NICU Flashcards
APGAR Scoring
Appearance: Blue, Acro, Pink Pulse: Absent, <100, >100 Grimace: Nothing, Grimace to pain, crying to pain Activity: Limp, mild tone, flexed Respiration: Absent, weak, good
Glucose Infusion Rate Formula
GIR = ID/6W I = Infusion Rate D= Dextrose W= weight in kg
What is periventricular leukomalacia
It is an area that has been subject to a water shed infarct
or due to hypotension in the weeks 24-26 of gestation and occurs around the ventricular space. It will then cause a decreased myelination around that area. It is the most common cause for spastic diplegia.
Respiratory Distress Syndrome
Common Age
What is it
Prevention
When the type II alveolar cells are not entirely functioning and do not produce enough surfactant. The surface tension is too high on the lungs making it difficult to have appropriate compliance.
Appearence is ground glass on chest xray.
Usually presents around 24-72 hours.
Prevention: Steroids to moms who are at risk of delivering <34 weeks and delivery anticipated within a week.
Transient Tachypnea of the newborn
This is transient pulmonary edema due to failed lung resporption.
Starts within a few hours of life up to 5 days.
CXR: Fissure has fluid, increased interestitial markings
NEC
Features on X ray
Treatment
Features: Portal Gas, Pneumatosis intestinalsis, fixed bowel, dilated loops
Bell’s criteria:
1: Suspected: NPO 24-72 hours; monitor cbc and diff for decompenstation.
2: Proven Tx: NPO x 7 days; serial abdominal x rays for evidence of perforation, Amp and Gent
3. Advanced - perforation TX: Surgery
Severe Hyperbilli risk factors
P2A MC
Prematurity Previous history of hyperbillirubinemia in family Asian Male Cephalohematoma
Common Teratogens and their manifestations: Phenytoin Lithium Phenobarbital VPA Wafarin
Fetal Hydantoin syndrome: IUGR, Clefts, nose digital and nail hypoplasia
Lithium: ebstein anomaly, endo, arrhythmia and seizures
Phenobarb: clefts, heart problems and hemorrhagic disease of the newborn
VPA: neural tube defects, thin long fingers
Wafarin: stippled bone epiphysis.
Hydrops Fetalis
What is it?
Risk Factors
RPN- GTC
Abnormal fluid collection in 2 or more compartments
Risk Factors:
Immune: Rh Incompatibility
Non Heme: Parvo, Metabolics (glycogen storage disorder), Genetic (turner/noonan), Cardiac
Fetal Tachycardia on NST
Risk Factors -
FAT-IMAH
Fever Anemia Thyrotoxicosis Infection Medications Arrhythmia Hypoxia/Distress
What are the major risk factors of hypothermia for HIE?
Arrhythmia
Thrombocytopenia
Need to be very careful in persistent pulmonary hypertension, bleeding and coagulopathy
What are the four grades of IVH?
When do they occur?
How do you prevent?
Grade 1 - Germinal Matrix only
Grade 2 - Into ventricules
Grade 3 - ventriculomegally
Grade 4 Extends into the parenhcyma
Most IVH are apparently by day 3 of life and 90% within the first week of life.
They are more common in <1500 g
Prevention: Steroids, delayed cord clamping
Spinal Cord Dysraphisms
Spina bifida oculta Meningocele Myelomeningocele (can also occur with a chiari II malformation) Tethered cord Diastematomyelia (split cord)
Risk factors: DM, Decrease Folate and VPA
Bronchopulmonary dysplasia
Defined as oxygen requirements at 36 weeks post menstural age and is thought to be due to a pathophysiology due to arrest in lung development.
The lungs may undergo a catch up in alveolar growth.
CCAM
Congenital Cystic Adenomatous Malformation
this is made of lung tissue and there is usually a connection between the tracheal bronchial tree.
