NEONATAL AND PEDIATRIC Flashcards
is the age of the infant computed from the date of birth
Chronologic age
is the age of the infant computed from the date of conception
Gestational age
Term infants are born between?
37 and 42
weeks of gestational age
preterm infants (premature or “preemies”) are born at fewer than
37 weeks of gestational age
postterm infants are born at
43 or more weeks of
gestational age
GRAVIDA is a pregnant woman, PARA is a woman who delivers a live infant,
and ABORTION is the delivery of a dead infant or embryo.
Infants born prematurely are more susceptible to develop?
- RDS
- pulmonary interstitial emphysema (PIE),
- intraventricular hemorrhage (IVH)
- bronchopulmonary dysplasia (BPD).
Post-term infants are more susceptible to:
- severe perinatal asphyxia
- meconium aspiration
- persistent pulmonary hypertension of the newborn (PPHN).
caused by a failure to re-absorb
fetal lung fluid after birth.
transient tachypnea
of the newborn (TTN)
is a simple, quick, and reliable means to assess and document the newborn’s status immediately after birth.
Apgar score
Those who are adjusting well to extrauterine life usually have 1-minute scores ____________
7 to 10 but may still show:
- acrocyanosis
- irregular respirations
- hypotonia
Moderately depressed infants with 1-minute scores of __________
4 to 6 may need more than routine care and often require an increased FIo2 with BVM ventilation.
Infants who have 1-minute scores of ___________
0 to 3 are:
- severely depressed
- need extensive medical resuscitation
that may include intubation and mechanical ventilation.
The simplest resuscitation required for newborns:
clearing the airway and drying the skin
Allows for the evaluation of the
L/S ratio to assess pulmonary lung maturity.
Amniocentesis
A healthy fetus has a minimum of an increase in heart rate of at least:
15 beats/minute
Low birthweight (LBW): _____
Very low birthweight (VLBW): _____
Extremely low birthweight (ELBW): ______
- less than 2500 g
- less than 1500 g
- less than 1000 g
- weight is appropriate for the gestational age: ______
- smaller than expected, the weight falls below the 10th percentile for the gestational age: _____
- heavier than expected, the birthweight is above the 90th percentile for the gestational age: ______
- Appropriate for gestational age (AGA)
- Small for gestational age (SGA)
- Large for gestational age (LGA)
Gestational age is assigned by
- maternal dates
- fetal ultrasound
- gestational assessment examination.
- Hyperthermia is a core body temperature of more than 37.5° C or 99.5° F.
- Hyperthermia in the newborn usually is caused by environmental factors.
- Hypothermia is a core body temperature of less than 36.5° C or 97.7° F.
- Hypothermia is a more common and
significantly more serious sign of INFECTION in the newborn than in the older child or adult.
The most common methods to measure temperature are:
axillary and rectal temperatures.
The normal pulse rate for newborns is between
100 and 160 beats/minute.
The normal respiratory rate for
neonates and infants is between:
30 and 60 breaths/minute
TACHYPNEA can be caused by
- hypoxemia,
- metabolic and respiratory acidosis,
- CCHD,
- anxiety,
- pain,
- hyperthermia and
- crying.
BRADYPNEA can be caused by
- certain medications (e.g., narcotics),
- hypothermia, and
- central nervous system diseases,
Respiratory rates that exceed 60 breaths/minute but normalize over the next several hours may indicate TTN (Transient tachypnea of newborn)
Apnea may be accompanied by
- cyanosis,
- bradycardia,
- pallor, and
- hypotonia.
Gasping respiratory efforts are never to be considered normal respiratory patterns in newborns.
Usually, a term neonate’s systolic blood pressure should be no higher than
70 mm Hg, with diastolic pressure no higher than 50 mm
Hg.
