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Pediatric/Neonatal Care 👶🏽 > Test 4 > Flashcards

Test 4 Flashcards

1
Q

What is the rule of 6 when it comes to estimating how far to tape the ETT?

A

Convert lbs to kg, then add 6

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2
Q

How do you treat a pneumothorax of less than 25%?

A

100% Oxygen

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3
Q

What is the minimum flow range for the OxyHood?

A

7 LPM

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4
Q

What is the best flow range for the OxyHood?

A

10-12 LPM

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5
Q

What causes PIE?

A
  • The use of high PEEP and PIP
  • Prolonged inspiratory times
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6
Q

What is another name for bronchopulmonary dysplasia (BPD)?

A

Neonatal Chronic Lung Disease

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7
Q

How long does long term exposure to high concentrations of O2 lead to BPD?

A

Causes edema and thickening of the alveolar membrane

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8
Q

What is another name for pulmonary dysmaturity?

A

Wilson-Mikity Syndrome

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9
Q

Pulmonary dysmaturity is similar to BPD with the exception of what?

A

The infant has NOT been ventilated

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10
Q

If both parents are carriers of CF, what is the likelihood of the child being a carrier?

A

50%

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11
Q

If both parents are carriers of CF, what is the likelihood of the child having CF?

A

25%

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12
Q

If both parents are carriers of CF, what is the likelihood of the child being CF negative?

A

25%

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13
Q

What are the four densities that are distinguished on CXR?

A
  1. Air (black)
  2. Bone (white)
  3. Fluid (gray)
  4. Tissue (grayer)
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14
Q

What are the radiologic findings for the following disease?

Respiratory Distress Syndrome

A
  1. Fine reticulogranular patterns
  2. Ground glass or a frosted glass appearance
  3. Bilateral opaque white density or “white-out”
  4. Air bronchograms
  5. No pleural fluid
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15
Q

What are the radiologic findings for the following disease?

Atelectasis

A
  1. Elevated diaphragm on affected side
  2. Mediastinal shift towards affected side
  3. Decreased intercostal spaces
  4. Possible hyperinflation of the adjacent lung lobes or of the opposite lung.
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16
Q

What are the radiologic findings for the following disease?

Transient Tachypnea of Newborn

A
  • Possible hyperaeration
  • Small amount of pleural fluid
  • Symmetrical, stringy infiltrates in the hilar region
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17
Q

What are the radiologic findings for the following disease?

Neontal pneumonia

A
  1. Diffuse lung markings
  2. Excessive pleural fluid
  3. Consolidation
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18
Q

What are the radiologic findings for the following disease?

Meconium Aspiration Syndrome

A
  1. Bilateral infiltrates
  2. Evidence of air trapping
  3. Atelectasis distal to the occlusion
  4. Pleural effusion
  5. Signs of edema and inflammation
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19
Q

What is the purpose of X-rays?

A
  1. To confirm pathologic processes related in history or physical
  2. Evaluate placement of tubes and lines
  3. Observe progression of disease or effectiveness of therapy
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20
Q

In order to fully visualize an abnormality in the chest of a patient what two views are required?

A
  1. Frontal (PA)
  2. Lateral view
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21
Q

For patients who cannot leave the bed, what view is done?

A

AP view

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22
Q

On patients who can stand and walk, what CXR view is taken?

A

PA view

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23
Q

What is the preferred chest x-ray view on any newborn or intubated pediatric patient?

A

AP

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24
Q

The heart lies more _______ in the chest, it will appear ________________ on an AP film than PA.

A

anterior ; larger

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25
Q

What does frontal views help identify?

A

Whether an abnormality is on the right or left side of the chest

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26
Q

What does lateral views help identify?

A

Abnormalities position (anterior or posterior)

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27
Q

A heart may appear to be enlarge if the distance is greater than ____ feet from the target.

A

6

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28
Q

In a neonate, where is the carina?

A

Near the level of the third vertebrae

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29
Q

By age 10, where is the carina typically at?

A

Near the level of the fifth vertebrae

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30
Q

The thymus is a gland located in the mediastinum extending from the lower edge of the thyroid gland in the neck near which rib?

A

Fourth

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31
Q

On an x-ray, the thymus appears what?

A

Less dense than the heart, but more dense than lung tissue.

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32
Q

The size of the thymus in relation to rest of body is largest at what age?

