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Paeds > Physiology of Neonates > Flashcards

Physiology of Neonates Flashcards

1
Q

What carries oxygenated blood to the baby [2]

What carries deoxygenated blood [2]

A

Umbilical vein
Carries O2 blood from placenta to foetus

Umbilical artery x2 - from bifurcation of aorta - placenta

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2
Q

What is the ductus venous and what type of blood

A

Foetal blood vessel connecting umbilical vein from placenta to IVC of baby

Mostly oxygenated
Liver gets most oxygenated blood as first organ where umbilical vein goes

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3
Q

What is the foramen ovale

A

Hole connecting RA-LA

Bypass immature lungs

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4
Q

What is the ductus arteriosus

A

Allows blood flow from Pulmonary artery to aorta without travelling through foetal inadequate lungs
If it doesn’t close blood flows from aorta -> Pa

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5
Q

What does ductus arteriosus allow

A

RV to strengthen

Protect lungs from circulatory overload

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6
Q

What does ductus arteriosus carry

A

Low oxygen saturated blood

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7
Q

What is the saturation in a foetus

A

60-70%

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8
Q

When does the cardiovascular system start to develop [2]

A

End of third week

Heart beats at 4th week

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9
Q

What happens at first breath [4]

A
  • Move fluids out of lungs and arteries in lungs open
  • Foramen ovale closes - hard to open after 14 days
  • PDA stays open 1-2 days
  • Others all become ligaments
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10
Q

What are vital signs of newborn
BP, RR, HR
What is considered tachycardia and bradycardia in a newborn?

A 
BP 70/40ish 
RR - 30-60
HR- 120-160
Tachy >160
Brady <100
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11
Q

How do new born babies thermoregulate [3]

A
  • Lack shivering thermogenesis
  • Rely on metabolic heat
  • Brown fat innervated by sympathetic nervous system
    If premature lack brown fat
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12
Q

What are the 4 ways to lose heat [4]

A

Radiation - to colder
Convection - moving air
Evaporation - to water
Conduction - to surface you touch

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13
Q

How do you assess newborn breathing non-invasively [3]

A
  • Clinical - RR
  • Blood gas determination - take capillary blood + analyser
  • Trans-cutaneous PCO2,O2
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14
Q

What should the PaCo2 and PaO2 be in a newborn

A

PaCO2 - 5-6

PaO2 - 8-12

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15
Q

How do you assess breathing invasively [2]

A

Capnography - monitors PaCO2 in intubation

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16
Q

Physiological jaundice

A

Day 2-3 and disappears in 7-10 days or three weeks in prem

Breast feed increases duration

17
Q

Fluid balance in term newborn
Will newborns require fluid support usually?
Urea and creatinine levels off in first 24h, is this normal?
Newborn not passing urine in first 24h, intervention?

A
  1. Should be able to maintain fluid and electrolyte balance
  2. U+E may be off first 24 hours as mother may have had IV fluids
  3. Normal not to pass urine for 24 hours
  4. Weight loss up to 10% is normal
18
Q

Fluid balance in premature babies - what to consider in their physiology? [3]

A

Less fat
Increased loss through kidney
Increased insensible water loss

19
Q

Why is there increased loss through kidney in premature babies [3]

A

Slower GFR
Reduced Na reabsorption
Decreased ability to concentrate or dilute urine

20
Q

Physiological anaemia

A

Reduced RBC production when born then increases

21
Q

What is physiological of anaemia in prematurity [3]

A

Reduced erythropoiesis
Blood letting
Infections

22
Q

How do you treat physiological anaemia

A

Give iron at 28 days if premature

23
Q

What do you do if low Hb

A

Look at reticulocyte count to see if haemolytic

24
Q

Why are bloods not accurate 1st 24 hours

A

Affected by mother e.g. if had IV fluid

So repeat

25
Q

What do you do when baby comes out not crying [3]

A

Dry baby
Stimulate
Assess tone / HR/ HRR

26
Q

If not breathing what do you do [3]

A

5 inflation breaths
By putting pressure on mask
Aim to sustain pressure to push fluid out

27
Q

If this doesn’t work what do you do

A

Continuous pressure

28
Q

If HR not improving or less than <60 [2]

A

CPR
Ratio 3:1
Consider IV access and drugs

29
Q

How often do you assess

A

30 seconds

Paeds (33 decks)

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