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Neonatal assessment Flashcards

1
Q

What is the fetal lung volume

A

30ml/kg

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2
Q

Retained liquid in the lung is thought to cause

A

transient tachypnea of the newborn (TTN)

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3
Q

Lung inflation releases what

A

surfactant

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4
Q

5 parameters of the APGAR score

A

HR, Respiratory effort, Reflex irritability, color

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5
Q

3 characteristics of Persistent Pulmonary HTN of the Newborn

A

Sustained Elevated PVR
Decreased lung perfusion
Continued R-L shunting (patent foramen ovale and ductus arteriosus)

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6
Q

What is the drug of choice in the fetus with bradycardia and decreased CO?

A

Epinephrine

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7
Q

Normal Respiratory Frequency Infant/Adult?

A

Infant 30-50

Adult 12-16

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8
Q

The MV:FRC is _____x higher in the newborn

A

2-3x

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9
Q

Normal TV in Infant/Adult?

A

Infant 7ml/kg

Adult 7ml/kg

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10
Q

Normal FRC in Infant/Adult?

A

Infant 27-30ml/kg

Adult 30ml/kg

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11
Q

_________/________may develop after stimulation of carina or SLN, following AW obstruction, of following lung inflation (Hering-Breuer reflex)

A

Respiratory depression/Apnea

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12
Q

What terminates between L2 and L3 in neonates?

A

Conus medullaris

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13
Q

The neonatal diaphragm is more responsive to (NDMRs or DMRs?)

A

NDMRs- Like Roc

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14
Q

What are some signs of fetal pain?

A 
Tachycardia
Elevated BP
Crying
Restlessness
Grimacing
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15
Q

The anterior fontanelle closes by age____

A

2 y/o

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16
Q

The blood/brain barriers is immature until about what age?

A

1 y/o

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17
Q

AW obstruction, Bronchospasm, Pulmonary Aspiration, Inadequate 02 delivery, Pneumothorax

A

What are respiratory causes of neonatal bradycardia and cardiac arrest?

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18
Q

What are Pharmacologic causes of neonatal bradycardia and cardiac arrest?

A

Inhalation Anesthetics, Succinylcholine, Anticholinesterases (Neostigmine).

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19
Q

Celiac reflex, Oculocardiac Reflex, SLN/Recurrent nerve stimulation

A

What are some neurogenic causes of neonatal bradycardia and cardiac arrest?

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20
Q

Hypoglycemia, Anemia, Hypothermia, Acidosis

A

What are the metabolic causes of neonatal bradycardia and cardiac arrest?

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21
Q

Neonates have a ____ GFR and Renal Blood Flow. What is the typical neonatal GFR?

A

Low GFR- 1.6ml/min/kg

22
Q

GFR reaches normal by _______

A

1-2 years (12-24 months)

23
Q

What is indicative of hypovolemia or decreased renal function in the neonate?

A

<1mg/kg/kr

24
Q

Half life of meds are ____ in the neonate.

25
Q

Neonates are obligate _____ excreters.

26
Q

3.0-3.5mm ETT

A

Appropriate ETT size for the FULL TERM NEONATE

27
Q

What is the most appropriate size ETT for a premature neonate?

28
Q

4.0mm ETT

A

Size ETT for 3month to 12 month old

29
Q

The length of insertion for neonatal ETT should be

A

<10cm, between 8-10cm

30
Q

Factors affecting metabolism of drugs in the neonate (pick 2)

A

Volume of distribution
Protein binding
Fat content

31
Q

Normal cardiac output in the neonate?

A

200ml/kg/min

32
Q

Why do inhalation agents equilibrate more rapidly in the neonate? (pick 3)

A

Increased level of ventilation
Increased Cardiac Output
Reduced Solubility in blood

33
Q

Correct dosage of Atropine in the neonate?

A

10ug/kg IV

20ug/kg IM

34
Q

Correct dosage of Glycopyrrolate in the neonate?

A

0.005-0.01mg/kg (5ug-10ug/kg)

35
Q

Correct dosage of Ketamine in the neonate?

A

2mg/kg IV

4-5mg/kg IM

36
Q

What is commonly interpreted as muscle rigidity with bolus doses of Remifentanil above 3ug/kg?

A

Vocal cord closure

37
Q

Fasting guidelines for clear liquids

A

2hr- for GA, reginal, MAC

38
Q

Fasting guidelines for light meal or nonhuman milk?

39
Q

Fasting guidelines for breast milk

40
Q

Fasting guidelines for infant formula

41
Q

Fasting guideline for fried or fatty food or meat?

42
Q

Indication for blood components in perioperative period for major surgery in neonate.

43
Q

Indication for blood components in perioperative period for neonate with moderate cardiopulmonary disease?

44
Q

Platelets should be >______ for invasive procedures

45
Q

How do you calculate postgestational age?

A

gestational age + postnatal age

46
Q

What postgestational age is the highest risk for complication?

A

<60 weeks have greatest risk (full term (40wks) +20 weeks).

47
Q

EBV in Premature

48
Q

EBV in Newborn (<1 month)

49
Q

EBV in Infants 3mos-3years

50
Q

EBV in children >6

51
Q

EBV in adults

52
Q

Preanesthetic assessment needs to include:

A 
Birth Hx
Pregnancy Course
Complications
Cigarette use
Alcohol or substance use
Primary interest in respiratory and CV Hx
Head and neck
AW

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