Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Neonatal assessment
Neonatal study guide
| Question | Answer |
|---|---|
| What are the 4 critical life functions? which is most important? | Ventilation, oxygenation, circulation, perfusion; ventilation is the most important |
| what assessment would measure ventilation? Oxygenation? | Ventilation: RR, chest movement, breath sounds Oxygenation: HR, skin color, sensorium |
| NEWBORNS MEDICAL RECORD | |
| For each course of onset, identify one pathology: Gradual Sudden Chronic | Gradual - croup, RSV, URI Sudden - cardiac abnormalities, foreign body aspiration Chronic - CF, asthma |
| Normal ranges for: Na+ Cl- K+ HCO3- | Na+ 133 - 149 mEq/L Cl- 87 - 114 mEq/L K+ 5.3 - 6.4 mEq/L HCO3- 19 - 24mEq/L |
| BUN and creatine are related to what organ? Urine output to what function? | Kidneys and circulation/perfusion |
| Common types of Hb? | Hemoglobin F - in fetus Hemoglobin A - in adults Hemoglobin A2 - small amounts in adults |
| Abnormal Hb? | Hemoglobin S Hemoglobin C |
| What does bilirubin evaluate, the normal value? | evaluate fetal development and the normal value is 4- 5 mg/dL at birth |
| Common causes of hyperglycemia? Hypoglycemia? | Hyperglycemia - cord compression or stress before birth Hypoglycemia - infection, cold stress, hyperinsulinism |
| Ways to test lung maturity? | L/S ratio - lecithin/sphingomyelin 2:1 is normal Shake test - presence of bubbles (surfactant) Phosphatidylglycerol - phospholipid present at about 35 weeks Phosphatidylcholine - phospholipid-lecithin >2 is normal |
| Results of C&S and Gram stain from | urine, blood, sputum, CSF |
| HISTORY AND NEONATAL DATA | |
| Factors that can affect pregnancy | Age: <16 years risk of pre-eclampsia, low birth weight >40 years risk of pre-eclampsia, c-section, congenital abnormalities |
| Why do c-sections put infants at risk? | TTN and RDS due to delayed removal of fetal lung fluid |
| Treatments for pre-eclampsia and eclampsia | bed rest, salt restriction and diet |
| Other factors | Prenatal care, smoking and substance abuse, diet and nutrition, maternal infections |
| smoking and substance abuse + excessive caffeine | decreased blood supply resulting in low oxygen, neonatal drug withdrawal, fetal alcohol syndrome, and low birth weight |
| Maternal hypertension | causing pre-eclampsia or eclampsia |
| previous pregnancy outcomes | if there were previous risky pregnancies or deliveries then possiblity of more rises |
| 4 breeches and which has highest risk of mortality? | Frank breech, complete breech, incomplete breech, transverse lie; all of them because they increase risk of trauma and asphyxia |
| Three decelerations | Normal one during head compression 110-160bpm Late deceleration occurring after contractions begin and persisting after Variable decelerations independent of uterine contractions, random onset, duration and severity |
| 4 methods of determining gestational age | Nagele's Rule Fetal Ultrasound Dubowitz method New ballard score Appearance |
| 5 factors evaluated in an APGAR score | Color HR Reflex Irritability Muscle tone respiratory rate |
| Four mechanisms by which an infant loses heat | Conduction - touching cold/wet object Convection - cool air blowing over neonate Evaporation - liquid evaporating from the skin surface Radiation |
| Three errors of inborn errors of metabolism | maple sugar urine disease, fructose intolerance, phenylketunuria |
| ASSESSMENT: INSPECTION | |
| central vs acrocyanosis | mucus membranes appear bluish due to hypoxemia VS extremities appear bluish due to peripheral vasoconstriction |
| Normal respiratory rate Tachypnea Bradypnea | normal is 30 - 60/min tachypnea >60/min bradypnea <30/min |
| causes of bradypnea? tachypnea? | Bradypnea: hypothermia, CNS diseases Tachypnea: hypoxemia, agitation, congenital heart disease |
| Pathologies resulting in unequal chest movement | PNX, atelectasis, PNA, phrenic nerve palsy, congenital diaphragmatic hernia |
| ASSESSMENT: PALPATION | |
| Normal heart rate Tachypnea Bradypnea | normal: 100 - 160/min Tachypnea: 210/min Bradypnea: 55/min |
| causes of tachypnea? bradypnea? | Tachypnea: pain, crying, heart disease Bradypnea: hypoxia, Valsalva maneuver, heart disease |
| Trachea shift away from affected side? towards affected side? | Trachea will shift towards atelectasis, diaphragmatic paralysis Trachea will shift AWAY from diaphragmatic hernia, neck or thyroid tumors |
| pulsus alternans vs paradoxus | Alternans: alternating weak and strong beats Paradoxus: weak pulse on inspiration and strong on expiration |
| ASSESSMENT: PERCUSSION | |
| percussion sounds | resonance - normal flat - heard on sternum, atelectasis dull - fluid-filled hyperresonance - PNX or air trapping |
| ASSESSMENT: AUSCULTATION | |
| breath sounds | consolidation - increased sounds HMD - decreased Occluded ETT - absent PNX - unequal |
| coarse crackles | low pitched sounds due to secretions |
| Medium crackles | secretions |
| Fine crackles | IRDS, pulmonary edema, PNA |
| Wheezes | high pitched expiratory sounds due to narrow or obstructed airways |
| Stridor | High pitched sounds due to upper airway obstruction |
Created by:
NemesisG
Popular Respiratory Therapy sets