1 Flashcards
What is the most important function to establish immediately after birth?
Respirations
What is the most critical step in neonatal resuscitation?
Ventilation
What can result from failure to establish respiration within 48 hours?
Increased mortality risk
What should be used for most term infants requiring respiratory support?
Positive-pressure ventilation (PPV) with room air (21% O2)
What is the most common cause of Persistent Pulmonary Hypertension of the Newborn (PPHN)?
Meconium Aspiration Syndrome (MAS)
What are some symptoms of PPHN?
- Poor ventricular filling
- Right-side overload
- Hypoglycemia due to increased glucose use
Name some risk factors for respiratory issues in infants.
- Premature infants
- SGA or LGA newborns
- Infections (e.g., GBS, MAS)
- C-section delivery
- Polyhydramnios
- Cold stress/hypothermia
- Hypoglycemia
List signs of respiratory distress in newborns.
- Retractions
- Grunting
- Nasal flaring
- Cyanosis
- Apnea
- Tachypnea
- Oxygen desaturations
What is the management for respiratory distress in newborns?
- Provide supplemental oxygen and monitor continuously
- IV fluids if NPO
- Antibiotics and/or surfactant therapy as needed
- Cluster care and maintain a quiet, neutral thermal environment
What causes Transient Tachypnea of the Newborn (TTN)?
Delayed clearance of fetal lung fluid traps air and causes hypoxia.
What are some risk factors for TTN?
- Gestational diabetes
- LGA
- Late preterm infants
- Cesarean or rapid births
What are common symptoms of TTN?
- High respiratory rate (>60-120 bpm)
- Grunting
- Retractions
- Nasal flaring
- Seesaw respirations
- Cyanosis
What does SGA stand for and what are its associated risks?
Small for Gestational Age; risks include hypoglycemia, feeding immaturity, and congenital issues.
What does LGA stand for and what are its associated risks?
Large for Gestational Age; risks include increased birth trauma, hypoglycemia, and MAS.
What percentage of infants are born preterm, contributing to infant deaths?
1 in 10 infants, contributing to 17% of infant deaths.
What are some common complications of prematurity?
- RDS
- BPD
- Hypothermia
- Hyperbilirubinemia
- IVH
- Feeding immaturity
- Anemia
- ROP
What are the risks associated with post-term newborns?
- Birth trauma
- C-section delivery
- Placental insufficiency
- MAS
What are the signs of post-term newborns?
- Meconium-stained fluid
- Cracked skin
- Muscle wasting
What is physiologic jaundice and when does it occur?
Occurs after 48 hours due to liver immaturity.
What is pathologic jaundice and when does it appear?
Appears within the first 24 hours, often due to Rh or ABO incompatibility.
What are some treatments for hyperbilirubinemia?
- Phototherapy
- Fluids
- Exchange transfusion
What are the symptoms of Neonatal Abstinence Syndrome (NAS)?
- Tremors
- Hypertonia
- Irritability
- Vomiting
- Poor feeding
- High-pitched cry
- Hyperthermia
What are non-pharmacological care strategies for NAS?
- Swaddling
- Quiet environment
- Clustering care
What are common causes of neonatal sepsis?
- GBS
- E. coli
- Prolonged rupture of membranes (>18 hours)
What is the management for neonatal sepsis?
- Antibiotics (ampicillin, gentamicin)
- Respiratory support
- Enteral feeding
- Cluster care
What should be prioritized in the care for high-risk newborns?
Individualized care
True or False: Engaging parents in the care and discharge process is important.
True
What approach should be used from delivery to discharge for high-risk newborns?
A team-based approach
What needs should be addressed for families facing unexpected outcomes?
Psychosocial needs
Diagnostics for Respiratory Diseases
CBCD, blood glucose, ABGs, blood/urine cultures, CXR
What is the management of prematurity
Cardiorespiratory monitoring
Medication to support cardiorespiratory status
Caffeine citrate
Furosemide (Lasix)
Sodium/potassium supplements
Thermoregulation
Nutritional/feeding support
Parent teaching/discharge planning
Extensive teaching with family to increase confidence in caring for premie
Multidisciplinary support after discharge
Home care: Nursing, PT, OT, SLP
MD/Specialists visits
Lactation support
Complication if bilirubin is not treated in newborns
Kernicterus causes significant neuro issues
