Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EMRG 1305 - Tina’s Class > NEONATOLOGY > Flashcards

NEONATOLOGY Flashcards

Week 3

1
Q

What is the age requirement to be considered a neonate?

A

> 24 hours to <30 days of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the age requirement to be considered a newborn?

A

< 24 hours of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where does gas exchange occur?

A

In the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the anatomical structure that connect maternal/fetal circulation?

A

The placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Preferential Streaming?

A

When the cardiovascular system is adapted to ensure the most highly oxygenated blood is delivered to the myocardium and brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fill in the blanks:
Oxygenated blood passes via 1 umbilical ____ to the fetus and deoxygenated blood is carried out via 2 umbilical ____ arteries

A
  1. vein
  2. arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the Ductus Venosus?

A

A continuation of umbilical vein, which bypasses most of the blood from the liver and connects the umbilical vein to the inferior vena cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fill in the blank:
Fetal circulation is described as _____ dependent and location dependent

A

duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Foramen Ovale?

A

A shunt (opening in septum) that allows blood to travel from the right atrium to the left atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Ductus Arteriosus?

A

The artery that joins the pulmonary system directly to the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fill in the blank:
Most of the fetal blood bypasses the immature liver via the _____ _____ into the inferior vena cava

A

ductus venosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fill in the blank:
Oxygen-rich blood travels into the heart’s right atrium through the _____ _____ to the left atrium

A

foramen ovale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or false:
From the left atrium, blood is transferred to the left ventricle into coronary arteries and aorta where oxygenated blood is delivered to the brain as well as some to the kidneys, lungs, etc.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or false:
The superior vena cava brings in deoxygenated blood also into the right atrium, therefore there is a mixing of oxygenated and deoxygenated blood in the right atrium of the fetal heart

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fill in the blank:
Some blood in the right atrium will pass into the right ventricle where it will be transferred into the pulmonary artery, but because the alveoli are fluid-filled most of the blood is shunted away from the lungs via the ______ ______ due to the pressure imbalance

A

ductus arteriosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fill in the blank:
Deoxygenated blood enters systemic circulation and is then carried back to the placenta via the ______ ______ where the blood can be oxygenated and the cycle can occur again

A

umbilical arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are 4 things that occur when a baby takes it’s 1st breath?

A
  1. The surface tension that collapsed the alveoli in utero is now broken allowing the opening of the alveoli, and spontaneous oxygenation/respiration
  2. Pulmonary resistance decreases and the blood flow from the placenta stops
  3. The pressure on the left side of the heart becomes greater than the right when the fetus is in utero
  4. Pressure in the aorta, the left side of the heart, increases systemic vascular resistance and pressure changes causes the fetal shunt to close within the 1st few hours of birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

With regards to ventilation, what happens to the baby’s lungs once delivery has happened?

A

The lungs are filled with the 1st breath, this establishes functional residual capacity within the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 major (physiological) systems involved post-delivery?

A
  1. Ventilation
  2. Hemodynamics
  3. Temperature Regulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If gas exchange does not occur immediately after birth, (functional residual capacity does is not established), how can it artificially be reproduced?

A

Through BVM ventilations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

True or false: regarding hemodynamics…..
as the pulmonary vascular resistance decreases as the lungs are now functioning blood flow increases, and is able to carry oxygen throughout the body

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

True or false: regarding temperature regulation……
due to large surface area, immature regulation and little fat, neonates are at risk of hypothermia and compensate with vasoconstriction and an increased metabolism

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When does Meconium Aspiration occur?

A

When a baby is stressed and gasps while still in the womb, or soon after delivery when taking their first breaths of air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does Meconium Aspiration cause? What does it lead to?

A

It causes small airways to become blocked which leads to a baby improperly breathing….this causes respiratory distress to develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What syndrome is a leading cause of severe illness and death in newborns?

A

Meconium Aspiration Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Primary Apnea?

A

The absence of spontaneous respirations after birth; often self-limiting and reversed with minimal resuscitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are 3 steps you can take to manage Meconium Aspiration?

A
  1. Wipe away excess with a cloth if present around nose or mouth
  2. If required, gently suction the nose first and then the mouth using a bulb syringe
  3. If there is copious amounts then turn their head to the side to allow gravity to assist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What complications are important to remember when suctioning?

