Neo Natal

Question 1

What is GURU?

^{(4 Pre-Birth Question)}

Answer 1

G- Gestational age

U - flUid Color

R - Risk Factors

U - Umbilical cord management

Question 2

If baby’s APGAR is less than _____, redo the APAGAR every ______ minutes for 20 minutes

Answer 2

Less than 7 APAGAR

Every 5 minutes for 20 minutes

Question 3

Initial steps of neonate stabilization (NRP)

^{(6 Steps)}

Answer 3

1. WD - Warm, dry, stimulate
2. SPAS -
   1.

Question 4

“MR SOPA” stands for

Answer 4

Msk Adjustment

Reposition Airway

Suction mouth/nose

Open Mouth

Pressure Increase

Alternative Airway (ET tube or laryngeal mask)

Question 5

LEAN acronym

Answer 5

Lido

Epi

Atropin

Narcan

(Doubled on ET TUBE - Adults

Peds - Kilos, Handtevy)

Question 6

Neonate Heart Rate Range

Answer 6

120-160

Question 7

Chest compressions for neonate

Answer 7

Depth ⅓ chest diameter

90 compressions 30 breaths (120 actions per minute)

3:1 (3 compressions:1 Breath)

Question 8

Neonate HR below 100

Answer 8

Positive Pressure ventilations at 40-60 breaths/min

Question 9

Average kilos for a baby

Answer 9

3 kilograms

Question 10

What increases early is PPV is working?

Answer 10

Heart rate

Question 11

When stop coding a baby for NRP?

Answer 11

20 minutes

Question 12

Bradycardia in neonates

Answer 12

Less than 100 bpm

Question 13

Low blood volume reasons for neonate at birth

Answer 13

1. Placenta abruption - neonate bleeds out too from umbilical cord
2. Twin-to-twin transfision - 1 umbilical cord and one twin takes more of the circualtion
3. Placenta previa
4. Septic Shock

Question 14

Respiratory Distress & Cyanosios

Answer 14

1. MR SOPA
2. Ask about increase symotims with feeding
   3.

Question 15

Low birth weight is below

Answer 15

5.5 pounds (2.5 kilograms)

Question 16

Smooth Hands an palms are correlated with ________ babies.

Answer 16

Premature

Question 17

Tpyes of siezures

Answer 17

1. Subtle
2. Tonic
3. Spasm
4. Myocolonic

Question 18

aSiezure TX

Answer 18

1. Blood glucose is les tha 40mg/dL (<45mg/dL treated)
   
   1. IV Dextrose 10% soluton
      2.

Question 19

Moro Reflex

Question 20

Vomiting Tx

Answer 20

1. High ICP - Need shunt from surgery
2. Kids loss lots of fluid - aggressive fluid resesitation
3. Zofran - weight based dose (they drop Blood Pressure so be aware)

Question 21

Diarrhea

Answer 21

• Poisoning
• Gastro enteritis
• Lactose intolerance
• Neonatal abstinence syndromne - withdrawing from drugs/alcohol

Question 22

Estimate volume of loose stools

Answer 22

How many diapers have they gone through

Degree of deydration

Decrease urinary output

Question 23

Diarrhea TX

Answer 23

ABC intacts

Rapid fluid resusitation

Lay them on their sides

Question 24

Neonatal Jaundice

Answer 24

• Transport is essential.
• Start on IV fluids if neonate shows significant clinical jaundice. (too fliush it out)
• Communicate with medical control.

(Blood overload at birth- not peeing/pooping bc the broken down blood cells but isn’t being excreted)

Question 25

Fever

Answer 25

* Rectal temperature greater than 38°C (100.4°F) *

Question 26

Normal Temp Range

Answer 26

* Range for neonate—36.6°C to 37.2°C (97.9°F to 99°F)

Question 27

Fever Assess

Answer 27

1. Examine for rashes 2. Het Hx 3. Not increase in resp rate/work of breathing

Question 28

Hypothermia

Answer 28

Less than 35 C (95 F)

Answer 29

* Caput succedaneum - **swelling of the scalp in a newborn**. It is most often brought on by pressure from the uterus or vaginal wall during a head-first (vertex) * Cephalohematoma -

Question 30

Congenital Heart Diseases

Answer 30

Most common birth defect Cyanosis Respiratory Support

Question 31

Left-to-Right shunting

Answer 31

* Noncyanotic disease (pink defects) * Oxygenated blood is shunted from the left side of the heart to the right side.

Question 32

Patent ductus arteriosus (CHD)

Answer 32

* Ductus arteriosus does not close after birth. * If left untreated, patient could develop heart failure.

Question 33

* Coarctation of the aorta (CoA)

Answer 33

* Narrowing of the aorta * May be associated with other cardiac defects * Often asymptomatic until later in childhood

Question 34

* Pulmonary stenosis presentation

Answer 34

* Jugular vein distention * Cyanosis * Right ventricular hypertrophy

Question 35

* Hypoplastic left heart syndrome

Answer 35

* Left side of heart is completely underdeveloped. * Unable to fulfill circulation needs * Heart transplant is necessary.

Question 36

* Tetralogy of Fallot (ToF)

Answer 36

* Combination of four heart defects: * Ventricular septal defect * Pulmonary stenosis * Right ventricular hypertrophy * Overriding aorta Requires open heart surgery

Question 37

* Transposition of the great arteries (TGA)

Answer 37

* Blood goes to the lungs, then returns to the lungs. * Blood from the body goes to the heart and returns to the body.

Question 38

* Total anomalous pulmonary venous return (TAPVR)

Answer 38

* Four pulmonary veins connect to the right atrium instead of the left atrium. * Results in diminished oxygen and increased load on right ventricle

Question 39

What is a fluid bolus for a neonate?

Answer 39

10 mL/kg over 5-10 minutes (pg 2089)