Neonatal ITU/TPN Flashcards by X X

whats a neonate time frame

1-28 days

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pre term baby is less than x weeks

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adolescent is x to y

10-19

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4 serious paediatric illnesses

epilepsy, asthma, obesity, T1DM

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first trimester is 0-12 weeks, list some different organs that form in this period

organs, eyes, ears, moving foetus

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heart beat starts at week

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2nd trimester is between what 2 weeks

13 - 26

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why are drugs avoided in the first trimester

all major organs formed in this time

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baby starts to move in the second trimester, what different things are formed in this time

hair, eyelashes, muscles, bone

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3rd trimester is week 27 to

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what happens in the third trimester

lung surfactant, skin thickening, bone mineralisation, rapid growth

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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

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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

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give some symptoms of influenza

fever
sore throat
fatigue
body aches
chills

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most cases of flu can be managed at home, at might they managed

medication
fluids
rest

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bronchiolitis occurs when airways in lungs swell and produce mucus, what are some symptoms

coughing
soreness in chest
fatigue
headaches
body ache
sore throat

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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

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hand foot and mouth disease HFMD symptoms

skin rash
fever
mouth sores
flu like symptoms

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symptoms of conjuctivitis/ pink eye

redness
discharge
itchiness
swelling in 1/ both eyes

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how is conjuctivitis treated

abx ointment/ eye drops

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treatment for gastroenteritis/ stomach flu

rest
giving fluids to avoid dehydration from vomiting and diarrhea

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most sinusitis is caused by viruses, name the symptoms

runny, stuffy nose
headache
pressure/ pain in face
sore throat
cough

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what bacteria causes strep throat

streptococcus pyrogens
abx to treat

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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

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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

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

a childs gut ph doesnt reach adult values for approx x years

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

every degree of temp increases metabolic rate hence babies require more or less fluid

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

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