Chapter 53 Neo/Peds Resp Care

Question 1

Fetal problems associated with maternal diabetes?

Answer 1

LGA, congenital malformations, RDS, hypoglycemia

Question 2

Fetal problems associated with pregnancy induced hypertension

Answer 2

Prematurity, SGA (preeclampsia)

Question 3

Fetal problems associated with mother being 17 yrs old or less

Answer 3

Prematurity, low birth weight

Question 4

Fetal problems associated with mother being 35 or older

Answer 4

chromosome defects, prematurity

Question 5

Fetal complications associated with placenta previa

Answer 5

prematurity, bleeding, SGA

Question 6

Fetal problems associated with apruptio placenate

Answer 6

fetal asphyxia (lack of oxygen), bleeding

Question 7

Fetal problems associated with alcohol consumption

Answer 7

SGA, CNS dysfunction, mental retardation

Question 8

Fetal problems associated with smoking during pregnancy

Answer 8

SGA, SIDS, prematurity, mental retardation

Question 9

Fetal problems associated with maternal drug use

Answer 9

Placental abruption, IUGR, prematurity, CNS abnormalities, withdrawal disorders

Question 10

A L:S ratio greater than 2:1 indictes?

Answer 10

Mature surfactant.

Question 11

Presence of 1% or greater PG indicates

Answer 11

Less than 1% risk of RDS

Question 12

Normal fetal heart rate is?

Answer 12

120-160 bpm

Question 13

Fetal heart rate 180 or greater can be caused by?

Answer 13

Prematurity, maternal fever

Question 14

Early fetal decelerations indicate?

Answer 14

Vagal response to compression of fetal head during contractions. Usually benign

Question 15

Late decelerations indicate?

Answer 15

Impaired blood flow to fetus. Is a serious risk

Question 16

Variable decelerations is related to?

Answer 16

Cord compression

Question 17

Fetal scalp ph less than ___ may indicate fetal asphixia

Answer 17

7.20

Question 18

What is the most important step in neonatal resuscitation?

Answer 18

Ventilation

Question 19

What are the 5 things scored in apgar

Answer 19

Heart rate
Respiratory effort
Muscle tone
Reflex irritability 
Colour

Question 20

What is the 5 minute targeted preductal SPO2

Answer 20

80-85

Question 21

When do you start chest compressions.

Answer 21

When heart rate is below 60 with 30 seconds of effective ventilation

Question 22

If you are giving Ppv and no chest rise what do you do

Answer 22

MRSOPA

Question 23

What is m in mrsopa

Answer 23

Mask seal

Question 24

What is r in mrsopa

Answer 24

Reposition airway

Question 25

What is s in mrsopa

Answer 25

Suction mouth and nose

Question 26

What is p in mrsopa

Answer 26

Pressure increase

Question 27

What is o in mrsopa

Answer 27

Open mouth

Question 28

What is a in mrsopa

Answer 28

Alternative airway

Question 29

What are two systems used to estimate gestational age

Answer 29

Ballard and dubowitz

Question 30

How much does a low birth weight baby weigh

Answer 30

2500g or less

Question 31

How much does a very low birthweight baby weigh

Answer 31

Less than 1500g

Question 32

How much does an extremely low birthweight baby weigh

Answer 32

Less than 1000g

Question 33

What impairs thermoregulstion in premature babies

Answer 33

Large surface area to body weight ratio

Question 34

Normal resp rate of infants

Answer 34

40-60

Question 35

Where is the apical pulse located on infants

Answer 35

The 5th intercostal mid clavicular line

Question 36

Causes of slow respiratory rates in infants

Answer 36

Hypothermia or neurological impairment

Question 37

What can weak pulses on infants indicate

Answer 37

Hypotension, shock or vasoconstriction

Question 38

What does bounding infant pulses indicate

Answer 38

A patent ductus Ateriosus with left to right shunt

Question 39

What is suggested by a strong brachial pulse and a weak femoral pulse

Answer 39

PDA or coarction of the aorta

Question 40

A pre and post ductal difference greater than 5 percent indicates

Answer 40

Pphn

Question 41

Indications for surfactant

Answer 41

Rds Less than 34 weeks with increased work of breathing Meconium aspiration

Question 42

Stridor / inspiratory noises indicate

Answer 42

Upper airway conditions

Question 43

Exploratory noises indicate

Answer 43

Lower airway problems

Question 44

Signs of impending resp failure

Answer 44

Head bobbing and seesaw respirations

Question 45

What is the narrowest part of the airway in babies

Answer 45

Cricoid cartilage

Question 46

When is cpap indicated

Answer 46

``` Respiratory distress with increased work of breathing Apnea of prematurity Decreased lung volume on cxr Hypoxemic resp failure Post extubation failure ```

Question 47

Contraindications for cpap

Answer 47

Choanal atresia, Tef, cdh

Question 48

Indications for intubation/ventilation

Answer 48

Respiratory failure Cdh Post thoracic surgery Surfactant delivery

Question 49

Ideal mode of ventilation for neonates

Answer 49

Pressure regulated volume control

Question 50

Criteria for extubating neonates

Answer 50

Rr set to 20, spont rr 40 or more Fio2 less than 40 Spont vt 4-5 mls / kg Stable vitals and hemodynamics

Question 51

How to adjust ventilation on hfo

Answer 51

Changing amps-increase to decrease co2

Question 52

How to adjust oxygenation in hfo

Answer 52

Increase map or fio2

Question 53

How does gas exchange occur in hfjv

Answer 53

Convection and diffusion

Question 54

Indications for ino in neonates

Answer 54

Pphn Cdh Oi greater than 25

Question 55

What does Heliox do

Answer 55

Reduces pressure needed to overcome airway resistance

Question 56

When is heliox less effective

Answer 56

When high oxygen concentrations are neeeded