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Module 5 > Respiratory Disfunction of the Newborn > Flashcards

Respiratory Disfunction of the Newborn Flashcards

1
Q

what are the 3 critical factors in the development of respiratory distress syndrome

A

preterm unable to produce enough surfactant
muscle coat of pulmonary blood vessels are incompletely developed
ductus arterioles may remain open due to hypoxia

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2
Q

what helps close the PDA

A

hyperoxemia

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3
Q

what could happen if the PDA does not close

A

pulmonary congestion and overload

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4
Q

why are preterm newborns at an increased danger of respiratory obstruction

A
  • the bronchi and trachea are very narrow and mucus obstructs airway
  • positioning
  • weak or absent gag reflex could result in aspiration
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5
Q

if O2 sats are dropping low what should you do

A

position them in a prone position for chest expansion

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6
Q

what are signs of respiratory distress

A 
nasal flaring
retractions
crackles
asthma (wheezing)
grunting
cyanosis
tachypnea
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7
Q

what are the two positions you can place the baby in for maintenance of resp function

A

supine with head slightly elevated without hyper flexion and prone position

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8
Q

why do you not want to do a lot of suctioning

A

this could put further stress on the baby

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9
Q

what should be assessed before oral feedings are started

A

infants gag and suck reflex as well as if they are breathing fast or not

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10
Q

why will a baby not go higher than 100% O2 sats on oxygen?

A

because we want to ween the baby off of the oxygen because too much can cause problems to the baby (ROP)

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11
Q

what delivers 400 breaths a minute to the infant and you will see a constant wiggle of their chest

A

high frequency oscillation

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12
Q

what is it when the baby poops in utero and they breath it into their lungs

A

meconium aspiration syndrome

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13
Q

what stops producing due to the meconium build up

A

surfactant

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14
Q

what is the biggest issue with MAS

A

mechanical obstruction because it plugs up the airway, making it sticky

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15
Q

MAS happens to….

A

full term or post term

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16
Q

what are clinical signs of MAS

A

severe respiratory distress shortly after birth and audible rales or rhonchi on auscultation

  • barrel chest
  • not a good apgar
  • PO2 is low
  • Acidosis
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17
Q

what is the management of MAS

A

ventilation and monitoring

surfactant admin

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18
Q

results when the normal vasodilation and relaxation of the pulmonary vascular bed do not occur

A

persistent pulmonary hypertension of the newborn (PPHN)

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19
Q

PPHN happens to…

A

term or near term infants (wimpy white boys don’t do well, african american females do the best)

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20
Q

what are 6 risk factors of PPHN

A 
hypoxia
RDS
pneumonia
bacterial sepsis
hypo or hyperthermia
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21
Q

for PPHN babies where do we check blood pressure

A

right arm

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22
Q

why do PPHN babies desat

A

their lung pressure is higher than systemic pressure and this makes blood bypass the lungs (going through PDA)

23
Q

what are assessment finding in a PPHN baby

A
  • term or near term infant
  • low apgar score
  • symp within 12 hrs
  • hypoxia at birth
  • tachypnea
  • retraction/grunting
  • cyanosis
  • hypotension
  • heart murmur
  • met acidosis
24
Q

preductal is the

A

right arm

25
Q

post ductal is the

A

left arm

26
Q

what helps increase systemic pressure so blood will go to lungs for the PPHN babies

A

vasopressors

27
Q

why are sedatives and analgesics given to PPHN babies

A

they are very sensitive and if we touch them they will drop their sats so care is done every hrs

28
Q

delayed clearance of fetal lung fluid and usually resolves by 48-72 hours

A

transient tachypnea of newborn (TTN) aka wet lungs

29
Q

what is a main cause of TTN

A

the babies don’t get a good squeeze of lungs as they make their way through vaginal canal or a c section is performed so there is no squeezing at all

30
Q

what are clinical manifestations of TTN

A

respiratory distress and or cyanosis

31
Q

cessation of breathing for 20 sec or longer or for less than 20 sec when associated with cyanosis, pallor, and bradycardia.

A

apnea

32
Q

what are two types of apnea

A

central and obstructive apnea

33
Q

caused by preterm infants irregular breathing pattern

A

central apnea

34
Q

preterm infant when there is a cessation of airflow associated with blockage of the upper airway

A

obstructive apnea

35
Q

apnea is a dx of _______

A

exclusion

36
Q

what is often used to treat apnea of prematurity

A

methylxanthine (caffeine citrate

37
Q

when would you hold the mthylxanthine (caffeine citrate)

A

when HR is high (>170)

38
Q

surfactant deficiency is the main issue of this and underdeveloped alveoli

A

respiratory distress syndrome

39
Q

RDS happens to…

A

usually preterm babies

40
Q

what is a good indicator that RDS babies are getting better

A

baby is starting to pee more

41
Q

what are risk factors for RDS

A

low gestational age
male predominance
maternal diabetes
perinatal depression

42
Q

why would maternal diabetes be a risk for RDS

A

increase sugar and insulin deactivates the surfactant

43
Q

how can you lessen the severity of RDS

A

giving mom steroids because it helps lung development but it should be given 30-1hr before birth

44
Q

what will the RDS baby look like

A

gray dusky color
nasal flaring
grunting

45
Q

how can we manage RDS

A 
artificial surfactant given via ET tube
resp support and monitoring
oxygen supplementation
fluid and metabolic management
(withhold feeding and give tpn)
46
Q

bone or mucus is blocking the nasal cavity

A

choanal atresia

47
Q

s/s of choanal atresia

A

cyanosis and retractions at rest
noisy respirations
difficulty breathing during feeding

48
Q

how do you assess potency of nares

A

listen for breath sounds while holding mouth closed and alternately compressing each nostril

49
Q

how should you position choanal atresia pt

A

head elevated

50
Q

what is a sign the baby probably has choanal atresia

A

put a pacifier in babies mouth and sats drop

51
Q

why is sx for choanal atresia put off

A

it is too close to the brain so they don’t want to do sx on it too soon (track is usually done first)

52
Q

too much oxygen can cause this to happen to the eye

A

retinopathy of prematurity (ROP)

53
Q

what is the main risk factor for ROP

A

hyperoxemia

54
Q

how can we prevent ROP

A

judicial use of supplemental oxygen therapy (for sats usually <93%)

Module 5 (18 decks)

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