Neonatal And OB Emergencies Flashcards
What does APGAR stand for?
Appearance, Pulse, Grimace, Activity, Respirations.
When is the APGAR scale performed?
1 minute after baby is born. Then every 5 minutes until an APGAR of 7 or higher is obtained.
What do you do when a baby is born?
Dry, Warm, Position, Stimulate, Suction
What is the number 1 cause of bradycardia in newborns and infants?
Hypoxia
What do you do if there is meconium staining present for active and limp babies?
Active: Dry vigorously and monitor.
Limp: consider intubation
A premature baby means the baby is could be how many weeks?
22-36 weeks
A newborn baby means baby is how old?
Birth to 23 hours old
Neonate means baby is how old?
1 day to 28 days.
Infant means the patient is how old?
1 month to a year old
The three H’s of a limp infant are?
Hypoxia, Hypothermia, Hypoglycemia.
What physiologic differences are in a neonate?
Fetal hemoglobin is leftward shifted. High BSA to body mass ratio, presence of brown adipose tissue, and patent ductus arteriosum
What is RDS?
Respiratory Distress Syndrome.
When is RDS typically present?
Premature birth less than 37 weeks.
What is the treatment for RDS?
Administer Surfactant in the ETT then ventilate patient.
What if Oxygen makes the patient worse?
It is a Cyanotic Lesion.
What does the patient need for treatment of cyanotic lesions?
Administration of Prostaglandins
What if the patient gets better with ventilation then decompensates?
Pneumothorax
What is the treatment of a pneumothorax?
Decompress in the 4th intercostal space mid to axillary line with a 24-18G needle. Attach a 3 way stopcock and a 10-20cc syringe to withdrawal air.
What is a common cause of seizures in neonates?
Hypoxic Ischemic Encephalopathy (HIE)
What does HIE need?
Hypothermic treatment. (33 degrees Celsius)
What medication is used to treat seizures in neonates?
Phenobarbital, Forsphenytoin, Midazolam
What is the dose of Phenobarbital?
20mg/kg slow IVP
What is the dose of Fosphenytoin?
20mg/kg slow IVP
What is the dose of midazolam?
0.2 mg/kg IM
What are the two major types of lesions in congenital heart defects?
Acyanotic, and Cyanotic
What type of Cyanotic lesions are there?
Tetralogy of Fallot, Transposition of the great arteries.
What is an Acyanotic heart lesion?
Hypoplastic Left Heart Syndrome
What is HLHS?
The patients left ventricle is underdeveloped, Patients Aorta is underdeveloped, Patient has an arterial septal defect. Edema to face, and back. Hepatomegaly.
What is the transposition of the great arteries?
A birth defect in which the two main arteries carrying blood out of the heart, The main pulmonary artery and the aorta are switched in position or transposed.
What is Blalock-Taussig Shunt?
A shunt used to create a pathway for blood to go from the arterial circulation to the lungs.
What is a possible treatment for Tetralogy of Fallot, or HLHS?
Blalock-Taussig Shunt
What is Tetralogy of Fallot?
4 Heart defects. Enlarged right ventricle, Stenotic pulmonary valve, Ventricular septal defect, and Shifting of the body’s main artery (Aorta) .
What are Neonatal Cardiac meds?
Digoxin, Ace Inhibitors, and Diuretics,
What is the protrusion of the intentions with lining covering?
Omphalocele
What is a protrusion of intestines without lining covering.
Gastroschisis
What is a protrusion of the spinal cord from the back?
Myelomeningocele
Cardiac arrest ratio?
3:1
Tube size for neonates?
Weeks of gestation divided by 10
EPI 1:10 dose for neonates?
0.001mg/kg
Atropine dose for neonates?
0.02 mg/kg
Adenosine dose for Neonates?
0.1mg/kg and repeat at 0.2mg/kg
Cardioversion in a Neonate?
0.5-1 J/kg
Treatment for hypoglycemia in a neonate?
2 mL/kg IV bolus of D10W
Treatment of dehydration in neonates?
10mL/kg NS bolus
In pregnant patients patients blood volume does what?
Increases 30-50% as early as 6 weeks and peaks at 28-34 weeks.
What happens to pregnant people’s cardiac output?
Increases by 30-50%
What is gestational hypertension also referred as?
PIH
What is the typical onset of gestational hypertension?
After 20 weeks
When does BP normalize?
12 weeks postpartum
What is pregnancy’s typical acid base?
Respiratory Alkalosis
What do you administer for preterm labor?
Terbutaline and magnesium sulfate
What are the signs of magnesium toxicity?
Loss of deep tendon reflexs, hypotension, and respiratory depression or CNS depression.
Reversal for magnesium toxicity?
Administer calcium
What is it called when the placenta is tearing away from the uterine wall?
Abruptio placenta
What is it called when the placenta is first and could be hemorrhaging?
Placenta previa
What is it called when there is catastrophic bleeding and severe abdominal pain?
Uterine rupture
What is the signs of superimposed preeclampsia?
History of chronic HTN with one of the following:
*New onset of proteinuria
*HTN and proteinuria before 20th week of gestation
*sudden increase in proteinuria
*Sudden increase in BP
*Abnormal ALT and AST levels
*thrombocytopenia
Presence of Hypertension, pathologic edema and proteinuria due to pregnancy or recent pregnancy?
Preeclampsia
Presence of hypertension, pathologic edema, and proteinuria due to pregnancy that escalates to seizures?
Eclampsia
What is HELLP syndrome?
Hemolytic anemia, Elevated liver enzyme levels, and Low Platelet Count
What medications are used as anti hypertensive meds in pregnancy?
Magnesium Sulfate, Labetalol, Hydralazine, Procardia
What is the pneumonic for FHM readings?
Veal Chop
What does Veal Chop stand for?
V: Variable C: Cord
E: Early H: Head
A: Accels. O: Ok
L: Late P: Placenta
What does G stand for?
Gravita # of pregnancy’s
What does P stand for?
Para # of deliveries
