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Special Populations > Neonatology > Flashcards

Neonatology Flashcards

1
Q

acrocyanosis

A

cyanosis of the extremities

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2
Q

antepartum

A

before the onset of labor

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3
Q

APGAR score

A

a numerical system of rating the condition of a newborn. It evaluates the newborn’s Appearance (skin color), Pulse (0,100), Grimace (reflex irritability: 0, grimace, cry), Activity (muscle tone: 0, some, active), and Respiratory Effort (0, slow, strong cry).

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4
Q

birth injury

A

avoidable and unavoidable mechanical and anoxic trauma incurred by the newborn during L&D.

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5
Q

choanal atresia

A

congenital closure of the passage between the nose and pharynx by a bony or membranous structure

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6
Q

cleft lip

A

congenital vertical fissure in the upper lip

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7
Q

cleft palate

A

congenital fissure in the roof of the mouth, forming a passageway between oral and nasal cavities.

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8
Q

DeLee suction trap

A

a suction device that contains a suction trap connected to a suction catheter. The negative pressure that powers it can come either from the mouth of the operator, or, preferably an external vacuum force.

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9
Q

diaphragmatic hernia

A

protrusion of abdominal contents into the thoracic cavity through an opening in the diaphragm

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10
Q

ductus arteriosus

A

channel between the main pulmonary artery and the aorta of the fetus

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11
Q

extrauterine

A

outside the uterus

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12
Q

glottic function

A

opening and closing of the glottic space

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13
Q

herniation

A

protrusion or projection of an organ or part of an organ through the wall of the cavity that normally contains it.

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14
Q

hyperbilirubinemia

A

an excessive amount of bilirubin – the orange-colored pigment associated with bile – in the blood. In newborns, the condition appears as jaundice. Precipitating factors include maternal Rh or ABO incompatibility; neonatal sepsis, anoxia, hypoglycemia, and congenital liver or gastrointestinal defects.

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15
Q

intrapartum

A

occurring during childbirth

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16
Q

isolette

A

also known as an incubator; a clear plastic enclosed bassinet used to keep prematurely born infants warm. The temperature of an isolette can be adjusted regardless of the room temperature. Some isolettes also provide humidity control.

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17
Q

meconium

A

dark green material found in the intestine of the full-term newborn. It can be expelled from the intestine into the amniotic fluid during periods of fetal distress.

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18
Q

meningomyelocele

A

herniation of the spinal cord and membranes through a defect in the spinal column.

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19
Q

nasogastric tube / orogastric tube

A

a tube that runs through the nose or mouth and esophagus into the stomach; used for administering liquid nutrients or medications or for removing air or liquids from the stomach.

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20
Q

neonatal abstinence syndrome

A

A generalized disorder presenting a clinical picture of CNS hyperirritibility, gastrointestinal dysfunctions, respiratory distress, and vague authonomic symptoms. It may be due to intrauterine exposure to heroin, methadone, or other less potent opiates. Nonopiate CNS depressants may also cause NAS.

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21
Q

neonate

A

an infant from the time of birth to one month of age.

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22
Q

newborn

A

a baby in the first few hours of life; also called a newly born infant

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23
Q

omphalocele

A

congenital hernia of the umbilicus.

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24
Q

PEEP

A

positive end-expiratory pressure

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25
Q

persistant fetal circulation

A

condition in which blood continues to bypass the fetal respiratory system, resulting in ongoing hypoxia

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26
Q

phototherapy

A

exposure to sunlight or artificial light for therapeutic purposes. In newborns, light is used to treat hyperbilirubinemia or jaundice

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27
Q

Pierre Robin syndrome

A

unusually small jaw, combined with a cleft palate, downward displacement of the tongue, and an absent gag reflex.

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28
Q

polycythemia

A

an excess of red blood cells. In a newborn, the condition may reflect hypovolemia or prolonged intrauterine hypoxia.

29
Q

thyrotoxicosis

A

toxic condition characterized by tachycardia, nervous symptoms, and rapid metabolism due to hyperactivity of the thyroid gland.

30
Q

vagal stimulation

A

stimulation of the vagus nerve, which in turn slows the heart rate.

