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193 Cards in this Set
- Front
- Back
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HYALINE MEMBRANE DISEASE |
former name of RDS |
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NB born PREMATURELY |
What NB does RDS where often seen? |
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MAS SEPSIS SLOW TRANSITION TO EXTRAUTERINE LIFE PNEUMONIA |
Causes of RDS |
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RDS |
formation of hyalinelike membrane formed from exudate of infant’s blood |
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LOW OR ABSENCE OF SURFACTANT |
Major cause of RDS |
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34th week |
When does surfactant formed? |
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LBW and VLBW |
What NB infants are susceptible to RDS? |
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40-70 cm H2O |
For the first breath, pressure will take between? |
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15-20 cm h2O |
For maintaining Quiet and continued breathing, pressure is? |
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Surfactant Deficiency |
Why does alveoli collapse? |
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Optimum Pressure |
Needed for forceful inspiration and required in inflating the alveoli. |
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Pulmonary Resistance |
This increases when areas of hypo-inflation occur? |
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Production of Surfactant decrease even further |
What happened if lungs are poorly perfused? |
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Low body temp. Nasal flaring Sternal and subcostal retraction Tachypnea Cyanotic mucous membrane |
Subtle Signs of RDS |
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Greater than 60 bpm |
What is tachypnea |
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Expiratory Grunting |
Due to “closure of epiglottis” |
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Fine rales and diminish breatj sound |
It can be heard during auscultation in RDS and is due to poor air entry |
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Seesaw Respiration Heart Failure Pale Gray Skin Bradycardia has Periods of apnea Pneumothorax |
As distress increases, infants may exhibit? |
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Seesaw Respiration |
INSPIRATION: - anterior chest wall retracts - abdomen protrudes
EXPIRATION: - Sternum Rises |
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Decreased UO Edema of extremities |
Evidence of HFailure |
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Grunting Central Cyanotic in room air Tachypnea Nasal Flaring Retractions |
Dx of RDS on Clinal Signs |
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CXR |
Reveal radio opaque looks like a ground glass (haziness in the lungs) |
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Blood Gas Studies/ABg? |
Reveal respiratory acidosis |
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B- hemolytic, Group B Streptococcal Infection |
Mimic RDS, sever that decrease production of Surfactant |
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Culture of blood - csf and Skin |
It is needed To rule out GBSI with specimen of ____&_____ |
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Antibiotics (penicillin/ ampicillin) Aminoglycosides (gentamicin/ kanamycin) |
Meds to be started while blood cultures are pending to r/o GBsI |
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Survanta |
Its action is to restore surfactant as naturally occurring lung-surfactant to improve lung compliance |
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Synthetic Surfactant Endotracheal Tube Syringe / lung lavage |
Surfactant Replacement is done with ______ administered in to the _____ via _____\_____ |
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- tipped in to upright position - close monitoring - anticipate ventilator settings |
Considerations in Surfactant replacement |
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Simple cannula/ mask CPAP PEEP |
Oxygen Administration can be done in variety of ways via? |
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Continuous Positive Airway Pressure |
CPAP stands for? |
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Positive end-expiratory pressure |
PEEEP stands for? |
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ROP BPD/ Chronic Lung Dse. |
Possible complication of o2 admin. |
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Liquid Ventilation |
Use of perflourocarbon which picks up o2 |
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Nitric Oxide |
Cause pulmonary vasodilatation Which helps increase blood flow to the lungs |
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Kept warm, cooling ⬆️ acidosis |
In supporting care of rds infant should be.... because |
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2:1 ratio |
L/S in rds must be monitor with a value of? |
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2:1 ratio |
L/S in rds must be monitor with a value of? |
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Magnesium Sulfate |
In rds tocolytics agent is used such as____ to prevent preterm birth for few days |
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2:1 ratio |
L/S in rds must be monitor with a value of? |
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Magnesium Sulfate |
In rds tocolytics agent is used such as____ to prevent preterm birth for few days |
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Betamethasone |
- possible to prevent rds - because steroid appear to quicken the formation of lecithin |
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2:1 ratio |
L/S in rds must be monitor with a value of? |
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Magnesium Sulfate |
In rds tocolytics agent is used such as____ to prevent preterm birth for few days |
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Betamethasone |
- possible to prevent rds - because steroid appear to quicken the formation of lecithin |
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Between 24 weeks and 34 weeks of pregnancy |
Betamethasone is given when? |
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24-48 hours |
Steroids doesn’t take effect before how many hours? |
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24-48 hours |
Steroids doesn’t take effect before how many hours? |