Normal pulse pressure (the difference between systolic and diastolic blood
pressure) in a term infant is between 15
and 25 mm Hg
Difference in blood pressure between upper and lower extremities can be an indication of a CCHD such as
Coarctation of the aorta
The infant should be unclothed and in a
______ position initially in a quiet environment.
SUPINE
Peripheral cyanosis of the hands and feet during the first 24 to 72 hours of life:
Acrocyanosis
An infant with respiratory distress characteristically exhibits:
- tachypnea (discussed earlier),
- retractions,
- nasal flaring, and sometimes
- grunting
Retractions in the infant generally indicate:
- decrease in lung compliance, and a
- serious increase in the work of
breathing or - airway resistance, or both.
It is a cardinal sign of respiratory distress and increased work of breathing in the infant.
Nasal flaring
Is a sound heard at the end of
expiration just before rapid inspiration
Grunting
Capillary refill should be less than 3 seconds and will be greater than 3 seconds if the infant has a ________ or _________
low cardiac output or decreased peripheral perfusion.
This can decrease blood flow to the
skin and prolong capillary refill:
- acidosis,
- hypoxemia,
- hypoglycemia
- hypothermia
Is a technique often used in examining the chest of neonates and small infants, but not an older child or adult?
Transillumination
In the presence of a pneumothorax or pneumomediastinum, the entire hemithorax lights up, dispersing the
light in an irregular shape
Leukopenia, particularly neutropenia is a more ominous sign. Usually, neutropenia indicates an infection and implies that the
infant may be developing an _________
overwhelming infection
A chronically ill infant with POOR NUTRITION has low levels of calcium and phosphorus and an increased risk for developing rickets.
Any condition that decreases blood flow under the electrode, such as acidosis, shock, hypovolemia, or hypoglycemia, can cause tcpo2 to be falsely lower than Pao2.
Three volumes can be measured easily in newborns independent of their cooperation:
- FRC,
- thoracic gas volume (TGV), and
- crying vital capacity (CVC).
Resistance is elevated in infants with:
MAS and BPD
The most important clinical lung volume measurement is the:
FRC
- In the older pediatric patient, the preferred position for taking x-ray films is upright:
- most chest x-ray films
are taken with the infant in the _________ position
Supine Position
Chest radiographs should be done in infants who have:
- unexplained tachypnea,
- cyanosis,
- abnormal breath sounds,
- malformations of the chest or airway, or an
- overall generalized sick appearance.
is a disease of inadequate surfactant production. The immature alveoli have increased surface tension and collapse. The chest radiograph of these infants is fairly typical. It includes a diffuse, hazy ground-glass appearance; air bronchograms extending out to the periphery of the lungs; and low lung volumes
RDS
is primarily an airway disease. The stressed mature fetus passes meconium into the amniotic fluid and then with gasping respirations inhales the meconium-laden amniotic fluid into its lungs.
MAS
The indications for umbilical artery catheterization include :
- source for frequent ABG sampling
- continuous blood pressure monitoring
- large-scale blood replacement
- is usually a viral disease affecting the trachea and small airways in children
- tends to appear in children between 3 months and 5 years old, but it can happen at any age
- The child may have cold symptoms, such as a stuffy or runny nose, for a few days and may also have a fever. These
symptoms progress to a loud, seal-like barking cough; rapid or difficult respiration; and grunting or wheezing while breathing.
CROUP
- is usually a bacterial disease that causes
significant edema and inflammation of the epiglottis - very uncommon because the Haemophilus influenzae type B (Hib) vaccine is a routine childhood
immunization. - The disease was once most often seen in
children aged 2 to 6 years
Epiglottitis
- is a chronic airway disease that is caused by airway inflammation and
hyperresponsiveness to irritants. - The typical symptoms
include intermittent dry cough and expiratory wheezing.
Asthma
First 2 weeks of pregnancy, when
the female ovum and male sperm unite
Conception
Pregnancy weeks 3 to 12,
encompassing 4 to 8 weeks of embryo development. This is when the major organs such
as the central nervous system and heart begin
development.
Embryonic stage
Encompasses the
remaining weeks 13 to 40 for a full-term delivery. Most lung development occurs during this phase
Fetal development stage
Toward the end of this phase, at about week 35,
mature surfactant begins to appear
Saccular Phase
