7- resp distress Flashcards
Differential Diagnosis for Tachypnea in the Newborn
Resp distress syndrome Transient tachypnea of the newborn Pneumothorax- premature Meconium aspiration Hypoglycemia- diabetic mom Hypothermia- premature Cardiac abnormalities sepsis- premature Congenital diaphragmatic hernia
Transient tachypnea of the newborn
Result of delayed clearance of fluid from the lungs following birth
Much more common in infants born to diabetic mothers and in infants born by c-section
Cardiac abnormalities that cause tachypnea
VSD coarctation of aorta PDA AVC - atrioventricular canal defect total anomalous pulmonary venous return
Persistent Pulmonary Hypertension of the Newborn (PPHN)
elevated pulmonary vascular resistance —> venous blood is diverted through fetal channels (the ductus arteriosus and foramen ovale) into the systemic circulation and bypasses the lungs, –> systemic arterial hypoxemia –> cyanosis, resp distress
result from: meconium aspiration syndrome, diaphragmatic hernia, hypoplastic lungs, and in utero asphyxia.
what can help distinguish TTN from RDS
chest x ray
TTN on chest x ray
Significant perihilar streaking: interstitial fluid and engorged lymphatics.
Coarse, fluffy densities that represent fluid-filled alveoli.
Fluid in the pleural space and a small amount of fluid in the fissures on the lateral view.
Normal cardiac size and silhouette.
RDS on CXR
diffuse reticulogranular appearance of the lung fields (“ground glass appearance”) and air bronchograms.
target glucose screen value prior to routine feeds
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risk factors for Developmental Dysplasia of the Hip
Breech position (30-50% of DDH cases occur in infants born in the breech position) Gender (9:1 female predominance) Family history
signs of newborn who is hypoglycemic
hypotonia, with absence of flexed posture and weak suck
signs of resp distress
subcostal and intercostal retractions, grunting, nasal flaring, persistent cyanosis, and tachypnea
