Week 2 Neonatal Assessment and Resuscitation (everything) Flashcards Preview

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Flashcards in Week 2 Neonatal Assessment and Resuscitation (everything) Deck (87)
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1

There are some similarities between the initial assessment of the neonate and the initial assessment of an adult who requires resuscitation. In both situations, the physician should give immediate attention to

ABCs of resuscitation (i.e., airway, breathing, circulation).

2

what is the normal neonatal respiratory rate

30-60 Breaths per minute

3

neonatal breathing should begin at ____seconds and be regular by ____ seconds of age

30
regular at 90

4

if a neonate does not breath by 90 seconds of age this may indicate ____ or ____ apnea

primary or secondary apnea

5

what helps initiate breathing efforts during primary apnea

tactile stimulation can initiate breathing efforts

6

low heart rate is presented which apneas

primary and secondary

7

reduction of blood pressure is presented during which apneas

secondary apnea

8

if tactile stimulation does not result in the initiated of spontaneous breathing what is the next step

aggressive resuscitation must be initiated promptly if tactile stimulation does not initiate spontaneous breathing

9

how many weeks gestation is the fetus for meconium to be present in the intentional tract

31 weeks

10

which type of pregnancy has the higher incidence of meconium stained amniotic fluid

post term pregnancies

11

meconium stained amniotic fluid is present in

10-15% of all pregnancies

12

the preterm neonate- especially the VLBW infant is at higher risk for what problems

Multiple organ system problems simply because of immaturity

13

what is the treatment for meconium aspiration syndrome?

PPV and is associated with a 5-20% incidence of pneumothorax from pulmonary ark leaks.

14

what is meconium aspiration syndrome

respiratory distress in a neonate whose airway was exposed to meconium and whose chest radiograph exhibits characteristic findings (pulmonary consolidation and atelectasis)

15

what was the common practice for meconium aspiration syndrome- no longer done, but may still see it in practice

In an attempt to reduce inhalation of meconium from the pharynx and thus prevent or reduce the severity of MAS the practice of suctioning the mouth and pharynx after delivery of the head, and subsequent intubation to remove meconium from the trachea , was common practice. However, studies have documented that airway suctioning at birth does not prevent MAS

16

Congenital Anomalies can cause special issues related to what

special resuscitation issues.

17

congenital abnormalities that cause upper airway obstruction include

micrognathia, macroglossia,laryngeal webs, laryngeal atresia, stenosis , subglottic webs, tracheal agenesis, tracheal rings

18

what is Exit Procedure - ex utero intrapartum treatment procedure

delivers the fetal head and shoulders, but keeps the lower torso and umbilical cord intact within the uterus. allows surgeon to perform direct laryngoscopy, rigid bronch, tracheostomy. allowing establishment of an airways prior to completing delivery.

19

what is the benefit of the exit procedure

thereby maintaining placental perfusion and oxygenation

20

Congenital high airway obstruction syndrome (CHAOS)

Intrinsic airway obstruction of the larynx or upper trachea (e.g., laryngeal web, subglottic cyst, tracheal atresia) can lead to retention of bronchial secretions and subsequent pulmonary distention; this constellation of findings is often classified as

21

long term survival of children with congenital high airway obstruction syndrome long term survival results when """ this procedure is used

exit procedure

22

talk to me about ethical considerations of non initiating resuscitating in the delivery room

extremes of prematurity < 23 weeks. (although massey said we can save down to 20) severe congenital anomalies (anencephaly, confirmed trisomy 13, 18)

23

talk to me about ethical considerations when stopping resuscitation is appropriate

once further information has been obtained and discussion with family has occurred.

-remember a trial of therapy may be appropriate

24

for those situation with a poor prognosis- unlikely survival or high morbidity (23-25 weekS) how to we handle the parents desires to initiation of resuscitation

should be supported

25

the fetus is connected by the

umbilical cord to the placenta

26

the fetus gets all needed nutrition and oxygen via

the blood vessels in the umbilical cord

"Life support"

27

Wast products and CO2 from the fetus are sent back through the umbilical cord and

placenta to the mother's ciruculation to be removed

28

**the fetal circulatory system uses how many shunts?

3 shunts

29

**The purpose of these shunts in fetal circulation is to

bypass the lungs and liver

30

**The shut that bypasses the lungs

Foramen Ovale ***
-moves blood from the RA to the LA