ENPC 6th Ed Chap 6 The Neonate

Question 1

Compare acrocyanosis with central cyanosis

Answer 1

Acrocyanosis is bluish coloration the the hands, feet or lips
Central cyanosis is to the trunk or head
Acro can occur when the baby becomes cold and resolves on warming (84 Bx)

Question 1

What is the most important and effective intervention fir neonatal resuscitation?

Answer 1

PPV (85)

Question 2

What is the most common metabolic disturbance in neonates?

Answer 2

Hypoglycemia (87)

Question 3

What might prolonged periods of hypoglycemia cause in a neonate?

Answer 3

“interruption in neurodevelopment or brain damage” (87)

Question 4

What is blue baby syndrome?

Answer 4

Infant methemoglobinemia. Will have a bluish discoloration to kips and hands especially when crying. The child has abnormal hemoglobin that cant carry enough O2 to meet needs.
Causes: genetics, dapsone, benzocaine, food high in nitrates
TX: methylene blue, blood transfusion, hyperbaric chamber, ascorbic acid (87)

Question 5

What is one adverse side effect of prostaglandin administration?

Answer 5

Apnea Have airway supplies ready, might be reversed or prevented with caffeine. (89 CP)

Question 6

How dose resuscitation of the child with a congenital diaphragmatic hernia differs from a normal child?

Answer 6

Avoid PPV via mask to reduce abdominal distention which can compromise lung expansion. Use an ETT and place an N/O GT (91 CP)

Question 7

When is the generally considered age of viability?

Answer 7

26 weeks (83)

Question 8

Describe the changes in an neonates weight?

Answer 8

May initially lose weight after birth then regain that weight after 10-12 days. (85)

Question 9

Describe neonatal growth during the first month of life in length and weight?

Answer 9

grows 1-1.5 inches
gains 4-8 ounces (85)

Question 10

At what age does the pulmonary pressure stabilize below the blood pressure?

Answer 10

3 weeks (85)

Question 11

What are the two types of congenital heart defects?

Answer 11

Cyanotic and acyanotic (88)

Question 12

What is another name for cyanotic CHD?

Answer 12

Critical CHD or CCHD (88)

Question 13

How long does the ductus arteriosus take to close?

Answer 13

“within a couple of days” (88)

Question 14

What is a ductal -dependant lesion?

Answer 14

When the child requires the DA to stay open to avoid cyanosis
TX w/ protaglandin

Question 15

What is Tetralogy of Fallot?

Answer 15

Most common CCHD
Comprises four defects
1. VSD,
2. right ventricular outflow tract obstruction (Pulmonary stenosis)
3. overiding aorta
4. right ventricular hypertrophy

Question 16

Transposition of the great arteries

Answer 16

second most common CCHD
dx w/in a week of birth
aorta is connected to RV
PA is connected to LV

Question 17

What is the leading cause on non-febrile seizures in infants less than 6 months?

Answer 17

Hyponatremia (90)

Question 18

What is the most common cause of hyponatremia?

Answer 18

Watered down infant formula (90)

Question 19

How are hyponatremic seizures treated?

Answer 19

With 3% saline solution, anticonvulsant medications are less likely to be responded to (90)

Question 20

What can happen in untreated jaundice?

Answer 20

ACUTE BILITUBIN ENCEPHALOPATHY AND KERNICTERUS –an irreversible condition leading to sensory and intellectual disabilities (91) Occurs at levels of unconjugated bilirubin of 25mg/dl of more

Question 21

What is neonatal abstinence syndrome?

Answer 21

drug withdrawal post birth from opioids. (91)

Question 22

What assessment tool is used to assess neonatal abstinence syndrome?

Answer 22

The Finnegan Neonatal Abstinence Scoring System. scored q 3-4 hours, used to determine if pharmacologic intervention may be necessary . (91)