Neonatal A&P APEX

Question 1

Newborn BP

Answer 1

70/40

Question 2

1 yr old BP

Answer 2

95/60

Question 3

12 yr old BP

Answer 3

110/70

Question 4

___ is the primary determinant of the newborns BP

Answer 4

HR

Question 5

Stress is likely to innervate the ___ system in the newborn

Answer 5

PSN/ bradycardia hotn
ANS is still immature

Question 6

In the newborn, hotn is defined as

Answer 6

SBP <60

Question 7

First line agent for hotn in the newborn

Question 8

Describe infant airway

Answer 8

Cephalad glottic opening- NOT more anterior
Anterior slant voal cords
Same angle r and l mainstem bronchi
C3C4 vocal cords
Epiglottitis U shape/ omega shaped
Epiglottitis is long and stiff (not floppy)

Question 9

Which blade is preferred in infants

Answer 9

Miller
Stiff epiglottis

Question 9

Which position in the infant? for DL/ VL

Answer 9

NO sniffing, only put a blanket under shoulders bc big head

Question 10

Bronchi angle up to 3 yrs old

Answer 10

55
Compared to adult, 25 R and 45 L

Question 11

O2 consumption neonate vs adult

Answer 11

Neonate- 6ml/kg
Adult- 3ml/kg

Question 12

Why do neonates desat faster?

Answer 12

Increased alveolar ventilation : FRC ratio
AKA
Less FRC but high Ventilation
So, FRC runs out fast

Question 13

The neonate has more of which type of muscle fibers in the lungs/ diaphragm

Answer 13

Type 2 - fast- more of these
They dont have type 1, long lasting, so they can fatigue faster

Question 14

Vd in the neonate and adult

Answer 14

2ml/kg

Question 15

Infants under the age of __ should be admitted for 24hr observatino with an apnea monitor

Answer 15

60 weeks PCA
Can use caffeine 10mg/kg iv to reduce risk of post op apnea

Question 16

Umbilical vein ABG

Answer 16

7.35
pao2 30
Paco2 40

Question 17

Umbilical artery abg

Answer 17

7.3
pao2 20
paco2 50

Question 18

What stimulates continuous breathing

Answer 18

An acute rise in pao2 after cutting cord
Hypoxemia causes apnea

Question 19

When does the respiratory center mature?

Answer 19

44 weeks PCA

Question 20

When does hgb f turn into hgb A

Answer 20

starts at 2months
Finishes by 6 months

Question 21

electrolyte imbalances ater mass tranfusions

Answer 21

hyperkalemia
hypocalcemia
met acidosis OR alkalosis

Question 22

Transfusion trigger for children under 4months old

Answer 22

13 if severe cardiopulmonary disease
10 if major surgery or moderate cardiopulmonary disease

Question 23

Dose for transfusion

Answer 23

10-15ml/kg

Question 24

Transfusion trigger over 4 months old

Answer 24

6-10 depending

Question 25

hgb at birth

Answer 25

14-20

Question 26

when does gfr fully mature

Answer 26

8 months- 2 years old

Question 27

signs of dehydration in the neonate

Answer 27

sunken fontanel
/1 weight loss
lethargy
dry
no tears
skin turgor
increased hct

Question 28

tbw of neonate in %

Answer 28

85%
Red book says 75

Question 29

hourly maintenance fluid for neonate

Answer 29

4:2:1
if over 20kg, used weight +40

Question 30

how soon to replace fluid deficit from npo

Answer 30

1st hour 50%
2nd 25%
3rd 25%

Question 31

Neonates and succ

Answer 31

Neonates suck up all the succ, they need more
2mg/kg

Question 32

Indications that neonate is ready for extubation

Answer 32

knees to chest
ELBOW/ hip flexion
grimacine
MIF -25