Assessment and resuscitation of newborn Flashcards
List Maternal risk factors
Gestational diabetes
Pre-eclampsia
Previous pregnancy complications
Advanced maternal age
Drug or alcohol use
Smoking
Placental previa
Placental abruption
Amniotic fluid volume disorders
What are the effects of Gestational Diabetes
Makes Baby very large
Poses delivery risks in birth canal
Babies may have hypoglycemia lead to resp issues
What is Pre-eclampsia
Hi blood pressure in mom (causes seizures) for mom
Eclampsia causes baby to be small for gestational age, baby born premature to save mom
What are effects of previous pregnancy complications
Incompetent cervix, leads to high risk pregnancy
What age is considered advance maternal age/ geriatric pregnancy
35
What effect does alcohol have during pregnancy / on the fetus
Nervous system abnormalities
Small for gestational age
Placental abruption
what is placental abruption
Placenta becomes detached from uterine wall
What affect does placental abruption have on the baby
Baby isnt getting O2 + Nutrients
Hypovolemic
fetal asphyxia
What effect does smoking have on the baby
Prematurity
Small for gestational age
Baby at higher risk for SID
How does Oligohydraminos effect the infant
Can cause umbilical cord compression on babies head
What is polyhydramnios
Premature rupture of the membranes
What is the Fern Test
A test done to see if mom is leaking amniotic fluid
What is cord prolapse
Cord comes out of the vagina before baby
What is Amniocentesis
A test done to test chromosomal abnormalities
what does an ultrasound do ?
Measure fetal growth
View position of fetus and placenta
Assess amniotic fluid amount
Identify potential anomalies
Is variability good or bad in fetal HR?
Good, there should be variability in HR
What do Decelerations mean in fetal HR
A drop greater than 45 indicates something is going on
During resuscitation what % FiO2 do you use on a infant over 35 weeks
21%
During resuscitation what % Fio2 do you use for an infant under 35 weeks
30%
What is an indication of delivery room CPAP
Newborns who are spontaneously breathing with signs of resp distress ( Accessory muscle use or grunting)
What are indications for PPV resuscitation
Apnea
Gasping after stimulation
HR <100
Indications for neonatal intubation
Bag mask ventilation is ineffective
Chest compressions are required
Prolonged positive pressure ventilation
What are routes of administration for a baby
Umbilical venous line
Intravenous
Instraosseous
How often do you repeat giving epi?
every 3-5 min
If baby has bloodloss/fetal asphyxia what do you need?
You need a volume expander and epi while doing chest compressions
*preterm babies may breathe faster than term abies
What is a term babies BP
60/40
That is a preterm babies BP
50/30
what is a key sat for newborns
> 90
What is a NewBorns babies HR
110-160
What is Pectus Excavatum
Sternum curves inward can be severe (funnel chest)
What is pectus carunatum
Bird chest, Chest curves outward
What does nasal flaring/grunting indicate ?
Baby is trying to breath with difficulty
Nasal flaring: baby trying to open nose more
Grunting: trying to create more pressure
What do retractions and grunting indicate
Trachea sinking in
What are types of retractions
Suprasternal
Substernal
Subcostal
Intercostal
Suprasternal Retractions
Tracheal tugging
Jugular notch at area close to trachea
Substernal Retractions
Beneath ribs at level of abdomen
Subcostal Retractions
Just below rib cage (belly breathing)
Intercostal retractions
(Inbetween ribs)
Presentation: rib will sink in
What us Acrocyanosis?
Cyanosis of hands and feet, fine can take up to 24 hours to go away. Baby has to reverse circulation
What is Circumoral Cyanosis
Cyanosis around nose/mouth/mucous membranes
More central (close to heart) will provide O2 and CPAP
what us the silverman anderson score?
score helps assess severity of resp distress
What are ABG sites in a Newborn
Radial Artery
Umbilical Artery
What is a capillary stick site
heel stick
What are noninvasive ways to monitor POC and PCO2?
Pulse oximetry and transcutaneous monitoring
What value do we not use from a capillary stick
PO2
What may appear enlarged on an xray after birth?
The heart
Where should the ETT be on a newborn?
at the level of T3, or between the clavicles and carina
What is thymus
Extra part in the mediastinum (goes away with age)
Where is the Umbilical Venous line on a cxr
Tip should be near IVC at the level of the diaphragm
Where is the Umbilical Arterial Line
At the level of T6-T9
How many ribs should you see on a CXR?
8-10
What is the definition of a maternal risk factor
Any condition that interferes with placental blood flow or the transfer of oxygen or the fetus
