Respiratory Disfunction of the Newborn Flashcards
(54 cards)
what are the 3 critical factors in the development of respiratory distress syndrome
preterm unable to produce enough surfactant
muscle coat of pulmonary blood vessels are incompletely developed
ductus arterioles may remain open due to hypoxia
what helps close the PDA
hyperoxemia
what could happen if the PDA does not close
pulmonary congestion and overload
why are preterm newborns at an increased danger of respiratory obstruction
- the bronchi and trachea are very narrow and mucus obstructs airway
- positioning
- weak or absent gag reflex could result in aspiration
if O2 sats are dropping low what should you do
position them in a prone position for chest expansion
what are signs of respiratory distress
nasal flaring retractions crackles asthma (wheezing) grunting cyanosis tachypnea
what are the two positions you can place the baby in for maintenance of resp function
supine with head slightly elevated without hyper flexion and prone position
why do you not want to do a lot of suctioning
this could put further stress on the baby
what should be assessed before oral feedings are started
infants gag and suck reflex as well as if they are breathing fast or not
why will a baby not go higher than 100% O2 sats on oxygen?
because we want to ween the baby off of the oxygen because too much can cause problems to the baby (ROP)
what delivers 400 breaths a minute to the infant and you will see a constant wiggle of their chest
high frequency oscillation
what is it when the baby poops in utero and they breath it into their lungs
meconium aspiration syndrome
what stops producing due to the meconium build up
surfactant
what is the biggest issue with MAS
mechanical obstruction because it plugs up the airway, making it sticky
MAS happens to….
full term or post term
what are clinical signs of MAS
severe respiratory distress shortly after birth and audible rales or rhonchi on auscultation
- barrel chest
- not a good apgar
- PO2 is low
- Acidosis
what is the management of MAS
ventilation and monitoring
surfactant admin
results when the normal vasodilation and relaxation of the pulmonary vascular bed do not occur
persistent pulmonary hypertension of the newborn (PPHN)
PPHN happens to…
term or near term infants (wimpy white boys don’t do well, african american females do the best)
what are 6 risk factors of PPHN
hypoxia RDS pneumonia bacterial sepsis hypo or hyperthermia
for PPHN babies where do we check blood pressure
right arm
why do PPHN babies desat
their lung pressure is higher than systemic pressure and this makes blood bypass the lungs (going through PDA)
what are assessment finding in a PPHN baby
- term or near term infant
- low apgar score
- symp within 12 hrs
- hypoxia at birth
- tachypnea
- retraction/grunting
- cyanosis
- hypotension
- heart murmur
- met acidosis
preductal is the
right arm
