Neonatal ITU/TPN Flashcards
whats a neonate time frame
1-28 days
pre term baby is less than x weeks
37
adolescent is x to y
10-19
4 serious paediatric illnesses
epilepsy, asthma, obesity, T1DM
first trimester is 0-12 weeks, list some different organs that form in this period
organs, eyes, ears, moving foetus
heart beat starts at week
6
2nd trimester is between what 2 weeks
13 - 26
why are drugs avoided in the first trimester
all major organs formed in this time
baby starts to move in the second trimester, what different things are formed in this time
hair, eyelashes, muscles, bone
3rd trimester is week 27 to
40
what happens in the third trimester
lung surfactant, skin thickening, bone mineralisation, rapid growth
common cold is a common viral illness that is easily spread via close contact, how can it be treated in children
otc paracetmol or ibuprofen for fever, muscles aches or headache
children are more prone to ear infections than adults and can be caused by bacterial or viral infections, give some symptoms
ear pain
fever
irritability
difficulty sleeping
tugging at ear
give some symptoms of influenza
fever
sore throat
fatigue
body aches
chills
most cases of flu can be managed at home, at might they managed
medication
fluids
rest
bronchiolitis occurs when airways in lungs swell and produce mucus, what are some symptoms
coughing
soreness in chest
fatigue
headaches
body ache
sore throat
respiratory syncytial virus (RSV) affects resp system and causes mild like cold symptoms, however can be more dangerous in young infants and older adults, why
cause inflammation in airways and cause pneumonia
hand foot and mouth disease HFMD symptoms
skin rash
fever
mouth sores
flu like symptoms
symptoms of conjuctivitis/ pink eye
redness
discharge
itchiness
swelling in 1/ both eyes
how is conjuctivitis treated
abx ointment/ eye drops
treatment for gastroenteritis/ stomach flu
rest
giving fluids to avoid dehydration from vomiting and diarrhea
most sinusitis is caused by viruses, name the symptoms
runny, stuffy nose
headache
pressure/ pain in face
sore throat
cough
what bacteria causes strep throat
streptococcus pyrogens
abx to treat
10 commonest birth defects
congenital heart defects
hypospadias
VSD
clubfoot
downs syndrome
pulmonary valve atresia + stenosis
cleft lip w cleft palate
cleft palate
AVSD
limb deformities
weight of low birth weight baby
below 2.5kg
weight of very low birth weight baby
below 1.5kg
weight of extremely low birth weight baby
below 1kg
most receptors are in higher or smaller numbers in neonates
smaller
is gastric pH higher or lower in neonates
higher
is gastric emptying time slower or faster in neonates
slower
adults gastric emptying time between 12 and x hrs
24
do neonates have a large or small amount of bile
small - fat soluble vitamins not absorbed well
is a gastric acid present in baby born before 32 weeks
no
a childs gut ph doesnt reach adult values for approx x years
3
paracetamol is conjugated by glutathione, babys dont have glutathione so what should be done to dose
reduce
why does a baby need feeding asap
low body fat so no reserves
do water soluble drugs (eg gentamicin) in neonates need higher or lower dosing?
higher
do neonates require higher or lower doses of fat soluble drugs
lower
albumin levels are low in neonates hence free level of drug must be measured if protein binding required true or false
true
are liver enzymes increased or reduced in neonates
reduced
where are anti epileptic drugs NTLevels metabolised
liver
gfr takes x months to attain adult values
3-5
why is jaundice in a neonate particularly important to treat?
BBB not fully functional so bilirubin can enter and stay in the brain causing permanent brain damage
if jaundice is mild to moderate what is treatment
uv light
if jaundice is severe what is the treatment
blood transfusion
give a drug that can be given in a single dose to mop up bilirubin and cause jaundice
immunoglobulin
alwaysc cehck hm weeks neonate is born at. what is CGA
corrected gestational age
proportionally do babies drink more or less fluid than adults
more
every degree of temp increases metabolic rate hence babies require more or less fluid
more
fluid req for neonates from days 1 2 3 4 increases from 60, 90, 120 to
150 ml/kg
what artery and vein can be used to give drugs if babies are sick
umbilical
umbilicus must be used within how many days of life before it dies
2
if a premature baby cant feed what needs to be started
intravenous feeding
what iv fluid is usually used for feeding
10% glucose =/- IV Na, K, Ca..
po delayed abs initially improves when baby is on milk, IM is largely unused why
reduced muscle mass, perfusion and sa can cause erratic levels
im route is rarely used apart from
vit k and immunizations
immunizations are at what weeks
8,12,16
surfactant is given to neonates that need it in the lung via
ETT
what drug is used in resus
adrenaline
true or false, oxygen is a drug that must be prescribed and too much can cause blindness in babies due to overproduction of blood vessels
true
intraosseous route of admin is rarely used, what is it
directly into bone
topically babies have good abs due to the thin layer of x which means only 0.5% hydrocortisone or chlorhexidine may be used
stratum corneum
1st line abx in neonates
benzylpenicillin and gentamicin
2nd line abx in neonates
fluclox
cefotaxamine
vancomycin
meropenem
Prophylaxis abx
trimethoprim
HAP abx
mupirocin
viral abx
acyclovir
ganiclovir
zidovudine
antifungals in neonates
fluconazole
miconazole
why do patients on ventilators require muscle relaxants and pain killers
if they are paralysed they cant express pain
ventilator drugs commonly used in neonates
morphine and atracurium
what is used in babies to prevent apnoea of prematurity
caffeine citrate
chronic lung disease in neonates is treated with diuretic treatment using
chlorthiazide or spironolactone
how is CHD in neonates treated
with PGE 2-prostin (dinoprostone)
how is PDA (patent ductus arteriosus) treated
ibuprofen clsoes duct
how is PPHN treated
nitric oxide/ sildenafil
hypotension treatment in neonates
inotropes,
hydrocortisone, dobutamine, dopamine
hypertension treatment in neonates
hydralazine
resus drugs used for neonates SAD
sodium bicarb
adrenaline
dextrose
NaCl 0.9%
Gastro-oesophageal reflux (GOR) tx in neonates
domperisone
gaviscon
ranitidine
omeprazole
all babies given vit K why
prevent haemorrhagic disease
what can be used for cradle cap
olive oil
anaemia, thrombocyto, albuminaemia, deranges clotting tx in neonates
FFP
cryoprecipitate
platelets
albumin
why might steroids be given to the mother in preterm labour?
to mature fetal lungs
why might you need to give phosphate to a preterm baby
bone mineralisation happens happens between 33-35 weeks