A

Two

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33
Q

The thymus is often triangular shaped and is called the “________________________.”

A

Sail sign

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34
Q

The thymus is often confused with the heart border and can even appear as _______________.

A

Upper lobe atelectasis or pneumonia

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35
Q

The heart should be centered but slightly to the:

a. Left
b. Right

A

a. Left

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36
Q

If a stomach bubble is present, which side should it be on?

A

Your right as you look at the film

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37
Q

What does it mean when the spaces between the vertebrae are not visible?

A

Too little energy was used; underexposed film

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37
Q

Many normal infants have been misdiagnosed as having a __________________, when the only issue was an upside-down film.

A

Diaphragmatic hernia

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37
Q

What does it mean when the intervertebral spaces are excessively dark?

A

Too much energy was used; overexposed film

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38
Q

On an inspiratory x-ray, the diaphragm should be at or below which rib?

A

Ninth

39
Q

What does it indicated if the diaphragm is near or below the tenth rib?

A

Overdistention or hyperaeration

40
Q

On an expiratory x-ray, the diaphragm will be at the level of which rib?

A

Sixth or seventh

41
Q

Hyperaeration will cause the ribs to appear __________________________ or the chest to be _______________.

A

Flattened; “bell” shaped

42
Q

What is one common method used to evaluate the ribs?

A

Start the examination at the posterior portions of the ribs first, then proceed to anterior. The examination is finished by examining the lateral aspects of each rib.

43
Q

The diaphragm should be ______-shaped on both sides.

A

Dome-shaped

44
Q

Which side of the diaphragm is usually one rib higher than the other and why?

A

Right higher than the left. Liver pushing the diaphragm upward.

45
Q

What may causes blunting of the costophrenic angles?

A

Fluid in the pleural spaces

46
Q

What does it mean if the right diaphragm is not slightly higher than the left?

A

May be a water density in the lung adjacent to the diaphragm

47
Q

A large air bubble in the stomach and excessive air in the bowel are indicative of what?

A

Gastric distention

48
Q

What can excessive distention in the stomach do to ventilation?

A

Decrease ventilation of the neonate by pressing upward against the diaphragm

49
Q

The liver should not be more than __________ cm below the rib cage.

A

1-1.5 cm

50
Q

A liver that is 1-1.5 cm below the rib cage is suggestive of what?

A

Blood engorgement resulting from right-sided heart failure.

51
Q

The tip of the UAC should lie where?

A

Between the seventh or eighth thoracic vertebrae or between the third and fourth lumbar vertebrae

52
Q

The UAC is positioned in the ________, just above the diaphragm.

A

Interior vena cava

53
Q

The cardiac silhouette should be less than ____% of the thoracic width.

A

60%

54
Q

What does a cardiac silhouette larger than 60% imply?

A

Enlarged heart

55
Q

The area where the trachea splits and enters both lungs is called the ____.

A

Hilum

56
Q

Excessive vascularity is seen in ___________.

A

CHF and certain congenital heart malformations.

57
Q

Undervascularity is seen in what?

A

Right-to-left shunting, resulting in decreased pulmonary blood flow

58
Q

The trachea often deviates slightly to the _____, but should always be located near the center.

A

Right

59
Q

A trachea that is deviated significantly may indicate what?

A
  • Atelectasis
  • Pneumothorax
  • Tension pneumothorax
60
Q

In the presence of atelectasis, which way will the trachea deviate?

A

Toward affected side

61
Q

In the presence of pneumothorax, which way will the trachea deviate?

A

Away from affected side

62
Q

What is the most common lung disease found in infants?

A

RDS

63
Q

TTN is thought to be partially caused by?

A

Retention of fetal lung fluids from nonvaginal births

64
Q

Radiographically, if seen within the first few hours of life, TTN may closely resemble _____.

A

Hyaline membrane disease (RDS)

65
Q

An important point in distinguishing TTN from other causes of respiratory distress is that ______.

A

Infiltrates clear rapidly, often within 24 hours.

66
Q

Often, pneumonia is diagnosed in a normal _______ lobe.

A

Right-lower lobe, due to prominence of vessels and airways on the CXR at that location, giving the appearance of consolidation

67
Q

What are the radiologic findings for the following disease?