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Rapid Respiratory Rate |
First sign of respiratory obstruction |
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2 hours of life Last ap. 36 hours |
Onset of TTN when dies it last? |
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72 hours |
Tx of TTN resolves in____? |
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Mild Glucosteroid O2 Administration |
Tx of TTN |
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Meconium |
Present as early as 10 wks |
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Meconium aspiration syndrome |
If hypoxia occurs, a vagus reflex is stimulated, resulting in relation of the rectal sphincter. This releases meconium into the AF |
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Babies born breech |
They may expel meconium dt buttocks pressure |
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Green to greenish black fluid color |
Appearance of Fluid if stained |
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ELBW |
MAS doesn’t occur in? |
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Utero or First breath at birth |
Infants may aspirate meconium via? |
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80 bpm when crying |
RRoR at birth |
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Between 30-60 bpm |
RRoR in 1 hour of TTN |
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Tiring effort of breathing |
Infant doesnt show distress aside from? |
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Mild retractions and nasal flaring |
Many be noticed in TTN but not marked cyanotic |
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X-ray |
TTN, shows fluid and hyper expansion of the lungs |
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Respi. Acidosis Hypercapnia Hypoxemia |
Blood Gases in TTN shows |
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Transient Tachypnea of the Newborn |
direct result of retained ling fluid, which limits the amount of alveolar surface that is available for oxygen exchange |
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Infant born via CS Birth |
Where does TTN mostly occurs? |
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Close observation |
Priority in TTN |
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24-48 hours |
Steroids doesn’t take effect before how many hours? |
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Rapid Respiratory Rate |
First sign of respiratory obstruction |
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2 hours of life Last ap. 36 hours |
Onset of TTN when dies it last? |
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72 hours |
Tx of TTN resolves in____? |
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Mild Glucosteroid O2 Administration |
Tx of TTN |
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Meconium |
Present as early as 10 wks |
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Meconium aspiration syndrome |
If hypoxia occurs, a vagus reflex is stimulated, resulting in relation of the rectal sphincter. This releases meconium into the AF |
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Babies born breech |
They may expel meconium dt buttocks pressure |
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Green to greenish black fluid color |
Appearance of Fluid if stained |
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ELBW |
MAS doesn’t occur in? |
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Utero or First breath at birth |
Infants may aspirate meconium via? |
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80 bpm when crying |
RRoR at birth |
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Severe RDS (tachypnea, grunting, retractions) |
Meconium can cause? |
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Between 30-60 bpm |
RRoR in 1 hour of TTN |
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Tiring effort of breathing |
Infant doesnt show distress aside from? |
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Mild retractions and nasal flaring |
Many be noticed in TTN but not marked cyanotic |
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X-ray |
TTN, shows fluid and hyper expansion of the lungs |
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Respi. Acidosis Hypercapnia Hypoxemia |
Blood Gases in TTN shows |
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Transient Tachypnea of the Newborn |
direct result of retained ling fluid, which limits the amount of alveolar surface that is available for oxygen exchange |
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Infant born via CS Birth |
Where does TTN mostly occurs? |
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Close observation |
Priority in TTN |
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24-48 hours |
Steroids doesn’t take effect before how many hours? |
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Rapid Respiratory Rate |
First sign of respiratory obstruction |
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2 hours of life Last ap. 36 hours |
Onset of TTN when dies it last? |
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72 hours |
Tx of TTN resolves in____? |
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Mild Glucosteroid O2 Administration |
Tx of TTN |
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Meconium |
Present as early as 10 wks |
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Meconium aspiration syndrome |
If hypoxia occurs, a vagus reflex is stimulated, resulting in relation of the rectal sphincter. This releases meconium into the AF |
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Babies born breech |
They may expel meconium dt buttocks pressure |
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Green to greenish black fluid color |
Appearance of Fluid if stained |
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ELBW |
MAS doesn’t occur in? |
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Utero or First breath at birth |
Infants may aspirate meconium via? |
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80 bpm when crying |
RRoR at birth |
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Severe RDS (tachypnea, grunting, retractions) |
Meconium can cause? |
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Increased Oxygen Mid - upper 90 Start in the first Couple of Hours after birth |
In MAS its required _______ to maintain saturation in ________-_____ It start at _________ |
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Between 30-60 bpm |
