L75 Flashcards
How many weeks is an un-viable fetus?
23 wks - cant survive out the womb
RF pre-term birth
Previous premies Teenage or > 35 yo mom AA Smoke/cocaine Diabetes // pre-eclampsia
What medical complications of pregnancy are RF for pre-term
Chorioamnionitis
Placenta previa//abruption
Cervical incompetence
Oligohydramnios/polyhydramnios
Problems in skin with pre-term
Can’t maintain body temp to the external environment
Immature stratum corneum - loses heat + H2O
WHY PREMIES IN INCUBATOR
Why is it hard for babies to stay warm?
No brown fat (shivering fat)
Why give steroids to mom who delivering pre-term?
Steroids - accelerate fetal lung maturation to avoid RDS
How does size of alveoli relate to pressure require to open them?
Smaller alveoli = more pressure to open Inversely related (LaPlace law)
4 ways babies lose heat through skin
Evaporative - hat on head
Conductive
Convective - no fan next to incubator
Radiant
4 ways to treat heat loss
Incubator (radiant)
Polyurethane wraps (evap loss)
Humidification (evap loss)
Gel mattress (conductive loss)
Symptoms of RSD in a premie
Tachypnea > 60 bpm Central cyanosis = desat Hgb Grunting = breathing against closed glottis (PEEP) Nasal flaring Intercostal retracting
Pathophys of RSD
Soft cartilage
↓Intercostal + diaphragm tone
1. Can’t create enough neg pressure on first breath
2. ↑tension due to ↓surfactant
Treat RDS
+Surfactant via breathing tube
How treat premies to eat
GT tube for nutrients
Pacifier
What is necrotizing enterocolitis?
“Gangrene of the bowel”
Bloody stool, enlarged ab
Progress to shock, acidosis, resp fail
Treat nec entero
Antibiotics + bowel rest
Monitor for bowel stricture
