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Pediactric and Neonatal Respiratory Care > PRNC 02 > Flashcards

PRNC 02 Flashcards

1
Q

What solution do you use in order to remove adhesives on infants?

A

citrus oil

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2
Q

What is the best indicator to assess if the infant is improving with bag mask ventilation?

A

Rising HR

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3
Q

What is the most narrow area of the infants trachea?

A

the cricoid cartilage

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4
Q

Whats different about the pharynx in an infant?

A

The pharynx is more anterior

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5
Q

Trachea size for a term

A

5-6cm long and 4mm wide

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6
Q

Trachea size for a preterm

A

2cm long and 2-3mm wide

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7
Q

Apgar score of 7-10 indicates what?

A

Monitor them, routine care

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8
Q

APGAR of 4-6 indicates what?

A

Support them, stimulate/warm/give O2

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9
Q

APGAR score of 0-3 indicates what?

A

Resuscitation efforts are necessary

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10
Q

When do you perform the the APGAR assessment?

A

At minute 1 and minute 5

**Can be repeated q 5 min but usually ceases at minute 20

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11
Q

The lower score correlated with APGAR at minute 5 indicates what?

A

It is directly correlated with neonatal mortality. Lower the score at minute 5 means higher mortality rate

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12
Q

Score for baby who is blue or pale

A

0

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13
Q

Score for being acrocyanotic

A

1

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14
Q

How to assign a score for reflex irritability

A

0 no response
1 Grimace/withdraws slightly
2 Crying/active withdraw

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15
Q

HR of 5 receives which APGAR score?

A

1

**A 0 is only assigned if HR is absent

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16
Q

What tool is used to assess the DEGREE of respiratory distress?

A

Silverman-Anderson Index

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17
Q

What does a higher silverman score tell you?

A

That the baby is in severe respiratory distress

**lower score is better

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18
Q

What are the four signs of respiratory distress?

A

Nasal Flaring–Needs oxygen
Grunting–Needs CPAP or BiPAP b/c trying to create own peep
Retractions– Decreased lung compliance
Tachypnea– >60 and indicates the baby is trying to increase their minute ventilation

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19
Q

What are the four signs of respiratory distress?

A

Nasal Flaring–Needs oxygen
Grunting–Needs CPAP or BiPAP b/c trying to create own peep
Retractions– Decreased lung compliance
Tachypnea– >60 and indicates the baby is trying to increase their minute ventilation

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20
Q

What tools help estimate the age of the baby?

A

Ballard and Dubowitz

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21
Q

What is the difference between the Ballard and the Dubowitz assessment tools

A

Ballard is more RAPID and examines only 6 physical signs and 6 neuro signs compared to 11 and 10

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22
Q

Gestational Age +5 will give you what value?

A

determines what the mean arterial pressure should be

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23
Q

what is pallor? and what causes it?

A

Pale or white skin usually due to blood loss or hypovolemia

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24
Q

When is jaundice okay in a baby?

A

This is normal AFTER the first day but not immediately after birth

25
Q

At what level of PaO2 does cyanosis begin to show?

A

Shows up once PaO2 falls below 30

26
Q

What is the most important thing to regulate during the physical exam?

A

Thermoregulation

***If a problem is suspected…check the temperature first

27
Q

What are the normal values for axillary temp vs skin temp?

A

axillary is 36-37 while skin temp is 36-36.5

28
Q

What does mottling indicate?

A

Mottling is usually caused by hypotension/shock/anemia

29
Q

periodic breathing vs apnea

A

periodic breathing is normal and can last 5-10 seconds long but WITHOUT cyanosis or bradycardia.
True apnea lasts longer than 15-20 seconds and WITH cyanosis or bradycardia

30
Q

Acrocyanosis

A

Typically seen in the first 24 hours but abnormal past 24 hours. Blue hands and feet

31
Q

What is the normal resting position for a baby?

A

Feet and Arms flexed towards the body

32
Q

What are some physical finding of chromosomal abnormalities?

A

only having a single palmar crease, wider set eyes, flatter face

33
Q

How is jaundice treated?

A

The use of Billi lights/tanning lights

34
Q

What do you need to do if a baby has True Apnea?

A

Stimulate baby by flicking foot or rubbing their back

**Don’t be an idiot and shake them

35
Q

What does a bounding pulse indicate?

A

R to L shunt through ductus arteriosis

36
Q

What does it mean if the lower extremities show a slower pulse than the brachial?

A

That there is PDA or coarction of the aorta

37
Q

Where do you place the BP cuff?

A

place cuff around the thigh

38
Q

How does BP change with age?

A

As they get older, they will have higher blood pressures

39
Q

When using a suction catheter, what pressure do you set it at?

A

set to 80-100

40
Q

What are the tools to assess pain level?

A

N-PASS scales and pediatric faces pain scale

41
Q

What can you use for infants to help control pain levels pre-procedure?

A

Dip their pacifier in sweet ease solution. Oral use ONLY

42
Q

What are the three indicators for PPV?

A

HR less than 100
Apnea
SpO2 less than desired target (**despite using free flow FiO2)

43
Q

How can you administer free flowing O2?

A

Only through flow inflating bag and T-piece resuscitator

44
Q

What is the only way to administer O2 without having a compressed gas source?

A

Self-inflating

45
Q

What are the three things that can cause free flowing bag mask not to work well?

A

Hole in the bag, mask not fully sealed, or not enough gas flow

46
Q

How to properly measure while placing an OG tube

A

From bridge of nose to ear lobe, then from ear lobe to between the xyphoid process and umbilicus

47
Q

Why do you place the pulse ox on the right wrist?

A

Because it is preductal

48
Q

Decision making during resuscitation is based off what assessments?

A

RR and HR

49
Q

Persistent fetal circulation is caused by what?

A

aphyxia causes pulmonary HTN which then causes PFC.

**PFC is secondary to pulmonary HTN

50
Q

Indications of cardiac problems?

A

Murmur, bounding pulses, weaker femoral pulses, and preductal/post ductal measurements are greater than 5% apart

51
Q

APGAR assesses what 5 things?

A

Appearance, Pulse, grimace, activity, and respiration effort

52
Q

HR for a newborn/premature

A

120-170

*Premature baby will be closer to the 170 (higher)

53
Q

What defines a term baby

A

37-42 weeks

54
Q

Anything over 4 kilos means what?

A

automatically the baby is LGA

55
Q

What does grunting sound like?

A

high pitched sound made by partially closing of the epiglottis over the trachea

56
Q

What is the only way to assess a PDA that is not invasive?

A

Pre and Post ductal pulse oximetry

**Done by placing one on the right hand and one on the left foot

57
Q

Why do infants require more oxygen?

A

higher metabolic rate

58
Q

How does a newborn appear (color) during first 24 hours

A

Blue hands and feet, pink membranes and trunk.

**This is acrocyanosis

Pediactric and Neonatal Respiratory Care (9 decks)

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