A

That rigorous suctioning can cause apnea/bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is Secondary Apnea?

A

Apnea that exceeds 20s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are 5 possible causes of Secondary Apnea?

A
  1. Difficult labor
  2. Airway obstruction
  3. Hypoglycemia
  4. Respiratory muscle weakness
  5. Narcotics or CNS depressants (DO NOT reverse with Narcan if drug abuse is suspected)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Within the baby, what 4 things can cause hypovolemia?

A
  1. Dehydration
  2. Sepsis
  3. Hemorrhage
  4. Trauma
27
Q

What physical signs would a newborn who is hypo perfused (hypovolemic) present with?

A
  1. Mottled, pale, and/or cool skin
  2. Lethargic
  3. Poor tone
28
Q

What can sunken fontanelles indicate? What can bulging fontanelles indicate?

A
  1. hypovolemia
  2. increased ICP
29
Q

What are 3 risk factors for hypoglycemia within a newborn?

A
  1. Apnea
  2. Preeclampsia/eclampsia
  3. Smaller babies/twins
29
Q

What are 5 things newborns experiencing hypoglycemia can present with?

A
  1. Seizure(s)
  2. Pale skin
  3. Poor tone
  4. Lethargy
  5. Apnea
30
Q

How do you check blood glucose levels in a newborn?

A

Take blood sugar from their heel

31
Q

True or false:
Simple Congenital Heart Defects may get better on their own, without surgery

A

True

31
Q

How much, and at what rate/interval, glucagon can you administer to a newborn?

A

You can give 0.5 mg of glucagon every 20 minutes for a maximum of 2 times

31
Q

What are 3 examples of Simple Congenital Heart Defects

A
  1. Atrial and ventricular septal defects
  2. Patent ductus arteriosus
  3. Pulmonary stenosis
32
Q

True or false:
Complex and Critical Congenital Heart Defects may cause life-threatening symptoms that require immediate treatment

A

True

33
Q

What is 1 example of a Complex/Critical Congenital Heart Defect

A

The Tetralogy of Fallot

34
Q

What is an Atrial Septal Defect?

A

It is a hole in the wall of the heart between the left and right atria

34
Q

What does an Atrial Septal Defect cause?

A

It causes blood to flow from the left atrium and mix with the right atrium, instead of going to the rest of the body

34
Q

Why is an Atrial Septal Defect considered a simple congenital heart defect?

A

Because the hole may close on its own as the heart grows during childhood

34
Q

What is Patent Ductus Arteriosus? What does it cause?

A

A simple congenital heart defect that occurs when a connection between the heart’s 2 major arteries, the aorta and the pulmonary artery, does not close properly after birth CAUSING an opening through which blood can flow when it should not

34
Q

What can a Ventricular Septal Defect (VSD) cause?

A

It may cause blood to flow from the left ventricle and mix with blood in the right ventricle, instead of going to the rest of the body

34
Q

What is a Ventricular Septal Defect (VSD)?

A

It is a hole in the wall between the left and right ventricles

35
Q

True or false:
A Ventricular Septal Defect (VSD) can cause fluid to build up in the lungs?

A

True

35
Q

What is Pulmonary Stenosis?

A

A type of heart valve disease in which the pulmonary valve is too narrow or stiff

36
Q

What does Pulmonary Stenosis affect?

A

It affects how well blood can move from the heart to the pulmonary artery, the blood vessel that connects the heart to the lungs

37
Q

How do you as a Paramedic treat complex heart defects?

A

By treating symptoms

38
Q

What are the 4 components of The Tetralogy of Fallot?

A
  1. Pulmonary Stenosis
  2. A large ventricular septal defect
  3. An overriding aorta
  4. Right ventricular hypertrophy
39
Q

How does the location of the aorta change when it becomes an overriding aorta?

A

Instead of being ABOVE the left ventricle, it is located BETWEEN the 2 ventricles

40
Q

What is Right Ventricular Hypertrophy?

A

When the heart has to work harder then normal making the muscle of the right ventricle thicker than normal

41
Q

What are 4 signs/symptoms of severe heart defects that can be seen in a newborn/neonate?

A
  1. Rapid breathing
  2. Cyanosis
  3. Fatigue
  4. Poor blood circulation
42
Q

Why are neonatal hearts dependent on heart rate for cardiac output as they have decreased vascular compliance?

