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Neonatal > Assessment and resuscitation of newborn > Flashcards

Assessment and resuscitation of newborn Flashcards

1
Q

List Maternal risk factors

A

Gestational diabetes
Pre-eclampsia
Previous pregnancy complications
Advanced maternal age
Drug or alcohol use
Smoking
Placental previa
Placental abruption
Amniotic fluid volume disorders

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2
Q

What are the effects of Gestational Diabetes

A

Makes Baby very large
Poses delivery risks in birth canal
Babies may have hypoglycemia lead to resp issues

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3
Q

What is Pre-eclampsia

A

Hi blood pressure in mom (causes seizures) for mom
Eclampsia causes baby to be small for gestational age, baby born premature to save mom

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4
Q

What are effects of previous pregnancy complications

A

Incompetent cervix, leads to high risk pregnancy

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5
Q

What age is considered advance maternal age/ geriatric pregnancy

A

35

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6
Q

What effect does alcohol have during pregnancy / on the fetus

A

Nervous system abnormalities
Small for gestational age
Placental abruption

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7
Q

what is placental abruption

A

Placenta becomes detached from uterine wall

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8
Q

What affect does placental abruption have on the baby

A

Baby isnt getting O2 + Nutrients
Hypovolemic
fetal asphyxia

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9
Q

What effect does smoking have on the baby

A

Prematurity
Small for gestational age
Baby at higher risk for SID

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10
Q

How does Oligohydraminos effect the infant

A

Can cause umbilical cord compression on babies head

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11
Q

What is polyhydramnios

A

Premature rupture of the membranes

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12
Q

What is the Fern Test

A

A test done to see if mom is leaking amniotic fluid

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13
Q

What is cord prolapse

A

Cord comes out of the vagina before baby

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14
Q

What is Amniocentesis

A

A test done to test chromosomal abnormalities

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15
Q

what does an ultrasound do ?

A

Measure fetal growth
View position of fetus and placenta
Assess amniotic fluid amount
Identify potential anomalies

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16
Q

Is variability good or bad in fetal HR?

A

Good, there should be variability in HR

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17
Q

What do Decelerations mean in fetal HR

A

A drop greater than 45 indicates something is going on

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18
Q

During resuscitation what % FiO2 do you use on a infant over 35 weeks

A

21%

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19
Q

During resuscitation what % Fio2 do you use for an infant under 35 weeks

A

30%

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20
Q

What is an indication of delivery room CPAP

A

Newborns who are spontaneously breathing with signs of resp distress ( Accessory muscle use or grunting)

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21
Q

What are indications for PPV resuscitation

A

Apnea
Gasping after stimulation
HR <100

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22
Q

Indications for neonatal intubation

A

Bag mask ventilation is ineffective
Chest compressions are required
Prolonged positive pressure ventilation

23
Q

What are routes of administration for a baby

A

Umbilical venous line
Intravenous
Instraosseous

24
Q

How often do you repeat giving epi?

A

every 3-5 min

25
Q

If baby has bloodloss/fetal asphyxia what do you need?

A

You need a volume expander and epi while doing chest compressions

26
Q

*preterm babies may breathe faster than term abies

A
27
Q

What is a term babies BP

A

60/40

28
Q

That is a preterm babies BP

A

50/30

29
Q

what is a key sat for newborns

A

> 90

30
Q

What is a NewBorns babies HR

A

110-160

31
Q

What is Pectus Excavatum

A

Sternum curves inward can be severe (funnel chest)

32
Q

What is pectus carunatum

A

Bird chest, Chest curves outward

33
Q

What does nasal flaring/grunting indicate ?

A

Baby is trying to breath with difficulty

Nasal flaring: baby trying to open nose more

Grunting: trying to create more pressure

34
Q

What do retractions and grunting indicate

A

Trachea sinking in

35
Q

What are types of retractions

A

Suprasternal
Substernal
Subcostal
Intercostal

36
Q

Suprasternal Retractions

A

Tracheal tugging
Jugular notch at area close to trachea

37
Q

Substernal Retractions

A

Beneath ribs at level of abdomen

38
Q

Subcostal Retractions

A

Just below rib cage (belly breathing)

39
Q

Intercostal retractions

A

(Inbetween ribs)

Presentation: rib will sink in

40
Q

What us Acrocyanosis?

A

Cyanosis of hands and feet, fine can take up to 24 hours to go away. Baby has to reverse circulation

41
Q

What is Circumoral Cyanosis

A

Cyanosis around nose/mouth/mucous membranes

More central (close to heart) will provide O2 and CPAP

42
Q

what us the silverman anderson score?

A

score helps assess severity of resp distress

43
Q

What are ABG sites in a Newborn

A

Radial Artery
Umbilical Artery

44
Q

What is a capillary stick site

A

heel stick

44
Q

What are noninvasive ways to monitor POC and PCO2?

A

Pulse oximetry and transcutaneous monitoring

45
Q

What value do we not use from a capillary stick

A

PO2

46
Q

What may appear enlarged on an xray after birth?

A

The heart

47
Q

Where should the ETT be on a newborn?

A

at the level of T3, or between the clavicles and carina

48
Q

What is thymus

A

Extra part in the mediastinum (goes away with age)

49
Q

Where is the Umbilical Venous line on a cxr

A

Tip should be near IVC at the level of the diaphragm

50
Q

Where is the Umbilical Arterial Line

A

At the level of T6-T9

51
Q

How many ribs should you see on a CXR?

A

8-10

52
Q

What is the definition of a maternal risk factor

A

Any condition that interferes with placental blood flow or the transfer of oxygen or the fetus

53
Q
A

Neonatal (4 decks)

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