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Pediatrics > Respiratory Distress > Flashcards

Respiratory Distress Flashcards

1
Q

Risk factors for neonatal respiratory distress

A 
Maternal diabetes
Prematurity
GBS infection --> possible sepsis
C-section 
Premature rupture of membranes (>18 hrs)
Meconium in amniotic fluid
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2
Q

Respiratory Distress Syndrome in newborn

A

deficiency in lung surfactant or lung maturation

- can be more common in diabetic mothers

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3
Q

Transient tachypnea of newborn

A

delayed clearance of fluid from lungs

- much more common in c-section and diabetic mothers

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4
Q

Pneumothorax in newborn

A

mechanical ventilation or underlying lung disease can cause it (meconium aspiration)

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5
Q

Hypoglycemia causing respiratory distress

A

chronic hyperinsulinemia from gestational diabetes can cause this
- tachypnea is nonspecific response

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6
Q

CHF in infant with respiratory distress

A

congenital heart defects

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7
Q

Neonatal sepsis

A

often due to GBS –> leads to tachypnea and sepsis

- progresses rapidly

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8
Q

Congenital diaphragmatic hernia

A

malformation resulting in defect of diaphragm –> GI contents in thoracic cavity –> collapsing lung or not allowing lung to develop (L-side)
- absent breath sounds or bowel sounds are diagnostic clues

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9
Q

Severe coarctation of aorta

A

severe left ventricular outflow tract obstruction

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10
Q

Meconium aspiration

A

aspirate meconium into lungs –> tachypnea –> respiratory distress

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11
Q

APGAR score

A

describes infants transition from intrauterine to extrauterine life

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12
Q

Large for gestational age

A

> 90th percentile for birth weight –> can be complication from maternal diabetes

  • can have hypoglycemia from diabetes
  • can have traumatic injuries from being taken out of womb and being so big
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13
Q

Appropriate gestational age

A

between 10th and 90th percentile

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14
Q

Small for gestation age

A

below 10th percentile for weight

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15
Q

Persistent pulmonary hypertension

A

elevated pulmonary vascular resistance causes blood to be diverted into systemic circulation bypassing lungs

  • tachypnea, tachycardia
  • generalized cyanosis, respiratory distress
  • low oxygen levels
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16
Q

Transition to extrauterine life

A

After birth

  • removal of low resistance circulation of placenta
  • initiation of air-breathing by infant
  • reduction of pulmonary arterial resistance
  • closure of PFO and PDA
17
Q

Signs of respiratory distress in infant

A

tachypnea, retractions, grunting

18
Q

Cyanotic newborn DDx

A

RDS, TTN
Tetralogy of fallot, transposition of great vessels
Hypoxic ischemic encephalopathy, sepsis, meningitis
Septic shock
Polycythemia

19
Q

Cyanotic newborn work-up

A 
Arterial blood gas
Blood and CSF cultures is sepsis suspected
CBC with differential
CXR, Echo
Oxygen challenge test
PE, pulse ox
20
Q

Fetal Effects of Maternal Hyperglycemia

A

high maternal sugars results in high fetal sugars –> lots of insulin production by fetal pancreas

  • insulin is primary anabolic hormone for fetal growth
  • can cause macrosomia and growth of heart, liver, and muscle
21
Q

Ideal nutrition for infants

A

Breast milk

  • provides lower renal solute load
  • anti-infective and anti-allergy properties
  • fosters mother-infant bonding
22
Q

Feeding infant in respiratory distress

A

probably ok to try, physician dependent

- but it may cause the infant to be in more stress if they are already tachypnic

23
Q

Hypoglycemia in neonate

A

can affect the brain!!!!

  • glucose initially declines after birth, but by 3-4 hrs it should be 65-71 range
  • drop in glucose can be more dramatic in infants of diabetic mothers because of the insulin
24
Q

Treatment of hypoglycemia in neonate

A

confirm strip test with a serum glucose test

  • tachypnea may cause a problem for oral feedings –> then try to pump breast milk and give it NG tube
  • if symptomatic hypoglycemia –> IV dextrose immediately
25
Q

Evaluation of tachypnea in newborn

A

CBC - look for infectious causes (sepsis)
Serum glucose - hypoglycemia
Blood culture - sepsis or PNA
CSF culture - sepsis or meningitis
Blood gas - oxygenation and acid-base status
CXR - TTN, RDS, structural abnormalities

26
Q

CXR findings in tachypnea

A

TTN - “wet” looking lungs with no consolidation
RDS - ground glass “white-out” appearance
Diaphragmatic hernia - Gi contents in thoracic cavity
PNA

27
Q

Ballard score for estimating gestational age

A

Should be performed in first 12-24 hours of life

- dates are +/- 2 weeks

28
Q

Developmental Dysplasia of Hip

A

Risks

  • breech presentation
  • female gender
  • family history
29
Q

Newborn hospital discharge criteria

A 
Follow-up scheduled
Feeding every 2-4 hrs
Jaundice low
Vitamin D
Car seat checked
Sleep position and co-sleeping
Weight loss

Pediatrics (36 decks)

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