A

Because a neonate is unable to generate increases in stroke volumes due to their non-compliant ventricles

42
Q

What are 4 signs/symptoms of heart failure within a neonate?

A
  1. SOB or trouble breathing
  2. Fatigue with physical activity
  3. A buildup of fluid in the lungs
  4. Swelling in the ankles, feet, legs, abdomen, and veins in the neck
43
Q

Fill in the blank:
Neonates possess a ______ parasympathetic tone placing them at risk for bradycardic episodes under stressful circumstances

A

dominant

43
Q

True or false:
Neonates lack cerebral autoregulation and have a mature blood-brain barrier?

A

False;
Neonates lack cerebral autoregulation and have IMMATURE blood brain barrier

44
Q

What are the 14 things you should have in your OB kit?

A
  1. Alcohol wipes
  2. A blanket
  3. Forceps
  4. Gauze pads
  5. Gloves
  6. Incontinent pad
  7. Obstetrical pad
  8. Obstetrical towelettes
  9. Plastic Bags
  10. Scissors
  11. Suction device (typically a bulb)
  12. Towels
  13. Twist ties
  14. Umbilical cord clamps
44
Q

What should you do when you’re initially assessing a newborn and breathing is not present?

A

Attempt to Dry, Warm, and Stimulate the newborn

44
Q

When should you perform an APGAR assessment on a newborn?

A

At 1 minute and 5 minutes post-birth

44
Q

Only supportive care is required if what 3 things are present upon your initial assessment of a newborn?

A
  1. Term gestation
  2. Good muscle tone
  3. Breathing/crying
45
Q

What is vernix?

A

A protective coating on newborns skin in utero

45
Q

What 2 stations should you set up when preparing to deliver a baby?

A
  1. A delivery area
  2. A newborn resuscitation area
46
Q

What would you do if you deliver a baby and notice the baby is flaccid?

A

IMMEDIATELY cut the cord and move the newborn to the resuscitation area

46
Q

What is the main cause of cardiac arrest in newborns?

A

Respiratory failure

46
Q

Where should the SPO2 probe be placed on a newborn?

A

On the right hand

47
Q

True or false:
If a neonate’s HR is above 100 bpm, you should consider bow by O2 near their mouth and nose if not hitting the pre-ductal targets?

A

true

47
Q

True or false:
If central cyanosis is present, but respirations appear adequate and the HR is greater than 100 bpm, oxygen administration is not required

A

true

47
Q

Provide the Targeted Pre-Ductal SPO2 After Birth values for the following:
- 1 minute
- 2 minutes
- 3 minutes
- 4 minutes
- 5 minutes
- 10 minutes

A

1 minute: 60-65%
2 minutes: 65-70%
3 minutes: 70-75%
4 minutes: 75-80%
5 minutes: 80-85%
10 minutes: 85-95%

48
Q

Why is it that during initial Positive Pressure Ventilation oxygen administration is not required?

A

Due to the risk of hyperoxemia, which neonates are sensitive to

49
Q

What does the mnemonic MR. SOPA stand for?

A

M: Mask
R: Reposition airway
.
S: Suction
O: Open mouth
P: increase Pressure
A: Alternate Airway

49
Q

What position should be used in the P phase of MR.SOPA?

A

The “sniffing position” … the “sniffing position” is when you placed a folded blanket under the newborn’s shoulder

50
Q

True or False:
Due to large body surface, poor thermoregulation and difficulty retaining moisture preterm babies <32 weeks should not be dried and placed in a plastic bag (below the neck), freezer bag (below the neck) or foil blanket to retain moisture and avoid hypothermia

A

true

51
Q

True or false:
Unless you cannot correct a reversible cause of cardiac arrest you should resuscitate on scene, and do it well within current guidelines

A

true

51
Q

As per the BLS in what 6 situations should you consider very early transport after the 1st analysis (and defibrillation is indicated)?

A
  1. Pregnancy is presumed >or= 20 weeks
  2. Hypothermia
  3. Airway obstruction
  4. Suspected pulmonary embolus
  5. Medication overdose/toxicology
  6. Other known reversible cause of arrest not addressed

EMRG 1305 - Tina’s Class (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions