Flashcards in Week 2 Neonatal Assessment and Resuscitation (everything) Deck (87)
WHY is surfactant important?
Surfactant is the liquid in alveoli that decreases surface tension, without it the alveoli would not stay open, they would collapse and no oxygen could make it's way down to them and no exchange of CO2 and O2 would occur. (collapse lungs)
When is surfactant present within the:
alveolar lining cells?
lumen of the airways?
(it shows up in each place at different weeks of gestation)
alveolar lining cells = 20 weeks
lumen of the airways = 28-32 weeks
terminal airways = 34-38 weeks.
(surfactant can show up in the terminal airways sooner IF stimulated by chronic stress or maternal corticosteroid administration.)
What negative thing can occur (for the fetus) if there is stress during labor and delivery?
(what can get into the babies lungs?)
Stress during labor and delivery can lead to the passage of meconium into the amniotic fluid and gasping efforts by the fetus, which may result in the aspiration of amniotic fluid into the lungs.
What time period of pregnancy is associated with a surge of catecholamines?
Transition to extrauterine life!
(hours before delivery and at delivery)
**** Catecholamines have an important role in the following areas: (four answers)
(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.
What is the major mechanism for neonatal heat regulation?
What two things does the neonate do in response to cold?
what do said responses cause?
raise their metabolic rate and release norepinephrine.
these responses above facilitates the oxidation of brown fat, which contains numerous mitochondria.
Thermal stress (cold) can be a big issue for what type of infants?
infants with low fat stores, such as preterm infants or infants who are small for gestational age. (they do not have as much brown fat and thus can not warm themselves as well)
For most infants, right after they are born, what do we do in order to try and keep them warmer?
dry them and place them in in an appropriate thermoneutral environment, for example with a radiant warmer.
True or false
nonshivering thermogenesis does not consume any oxygen bc no actual shivering is occuring?
This process may lead to significant oxygen consumption, especially if the neonate has not been dried and placed in an appropriate thermoneutral environment
What is an alternative method to drying and warming the baby immediately?
An alternative method to eliminate heat loss from evaporation is to provide an occlusive wrap rather than drying the infant.
For what infants would NOT drying and using an occlusive wrap be recommended?
For infants born at less than 28 weeks’ gestation, the use of polythene wraps or bags is recommended to minimize heat loss.
What is the actual temp. for neutral thermal environment for a newborn baby?
34-35 degrees C
Who is the only exception to the "keep warm" after birth rule? You want to keep these infants cool for a while.
the neonate with a perinatal brain injury, mild hypothermia therapy through selective head or whole-body cooling is initiated in the first 6 hours of life and may be neuroprotective in the setting of hypoxia-ischemia.
A nonreassuring FHR tracing is considered a predictor of the need for WHAT?
what percentage of neonates require some level of resuscitation?
Infants with congenital anomalies (e.g., tracheoesophageal fistula, diaphragmatic hernia, CNS and cardiac malformations) may need what after they are born?
resuscitation and cardiorespiratory support.
True or False
Preterm delivery increases the likelihood that the neonate will require resuscitation?
Anything that causes neonatal depression at birth can increase the likelihood that the neonate will need resuscitation, can you think of some examples of things that cause neonatal depression? (not bold, but just a knowledge check)
neonatal depression at birth can result from acute or chronic uteroplacental insufficiency or acute umbilical cord compression.
Fetal hemorrhage, viral or bacterial infection, meconium aspiration, and exposure to opioids or other CNS depressants also can result in neonatal depression.
What are the parameters for the APGAR score? (what do the letters stand for?)
at what time intervals after birth is the APGAR assessed?
Apgar score done a 1, 5 and 10 minute interval post delivery.
What points are you assigned based on the APGAR scale? (slide 12)
0, 1, or 2 points assigned for each parameter.
APGAR acronym tells you what to look for after birth of an infant but according to the ppt the paramerters are also listed as?
(these parameters are the same essentially as the direct APGAR signs to letters stuff, but I guess this was just another way to say it??)
Irritability and color
(see it covers the same things as A, P, G, A, R)
APGAR was developed by who?
Developed in 1953 by Anesthesiologist Virginia Apgar.
fetal lungs contain a liquid composed of an
ultrafiltrate of plasma
- that's secreted by the lungs inutero.
volume of fetal lung ultrafiltrate plasma?