31
Q

Antepartum factors indicating possible complications in newborns:

A

multiple gestation; inadequate prenatal care; mother’s age -16 or +35; Hx of perinatal M and M; post-term gestation; drugs/meds; toxemia, HTN, DIA

32
Q

Intrapartum factors indicating possible complications in newborns:

A

premature labor; meconium stained amniotic fluid; early rupture of membranes (>24h); narcs w/in 4h of delivery; abnormal presentation; prolonged labor or precipitous delivery; prolapsed cord or bleeding

33
Q

Factors that stimulate baby’s first breath include:

A

mild acidosis, initiation of stretch reflexes in lungs, hypoxia, hypothermia

34
Q

Newborn normal vital signs

A

40-60RR; 150-180HR at birth, 130-140 after

35
Q

APGAR

A

Appearance; Pulse Rate; Grimace; Activity; Respiratory Effort

36
Q

Appearance 0-2

A

0: blue, pale;
1: acrocyanotic;
2: pink

37
Q

Pulse Rate 0-2

A

0: absent;
1: 100

38
Q

Grimace 0-2

A

0: no response;
1: Grimace;
2: Cries

39
Q

Activity 0-2

A

0: Limp;
1: flexion of extremities;
2: active motion

40
Q

Respiratory Effort 0-2

A

0: absent;
1: slow and irreg;
2: strong cry

41
Q

Inverted pyramid of neonatal resuscitation, 6 steps

A

1: drying, warming, positioning, suction, tactile stimulation
2: O2
3: BVM
4: Cx Compressions
5: Intubation
6: Meds

42
Q

When to ventilate newborn?

A

HR less than 60 or

60-80 that does not improve

43
Q

When to intubate newborn?

A 
CPR
can't ventilate with mask
tracheal suctioning
prolonged ventilation
diaphragmatic hernia
inadequate respiratory effort
44
Q

Newborn intubation considerations

A

Use size 2.5 for tiny, 3.5 for small, 4.0 for big.
Use PEEP, 2-4 cmH2O
Use NG or OG tube if allowed

45
Q

When to give chest compressions to newborn?

A

HR

46
Q

Hypovolemia in infants, treatment

A

Start w/ 10mL/kg crystalloid (NO Dextrose!) over 5-10m

May need 40-60 mL/kg

47
Q

Diaphragmatic Hernia assessment findings

A 
little to severe distress
dyspnea and cyanosis unresponsive to ventilations
small, flat (scaphoid) abdomen
bowel sounds in chest
heart sounds displaced to right
48
Q

Diaphragmatic Hernia treatment

A

position with head and thorax higher than abd and feet
NG or OG tube with low, intermittent suctioning
DO NOT USE bag valve mask ventilation
If necessary, ventilate cautiously through ETT

49
Q

Epinephrine for neonatal resuscitation:

A

0.01 mg/kg IV/IO

50
Q

Most common cause of bradycardia in newborn…

A

hypoxia

51
Q

caput succedaneum

A

a large scalp hematoma, developed during birth process and usually resolved over the first week of life.

52
Q

Newborn hypothermia findings

A 
pale, cool skin
acrocyanosis
respiratory distress to apnea
bradycardia 
irritability to lethargy
53
Q

Newborn hypoglycemia findings

A 
twitching or SZ
limpness
lethargy
eye rolling
high-pitched cry
apnea or irregular respirations, cyanosis
54
Q

Causes of neonatal diarrhea:

A 
infection
gastroenteritis
lactose intolerance
phototherapy
neonatal abstinence syndrome
thyrotoxicosis
cystic fibrosis
55
Q

newborn hypovolemia findings:

A 
pale, cool skin
diminished peripheral pulses
delayed capillary refill when warm
AMS
oliguria: dark urine or dry diaper
56
Q

Most of fetal development that could lead to congenital problems occurs during:

A

first trimester

57
Q

neonatal SZ causes:

A

sepsis, fever, hypoglycemia, hypoxic-ischemic encephalopathy, metabolic disturbances, meningitis, developmental abnormalities, or drug withdrawal

58
Q

The most common cause of cardiac arrest in a newborn is

A

hypoxia

59
Q

The most common form of congenital heart disease

A

Ventricular Septal Defect

60
Q

Vomiting in the neonate is usually caused by

A

an anatomical abnormality; or a symptom of ICP or infection

61
Q

Neonatal Apnea causes:

A 
Narcotic or CNS Depressants
Respiratory muscle weakness
Sepsis
Metabolic Disorders
CNS disorders
62
Q

Patent Ductus Arteriosus

A

ductus arteriosus fails to close

63
Q

Atrial Septal Defect

A

a hole between the atria allows commixing of blood

64
Q

Ventricular Septal Defect

A

a hole between the two ventricles

65
Q

Tetralogy of Fallot

A
  1. overriding aorta
  2. VSD
  3. right ventricular hypertrophy
  4. pulmonary outflow tract stenosis
66
Q

Transposition of the great vessels

A

normal outflow tracts of the right and left ventricles are switched

67
Q

coarctation of the aorta

A

narrowing in the arch of the aorta that obstructs blood flow

68
Q

pulmonary stenosis

A

problem with the pulmonary valve that obstructs flow

69
Q

aortic stenosis

A

problem with the aortic valve that obstructs flow

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