PNRC04 Flashcards
Synonym for ground glass appearance
Reticulogranulonar
Main difference between RDS and TTN (transient tachypnea of newborn)
TTN is only going to last for a few days and will only require O2 for treatment
*Remember RDS will require surfactant replacement
Most commonly occurs in elective C-sections and is primarily caused by delayed reabsorption of the fetal lung fluid
Transient tachypnea of the newborn
interchangeable with CLD
Bronchopulmonary Dysplasia
Umbrella term for O2 dependant infants and gets classified by severity
BPD
What are the three criteria to determine severity of BDP?
gestational age, age, and O2 needs
Which baby will almost always be seen with O2?
BDP
If RDS isn’t treated quickly/appropriately, what is the serious illness it can cause?
BPD Bronchopulmonarydysplasia
Main treatment is resuscitation efforts
Pulmonary Hemorrhage
Reticulograndular densities
Found in RDS
**Also referred to as ground glass
Primary cause of RDS
Decreased surfactant production
who is at greatest risk for Neonatal Pnuemonia?
Premature and low body weight infants
Two main causes of neo pnuemonia and who is likely to have these infections
Group B strep in term/near term
E. Coli in LBW
Increased respiratory distress AEB grunting
Primary s/s associated with Meconium aspiration syndrome
MAS will most likely occur in ……
term to post-term
Persistent pulmonary HTN can be a result of what dz if not treated correctly
MAS meconium aspiration syndrome
Only infants that will ALWAYS have a PaO2 goal of 80-100
PPHN
**SpO2 goal is >95%
Which dz need a PDA
hypoplastic left heart syndrome
tetrology of Fallot
coarction of aorta
Which dz is caused by narrowing or the aorta
Coarction of the aorta
Correct placement of an ETT on infant
between the clavicles and carina, below thoracic inlet
What is an air bronchogram
dilated bronchi surrounded by consolidation
Primary finding on x ray for PIE
pulmonary interstitial emphysema….on x ray looks SPONGE LIKE
A pnuemothorax will appear how on an x ray?
transillumination will show a bright light on x ray (hyperluecency)
**will also have deep sulcus
PaO2 goals for term and preterm
term 60-80
preterm 50-80
How do you treat the flip flop phenomenon
This is when a slight drop of FiO2 results in a much larger drop in PaO2.
***With these patients you need to wean the FiO2 extremely carefully and slowly
When weaning a patient with flip flop, is it time consuming?
YES….because you need to STAY IN THE ROOM when weaning them to monitor very closely
DOC for apnea of prematurity
Caffeine
crying in choanal atresia
This is okay and doesn’t mean the infant is in distress. Remember that infants are obligatory nose breathers and this is blocked in this dz
If you can’t pass an 8Fr suction catheter, what should you assume?
The infant has choanal atresia
Digoxin is used to treat …
CHF
Milrinone does what
Improves CO and contractility
two diuretic drugs
lasix and **Bumetanide
Drug that keeps the PDA open
Prostaglandin
Drugs that close the PDA
O2, Neoprofen, Indocin
Drug that treats pulmonary HTN
Talozine
What type of drug is Versed
sedative
Condition which the mandibular bone is under developed and what is the main problem
Pierre Robin
Main issue is the tongue is pushed back and likely causes obstruction
Treatment of Pierre Robin
Place prone and might need an oral airway
Three main symptoms with a TE fistula
Copious oral seretions, respiratory distress with feedings, continued regurgitation of feedings
Scaphoid abdomen
Primary s/s of congenital diaphragmatic hernia
Three main things to remember in treatment of CDH (Hernia)
Never bag-mask them, Large og/ng tube, and needs to be intubated with ETT immediately
gastroschisis vs omphalocele
In omphalocele, the organs are outside the body but still in the peritoneum while gastroschisis involves usually only the intestines and is not protected by the peritoneum making infection a massive problem
Explain the scale for IVH
Scale of severity. Grade 1 to grade 4
Grade 1 is least severe
Number one hazard with transcutaneous monitoring
Thermal burns
A loose probe during TC monitoring will look like what?
Higher PaO2 and lower CO2
***This is because there is a higher concentration of oxygen in RA and less CO2 compared to inside the body
Two main uses of a UAC
umbilical artery catheter
- Continuous BP monitoring
- ABGs
What four defects typically accompany tetrology of fallot?
VSD, overriding aorta, pulmonary stenosis, right ventricular hypertrophy
What treatment is always necessary for tetrology of fallot?
Surgery
pulmonary veins connect to superior vena cava
TAPVR total anomalous pulmonary venous return
**Requires ASD to survive
If the PDA doesn’t close, what type of circulation will follow?
Persistent fetal circulation
PDA is an opening between what?
the pulmonary artery and the aorta
Norwood operation
This is the first surgery in staged reconstruction of HLHS
What does TC monitoring read?
The patient’s CO2 and O2
Difference in upper vs lower extremity pulse strength
This is seen in coarction of the aorta
On expiration where will the diaphragm be on x ray
6th or 7th rib on expiration
air bronchgrams are seen in what dz
atelectasis
sail sign on x ray
thymus gland
What does the sponge like appearance represent in PIE on the x ray
this is from the air leaking from a lung puncture and migrating throughout the lung
three main causes of atelectasis
airway obstruction
compression
sedation (breathing at low lung volumes)
reopening of fetal shunting most commonly causes what
the flip flop phenomenon
pneumonia will appear like what on x ray?
Patchy
sponge-like
PIE
who are the only infants that we want a PaO2 of 80-100 always?
PPHN
