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Phase 3a Paeds > neonates, resp > Flashcards

neonates, resp Flashcards

1
Q

What is a neonate by definition?

A

0-28 DAYS OLD

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2
Q

What score do we use to assess neonates?

A

APGAR

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3
Q

When is the APGAR Score done?

A

1, 5 and 10 mins post birth

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4
Q

What does APGAR stand for?

A

Appearance
-pale, cyanotic

Pulse
->100 good, <100 ok

Grimace
-sneeze, cough, cry good, grimace ok, no response bad

Activity
-active good, flexed A+L ok, absent bad

RR
-crying good, gasping + irregular ok

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5
Q

what do the APGAR scores mean?

A

0-4 = bad
5-6 = not amazing
7-10 = good

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6
Q

what will many neonates not have an APGAR score of 10?

A

Most kids are acrocyanotic (cyanosis of peripheries) at birth

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7
Q

what is given to all neonates one off and why?

A

Vit K IM injection as there’s no vitamin K in breastmilk

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8
Q

What 2 other tests are done within 72 hrs of birth?

A

NIPE (done after 34+0)
Otoacoustic emission testing

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9
Q

name 4 neonatal respiratory syndromes?

A

respiratory distress syndrome (NRDS)
Bronchopulmonary dysplasia (BPD)
Transient tachypnoea of newborn (TTON)
Meconium aspiration syndrome (MAS)

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10
Q

What is respiratory distress syndrome?
when does it usually occur?
what is it caused by?

A

<24hrs post birth

Atelectasis (collapse of part/all lung) due to low production of surfactant = high alveolar surface tension + collapse = Resp distress!!!

In premature baby, C section, maternal DM

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11
Q

When is surfactant produced?

A

26wks - 35 weeks (sufficient)

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12
Q

Sx of Resp distress syndrome?

A

resp distress Sx
laboured rapid breathing
cyanosis
indrawing chest wall

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13
Q

Dx of resp distress syndrome?

A

Chest xray - ground glass reticular

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14
Q

Tx prenatal and post natal for resp distress syndrome?

A

pre = maternal corticosteroids

post = surfactant (through endotracheal intubation), CPAP + O2

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15
Q

What are 2 complications of resp distress syndrome?

A

traumatic pneumothorax (with high O2/CPAP)
Bronchopulmonary dysplasia

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16
Q

What is bronchopulmonary dysplasia? (BPD)
What is it caused by?

A

Re perfusion injury due to chronic high flow O2 >4 weeks (used due to chronic lung disease) - alveolar septal injury

Prematurity

17
Q

Sx of bronchopulmonary dysplasia?

A

Chronic resp distress Sx, recurrent chest infection, poor feed

18
Q

Dx of bronchopulmonary dysplasia?

A

CXR = widespread opacity

19
Q

Tx for bronchopulmonary dysplasia?

A

Vit A for 7 days postnatal + IV caffeine, CPAP, Consider IM palivizumab monthly (RSV)

20
Q

What is the MC cause of resp distress neonatally in full term babies?

A

transient tachypnoea of newborn (TTON)

21
Q

What is transient tachypnoea of newborn (TTON)?
caused by?

A

delayed resorption + clearance of fetal alveolar fluid due to C.section + prematurity

22
Q

Sx of transient tachypnoea of newborn (TTON)?

A

Resp distress Sx

23
Q

Dx of transient tachypnoea of newborn (TTON)?

A

chest xray = fluid in horizontal fissure and hyper inflated lungs

24
Q

Tx of transient tachypnoea of newborn (TTON)?

A

self resolving <48hrs
consider CPAP/O2

25
Q

What is meconium aspiration syndrome (MAS)?
caused by?

A

Aspirated meconium (bile water, vernix, desquamation), chemical irritation, inflammation and mechanical obstruction in post term baby

26
Q

Sx of meconium aspiration syndrome (MAS)?

A

-<1hr resp distress
-Meconium stained amniotic fluid (MSAF)
-Yellow/green stained skin and nails
-Low APGAR score
-crackles auscultated in fetal lung

27
Q

Dx of meconium aspiration syndrome (MAS)?

A

Chest xray = consolidation, patchy atelactesis

Amniotic Fluid = High -ve RODS

28
Q

Tx of meconium aspiration syndrome (MAS)?

A

suction nose + mouth
supportive O2
supportive (IV Fluid)
Abx?

29
Q

MSAF + NO Resp distress =
MSAF + Resp distress =

A

monitor
Tx + O2….

30
Q

What is apnoea of prematurity?
when does it usually occur?
Tx?

A

decreased myelination of autonomic ns resp centre (ponto-med)

occurs 32-34 weeks therefore premature infant high risk

Tx = IV Caffeine

Phase 3a Paeds (14 decks)

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