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Pediatrics > APAR > Flashcards

APAR Flashcards

1
Q

What are 4 pre-birth questions to ask?

A
  1. What is expected gestational age
  2. Is the amniotic fluid clear
  3. How many babies are expected
  4. Are there any additional risk factors
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2
Q

What are 3 questions to ask with baby birth?

A
  1. Does the baby appear term
  2. Is the baby breathing or crying
  3. Is there good muscle tone
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3
Q

If yes to birth questions what’s next?

A

initial steps can be performed on mother’s chest

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4
Q

If no to birth questions what’s next?

A

initial steps, ventilation, chest compressions, admin of epi/volume expanders

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5
Q

Who created the APGAR score?

A

Dr. Virginia Apagar in 1952

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6
Q

What does the APGAR score access?

A

newborn transition from the womb to the outside

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7
Q

What does APGAR stand for?

A 
A- Activity (muscle tone)
P- Pulse
G- Grimace (reflex irritability)
A- Appearance
R- Respiratory
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8
Q

What is the assessment for activity 0-2

A

absent, flexed arms and legs, active

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9
Q

What is the assessment for pulse 0-2

A

absent, <100rpm, >100rpm

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10
Q

What is the assessment for grimace 0-2

A

floppy, minimal response to stimulation, prompt response

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11
Q

What is the assessment for appearance 0-2

A

blue;pale, pink body blue extremities, pink

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12
Q

What is the assessment for respiratory 0-2

A

absent, slow and irregular, vigorous cry

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13
Q

What is the scoring for APGAR?

A

0-3 extremely depressed, 4-6 moderately depressed, 7-10 excellent condition

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14
Q

What age is border of viability?

A

22 to <25wks

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15
Q

What age is considered pre-mature?

A

born before <37 wks gestation alive

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16
Q

What is considered term?

A

37-41 wks

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17
Q

WHO says a induction or cesarean birth shouldn’t be done when?

A

<39 wks

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18
Q

What is the leading cause of death?

A

premature birth complications

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19
Q

IVH is treated how?

A

antenatal steroIds prophylaxis

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20
Q

What is the most severe IVH?

A

Grade III, IV

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21
Q

Where does the bleeding occur in IVH?

A

germinal matrix

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22
Q

What can ROP lead to?

A

retinal detachment and blindness

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23
Q

Leading cause of blindness in developing countries?

A

ROP

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24
Q

What babies are at high risk for ROP?

A

<30 wks or <1500g

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25
Q

What is the txt for ROP?

A

laser, vitreal anti-VEGF injection, cryotherapy

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26
Q

What two hearing screenings is done in TEJAS?

A

ABR or OAE

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27
Q

NICU babies are required to get hearing screens when?

A

rescreening at 9 mo - 1yr

28
Q

Why is the AABR used?

A

due to increased risk for neural dysfunction

29
Q

What does AABR stand for?

A

Automated Auditory Brainstem Response

30
Q

What is the txt for PDA?

A

Indomethacin/ Ibuprofen/ Tylenol

31
Q

Formerly known as Hyaline Membrane Dx?

A

RDS

32
Q

What is deficient in RDS and what produces it?

A

surfactant, type II pneumocytes

33
Q

What is txt for RDS?

A

antenatal steroids for women at risk before 34wks

34
Q

What is the long term sequelae for RDS?

A

BPD

35
Q

What is the major factor contributing to BPD?

A

larger and fewer alveoli w/ reduced pulmonary capillar leading to PHTN

36
Q

What is BPD/CLD?

A

persistent oxygen required beyond 28 days of life

37
Q

What is the most common acquired acute gastro-intestinal illness?

A

Necrotizing Enterocolitis

38
Q

What are premature infants at a higher risk for in feeding difficulties?

A

oral aversion

39
Q

What is the txt for feeding difficulties?

A

feeding therapy, restricted milk flow, G tubes

40
Q

Why is the weight gain in the NICU lagging?

A

low BW and GA, severity of illness, and postnatal steriods

41
Q

Energy and protein deficits leads to?

A

less lean tissue growth

42
Q

Mineral deficiency leads to?

A

low bone mineral content

43
Q

Zinc deficiency leads to?

A

less lean mass accretion

44
Q

Iron deficiency leads to?

A

anemia and poor growth

45
Q

What are the goals of growth failure?

A

promote human milk feeding
avoid over nourishing
minimize nutritional deficits

46
Q

Growth chart used for 22wks-50wks?

A

Fenton Preterm growth chart

47
Q

Growth chart used for 50wks- 24 months?

A

WHO-CBC growth chart

48
Q

How much calcium should be consumed?

A

150-220 mg/kg

49
Q

How much phosphorus should be consumed?

A

75-140 mg/kg

50
Q

How much Vitamin D should be consumed?

A

400 IU/day

51
Q

How much Iron should be consumed?

A

2-4 mg/kg day

52
Q

How should gastro-reflex be treated in a premature?

A

non-med, feed in reclined position, left lateral or prone position

53
Q

Should breastfed pt receive multi-nutrient fortifier?

A

human milk is preferred, individualized approach

54
Q

When is milk fortification recommend?

A

subnormal weight for gestational age infants

55
Q

Should preterm infants receive enriched or standard formula?

A

enriched (continue until 40wks)

56
Q

When should preterm babies be weighed?

A

biweekly to weekly for 1st 4-6wks, then q 2mo

57
Q

When should nutrient fortified breast milk or formula ben used?

A

when infant falls below 10th percentile

58
Q

Which infants receive RSV vaccination?

A

born <29 wks GA, CLD of prematurity, and hemodynamically significant heart disease

59
Q

What is the RSV vaccine?

A

Palivizumab (Synagis)

60
Q

What is the dose for RSV vaccine

A

max of 5 monthly doses during RSV season

61
Q

What age should preterm babies be screened for iron?

A

4 mo, 9 mo, 12mo

62
Q

Who should receive iron supplementation?

A

breastfed infants

63
Q

What is the risk for developmental delays in preterms?

A

12-50% risk

64
Q

What subjects do preterms preform worser in?

A

math, reading, spelling

65
Q

What screening recommendation for neurodevelopment in preterms?

A

9, 18, 24, 30 mo W/ standardized tool

Pediatrics (7 decks)

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