 24-48 hours

Abdominal distension and vomiting

29

What would be the x-ray appearance in a newborn with meconium ileus?

Colon appears narrow and thin - meconium has not been passed and therefore the bowel has never been used before

30

What is jejunal atresia?

Obstruction in the wall of the bowel