Neonatal Care Chpt 6

Front 1

why is airway clearance impt?

Back 1

assistance in airway clearing becomes impt when the airway is impaired or ineffective

Front 2

As mucus increase in the airways, obstruction occurs leading to

Back 2

air trapping**atelectasis**Ineffcetive gas exchange** Inflammation **Infection

Front 3

What are some indicatiosn that a pt needs airway clearnace

Back 3

increased rention of secretion, aspiration, prophylaxis,

prevents ateleclasis, infection, barotrauma, air trapping

Front 4

list some contradindications and hazards of airway clearance

Back 4

pulmonary hemmorhage, excessive agitation or hypoemia, feeding within 1 hr, history of reflux, untreated pneumo, CHF

Front 5

What are the 5 techniques used in airway clear.?

Back 5

Postitive Expiratory Pressure (PEP)
Forced Exhalation Technique (FET)
Autogenic Drainage
High Freq Chest Compression
Flutter Valve Therapy

Front 6

how are aerosolized drug therapies delivered

Back 6

small volume nebulizer, large volume nebulizer, metered dose inhaler, dry powder inhaler

Front 7

With aerosolized drug therapy an effective tx depends on?

Back 7

size and amount of particles produced, characteristics of particles, anatomy of airway, pts' ventilatory pattern

Front 8

What type of nebulizer is used in a stsuts asthamticus pt

Back 8

LVN

Front 9

What are some advantages of SVN

Back 9

requires little pt corrnidtaion, can be used in acute distress or with reduced inspirtaory flows & volumes, allows modifcation of drug

Front 10

Disadvantages of SVN

Back 10

expensive, less easily transported, must clean and prepare, dose in inefficient, delivers a cold wet spray

Front 11

Advantages of MDI

Back 11

very portable, provide effiecnt drug delivery, require a very short prep and delivery time

Front 12

Disadvantages of MDI

Back 12

diffu. coordination, fixed rug concentation, limited choice of drugs, possible rxn to the propellants used.

Front 13

Advantages of DPI

Back 13

limited hand -breath corrdination is needed, no propellants are used, drug doses are easily counted

Front 14

Disadvantages of DPI

Back 14

limited # of drugs, possible irrtation of airway from the dry powder

Front 15

There are 3 categoried that aerosolized drugs fall into what are they?

Back 15

broncholdilators, Mucolytics, Steroids

Front 16

What class of drug would you give a premature infant- decreased breath sounds, decreased chest expansion, presence of wheezes & retractions , increased RR, nasal flaring and grunting

Back 16

Bronchodilator

Front 17

what class of aerolozed therapy do you give a pt with presence of thick secretions that are difficult for the pt to expel

Back 17

Mucolytics

Front 18

What type of aerosolized therapy do you give a pt that had infalmmatory process that is present- BPD or asthma

Back 18

Steroids

Front 19

What are some hazards assocaited with SVN Therapy

Back 19

Nosocomial INfection, medictaion side effects, drug reconcentartion, ventilator malfunction, excessive noise

Front 20

What are some indications for SX

Back 20

need to remove secretions, after CPT, ETT tube q 4-6

** Sx must be done 20 min prior ro ABG****

Front 21

What type of equip,. is needed to SX

Back 21

cardiac, oxygen sat, sethoscope, resuscitation bag and mask with O2 source, Sterile saline for lavage, suction catheter kit, water soluble jelly

Front 22

In neonates the Sx regulator should be set at

pediatric pts

Back 22

-50 to -80 mmhg

-80 to 100 mmhg

Front 23

WHen Sx a neonate how long should it take

Back 23

10 seconds
5 second suctioing

Front 24

What are some hazards of Sx

Back 24

bradycardia, hypoxemia, musocsal damge, atelectasis, airway contamnation, accidental extubation

Front 25

skin will not appear cynatoic until ________ gm of Hgb becomes destaurtaed

Back 25

5 gm

Front 26

What are some hazards of O2 therapy

Back 26

retinopathy of prematurity, O2 toxcity leading to BPD, Cerebral Vasocnstriion, Fire Hazard

Front 27

The FiO2 blender can acheive concentarions of what

Back 27

21-100%

Front 28

When using an oxygen alalyzer its hould be calibrated to what and how oftern should they be done?

Back 28

calibrated to RA and to 100 %
Calibrations should be done at least every 8 hours

Front 29

What are the characteristics of a low flow humidifer?

Back 29

designed for flows 10 L/min or less, supplies a relatively small amt of humdity, does not heat the gas, allows the gas to bubble up through a reservoir of sterile H2O

Front 30

What are some Characteristics of a high flow Humidifer

Back 30

flows > 10 L/min
Provides a fully saturated gas at a desired temp
**passover humidifer**

Front 31

What is an O xygen hood and what FIO2 % does it provide

Back 31

clear hard plastic hood that fits over the infants head, provides O2 enriched environment for pt provide FIO2 less than 50%

Front 32

what is the typicla flow used on a neonate via nasal cannula

Back 32

< 1 L/min

Front 33

What is the purpose of an Oxygen Tent

Back 33

Provide an O2 enriched, cool mist to the pt environment for the Tx of croup & other airway swellings

Front 34

When is an O2 tent most commonly used

Back 34

for croup

Front 35

What is the purpose of a incubatory

Back 35

provide a temp controlled, quiet environment, allows direct flow of O2, [ ] of O2 depneds on liter flow of O2 into the venturi

Front 36

What is the main problem with the Incubator

Back 36

constant opening of doors and portholes- makes for diffculty to maintains [ ]'s

Front 37

What are the 2 type of Resusciation bags

Back 37

self inflating
flow rating

Front 38

what is a flow rating bag

Back 38

Rt provides the % of O2 that is used to power them, FiO2's of 100 % can be achieved by using pure O2 to inflate the bag