Neonatology/Ped/OB Flashcards
Physiological changes to mother during pregnancy
Increases blood volume
Increased cardiac output
Increased Minute Ventilation
ABG changes to compensates respiratory alkalosis
Fungal heights to know
Peak is at 36 weeks. Will drop back down as fetus moves
20 weeks is marked at the umbilicus
Preterm Labor definition
Labor between 24-36 weeks
What medications to give for preterm labor?
Administer Tocolytic agent such as Terbutaline 0.25 mg or Mag 4 g infuse
How to detect Abruptio placenta?
Lots of pain, little bleeding.
Caused by trauma or spontaneous tearing of the placenta from the uterine wall.
How to detect placenta prévia?
Little pain, lots of bleeding.
Caused by placenta covering the cervical opening. No digital exams.
How to detect uterine rupture?
Caused by trauma. Fetal parts can be felt in abdomen.
Pregnancy with HTN crisis: what do we do in order?
Magnesium 4g in 100 mL over 20 min
Labetolol: 10mg SIVP with stacked dosing ( 10,20,40)
Hydralazine: also known as alpresoline- vasodilator
Nifepidine: also known as procardia- CCB that targets arteries
Magnesium Toxicity, what are the signs and what is the reversal?
Reduced DRT’s (deep tendon reflexes)
CNS depression
Hypotension
Give Calcium
What does EFM stand for?
Electronic (external) Fetal Monitoring
What is a normal FHR (fetal heart rate)?
120-160 bpm
What are the 3 levels of variability with EFM?
Mild: less than 8bpm variance (Bad)
Moderate: 8-25 bpm variance (good)
Severe: greater than 25 bpm (Not good)
What does VEAL CHOP stand for?
Variable decels Cord problem
Early decels Head compression
Accelerations Okay
Late decels Placenta
What is Pitocin?
Hormone that elicits uterine contraction.
Indicated in post partum hemorrhage and labor induction.
When should you discontinue Pitocin?
Develops uterine tetany
Definition of a neonate?
1-28 days of life
What does PDA stand for with neonates?
Patent Ductus Arteriosis
How does a PDA close?
Oxygen and NSAIDS
When do you treat hypoglycemia in a neonate?
Less than 40
Administer D10
What is hypothermia defined as in a neonate?
Body temp less than 36.5 degrees C
What is a normal HR for a neonate?
120-160
What is the CPR ratio for neonates?
3:1
What are the 4 things that make up Tetraology of Fallot?
VSD
RVH
Narrowed PA
Overriding aorta
How to treat a patient with Tetraology of Fallot?
Keep pt calm
Knees to chest maneuver
What is transposition of the Great arteries? (TGA or TGOV)
Aorta and the pulmonary artery switch places
Treatment for cyanosis lesions that are pre-surgery?
DO NOT GIVE OXYGEN!
Prostaglandins (PGE): 0.05-0.1 mcg/kg/min
What are the side effects to prostaglandins (PGE)?
Apnea and hypotension
Treatment for cyanosis lesions post surgery?
Prone to heart failure
Digoxin, ace inhibitors, diuretics when in exacerbation
What is Hypoplastic Left Heart Syndrome?
Acyanotic lesion
Patient has a tiny left ventricle
Prone to heart failure
Hepatomegaly is a sign of HF in neonates
Will receive digoxin, ace inhibitors, diuretics when in exacerbation
Define prematurity
Delivery before 37 weeks
How do seizures present in a neonate?
Lip smacking, bicycling of the legs, nystagmus/fixed gaze.
What is myelomeningocele?
How do you transport that Pt?
Spina Bifida
A protrusion of spinal nerve and meninges are exposed
Transport the patient prone
What does a FLACC scale score?
Pediatric pain
What does a “steeple sign” indicate on an x ray and what do you give first as a treatment?
Indicates croup
Epinephrine first
What is epiglottis caused by?
H. Influenza B bacteria
