Perinatal Period Flashcards
infants born at or before 36 weeks 7 days are called?
preterm infants
infants born between 34 0/7 and 36 6/7 weeks’ gestation are called?
Late preterm (near-term)
gestations between 37 weeks 0 days and 41 weeks 7 days are called?
what type of infant
term infants
gestations of 42 weeks 0 days and longer are called?
what type of infant
Post term infants
what type of infant is at higher risk for more conditions?
Late preterm
hypoglycemia, jaundice, respiratory distress, temperature instability, feeding challenges, and increased rates of readmissions compared with a term counterpart.
most hospital systems have protocols that require late preterm infants to be monitored for how long, in addition to interventions such as passing a car seat trial before discharge?
48 hours
what type of infants are at risk for FGR secondary to uteroplacental insufficiency plus increased risk of meconium aspiration, intrauterine infection, and dysmaturity?
Post term neonates
what components are evaluated on standardized growth curves
- wt
- length
- head circumference
3 categories of the standardized growth curves
- Small for gestational age (SGA): Birthweights < 10th percentile.
- Large for gestational age (LGA): Birthweights > 90th percentile
- Appropriate for gestational age (AGA): Birthweights within 10-90th percentiles.
MC caused by early first-trimester insults, such as chromosomal abnormalities or congenital infection, resulting in a global growth delay.
Symmetrical FGR/IUGR
characteristic of uteroplacental insufficiency or maternal malnutrition often occurring later in 2nd or 3rd trimester, which results in “head-sparing” growth delays due to fetal blood flow redistribution to vital organs.
Asymmetrical FGR
what type of neonates are at increased risk for birth trauma such as brachial plexus injuries, clavicular fractures, or scalp hematomas
Neonates who are LGA
an important part of the transitional process; it helps promote lung expansion and protect lung volume.
crying
initially, breathing pattern is irregular, how does it become rhythmic?
soon after birth, modulation of chemoreceptors and stretch receptors makes it rhythmic
For successful gas exchange, newborn lungs require what two things?
- adequate pulmonary gas exchange surface area
- well-developed pulmonary vasculature
the primary muscle used during quiet breathing.
diaphragm
Major physiologic changes during the first 6 hrs after birth lead to ?
increase in oxygenation
decrease in partial pressure of carbon dioxide, arterial (PaCO2)
what two factors play an important role in alveolar fluid clearance
- ion exchange across the pulmonary and airway epithelium
- sodium uptake
Glucocorticoids, catecholamines, and oxygen play an important role in regulating the activity of this uptake
what is the preferred vascular access point for IV medications for neonates?
umbilical vein
for resuscitation, what are the 3 considerations at birth?
- Is the baby term?
- What is the tone? You want to see flexion of the extremities.
- is the baby breathing or crying?
If yes to all —› no resuscitation needed
if answers no to resuscitation questions, what is the next step?
- cut the cord immediately and take the baby to the warmer
- Stabilize: warm, dry, stimulate, position airway, clear secretions
- Tactile stimulation is typically performed while drying and suctioning infant. Should take no more than 30 seconds
- Suction if necessary. If bulb suction needed clear mouth before nose
- Start the APGAR monitor clock and begin resuscitation
if infant has labored breathing or persistent cyanosis, what are the next steps?
- position and clear airway
- place SpO2 monitor on right hand or wrist
- provide O2 if needed
- consider CPAP
If apnea/gasping and HR <100 bpm, what are the next steps?
- Begin Positive Pressure Ventilation (PPV) x 40-60 breaths per minute - if not effective - MR. SOPA (M-Mask adjustment, R- Reposition, S- Suction, O- Open the mouth, P- Increase the pressure, A- Change the airway)
- possible laryngeal mask or endotracheal intubation
- Place on SpO2 monitor and continuous ECG
when to start compressions on an infant?
HR < 60 bpm despite adequate PPV for 30 seconds
3:1 ratio (3 compressions before or after each inflation). 30 inflations and 90 compressions per minute