Diaphragmatic Hernia

A
  • Presence of stomach and bowel loops in the left thoracic cavity
  • Severe deviation of the mediastinal structures and its contents away from the side of the hernia
68
Q

Roughly 80-85% of diaphragmatic hernias occur on which side?

A

Left

69
Q

A diaphragmatic hernia is almost always accompanied by what?

A

Severe respiratory distress and a flat or sunken abdomen (scaphoid).

70
Q

What are the radiologic findings for the following disease?

Congenital Lobar Emphysema

A
  • Single lobe becomes overdistened and emphysematous
  • Remaining lung is atelectatic
  • Depression of diaphragm and displacement of mediastinum to opposite side
71
Q

What are the radiologic findings for the following disease?

Pneumothorax

A
  1. No lung markings
  2. Border of the lung seen as a white line
72
Q

Radiographically, a ____________ is identified when the lung is displaced away from the chest wall by a dark (black) band of air.

A

Pneumothorax

73
Q

What are the radiologic findings for the following disease?

Tension pneumothorax

A
  1. No lung markings
  2. Border of the lung seen as a white line
  3. Depressed diaphragm on affected side
  4. Wide intercostal spaces
  5. Mediastinal shift away from pneumothorax
74
Q

What are the radiologic findings for the following disease?

Pneumoperdicardium

A
  1. Air completely surrounds the heart
  2. “Halo”
75
Q

What are the radiologic findings for the following disease?

Pneumomediastinum

A
  1. Air surrouds lateral sides of the heart
76
Q

What are the radiologic findings for the following disease?

Pulmonary Interstitial Emyphsema

A

1 Atelectasis
2. Small dark streaks and cysts
3. Looks like black paint flicked onto white background
4. Sponge-like appearance
5. Ground hamburger with air in it

77
Q

What is PIE caused by?

A

Air leaking from a lung rupture and migrating throughout the lung parenchyma

78
Q

What stage of BPD is this?

Appearance similar to ARDS. Occurs 2-4 dayd following delivery.

A

Stage I

79
Q

What stage of BPD is this?

RDS appearance changes to coarse, irreularly shaped densities.
Occurs. 4-10 following delivery.

A

Stage II

80
Q

What stage of BPD is this?

Small cysts are now arranged in generalized patterns. Fibrotic areas show up as irrugular white streaks throughout the lungs. Occurs 10-20 days following delivery.

A

Stage III

81
Q

What stage of BPD is this?

The lung field has a “bubbly” appearance caused by continued enlargement of the cysts. Signs of chronic air trapping with low set flattened diaphragms.

A

Stage IV

82
Q

What are the radiologic findings for the following disease?

Foreign Body Aspiration

A
  1. Air trapping and atelectasis distal t offending object
  2. Diminished lung volume distal to the objet
  3. Hyerlucency in areas distal to the object
83
Q

What are the radiologic findings for the following disease?

CF

A
  1. Consolidation
  2. Cystic changes
  3. Fibrosis
  4. Thickening of peribronchial cells
84
Q

What are the radiologic findings for the following disease?

Asthma

A
  1. Hyperinflation
  2. Depressed diaphragm
  3. Hyperlucency of both lungs
  4. Bulging at the intercostal margins
85
Q

How does epiglottitis look on a chest x-ray?

A

Thumb sign

86
Q

Is the epiglottitis supraglottic or subglottic?

A

Supraglottic

87
Q

How does croup look on a chest x-ray?

A

Hour glass; steeple

88
Q

Is croup supraglottic or subglottic?

A

Subglottic

89
Q

What is the mortality rate of ARDS?

A

30%

90
Q

True or false.

CPAP is a mode of oxygenation and ventilation.

A

True

91
Q

What is the most effective CPAP delivery device?

A

Mask, good seal

92
Q

How do you treat a mild case of croup?

A

Cool mist

93
Q

Define liable hypoxemia.

A

Significant change in O2 saturation with no changes in ventilator settings or FiO2.

94
Q

Where is PPHN most often seen?

A

Term or postterm infants

95
Q

What test helps diagnose PPHN?

A
  1. Hyperoxia test
  2. Pre and post ductal measuring
  3. Hyperoxia-hyperventilation test is the most accurate.
96
Q

What is the most dangerous cause of asphyxia?

A

Bradycardia

Pediatric/Neonatal Care 👶🏽 (5 decks)

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