RRoR in 1 hour of TTN |
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Tiring effort of breathing |
Infant doesnt show distress aside from? |
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Mild retractions and nasal flaring |
Many be noticed in TTN but not marked cyanotic |
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X-ray |
TTN, shows fluid and hyper expansion of the lungs |
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Respi. Acidosis Hypercapnia Hypoxemia |
Blood Gases in TTN shows |
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Transient Tachypnea of the Newborn |
direct result of retained ling fluid, which limits the amount of alveolar surface that is available for oxygen exchange |
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Infant born via CS Birth |
Where does TTN mostly occurs? |
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Close observation |
Priority in TTN |
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24-48 hours |
Steroids doesn’t take effect before how many hours? |
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Rapid Respiratory Rate |
First sign of respiratory obstruction |
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2 hours of life Last ap. 36 hours |
Onset of TTN when dies it last? |
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72 hours |
Tx of TTN resolves in____? |
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Mild Glucosteroid O2 Administration |
Tx of TTN |
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Meconium |
Present as early as 10 wks |
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Meconium aspiration syndrome |
If hypoxia occurs, a vagus reflex is stimulated, resulting in relation of the rectal sphincter. This releases meconium into the AF |
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Babies born breech |
They may expel meconium dt buttocks pressure |
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Green to greenish black fluid color |
Appearance of Fluid if stained |
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ELBW |
MAS doesn’t occur in? |
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Utero or First breath at birth |
Infants may aspirate meconium via? |
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80 bpm when crying |
RRoR at birth |
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Severe RDS (tachypnea, grunting, retractions) |
Meconium can cause? |
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Increased Oxygen Mid - upper 90 Start in the first Couple of Hours after birth |
In MAS its required _______ to maintain saturation in ________-_____ It start at _________ |
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Difficult of establishing respiration Tachypnea Retractions Cyanosis |
Assessment |
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Between 30-60 bpm |
RRoR in 1 hour of TTN |
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Tiring effort of breathing |
Infant doesnt show distress aside from? |
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Mild retractions and nasal flaring |
Many be noticed in TTN but not marked cyanotic |
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X-ray |
TTN, shows fluid and hyper expansion of the lungs |
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Respi. Acidosis Hypercapnia Hypoxemia |
Blood Gases in TTN shows |
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Transient Tachypnea of the Newborn |
direct result of retained ling fluid, which limits the amount of alveolar surface that is available for oxygen exchange |
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Infant born via CS Birth |
Where does TTN mostly occurs? |
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Close observation |
Priority in TTN |
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24-48 hours |
Steroids doesn’t take effect before how many hours? |
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Rapid Respiratory Rate |
First sign of respiratory obstruction |
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2 hours of life Last ap. 36 hours |
Onset of TTN when dies it last? |
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72 hours |
Tx of TTN resolves in____? |
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Mild Glucosteroid O2 Administration |
Tx of TTN |
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Meconium |
Present as early as 10 wks |
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Meconium aspiration syndrome |
If hypoxia occurs, a vagus reflex is stimulated, resulting in relation of the rectal sphincter. This releases meconium into the AF |
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Babies born breech |
They may expel meconium dt buttocks pressure |
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Green to greenish black fluid color |
Appearance of Fluid if stained |
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ELBW |
MAS doesn’t occur in? |
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Utero or First breath at birth |
Infants may aspirate meconium via? |
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80 bpm when crying |
RRoR at birth |
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Severe RDS (tachypnea, grunting, retractions) |
Meconium can cause? |
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Increased Oxygen Mid - upper 90 Start in the first Couple of Hours after birth |
In MAS its required _______ to maintain saturation in ________-_____ It start at _________ |
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Difficult of establishing respiration Tachypnea Retractions Cyanosis |
Assessment |
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warmer and resuscitate, initiate + ventilation |
If MAS OCCUR |
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Between 30-60 bpm |
RRoR in 1 hour of TTN |
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Tiring effort of breathing |
Infant doesnt show distress aside from? |
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Mild retractions and nasal flaring |
Many be noticed in TTN but not marked cyanotic |
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|
X-ray |
TTN, shows fluid and hyper expansion of the lungs |
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|
Respi. Acidosis Hypercapnia Hypoxemia |
Blood Gases in TTN shows |
|
|
Transient Tachypnea of the Newborn |
direct result of retained ling fluid, which limits the amount of alveolar surface that is available for oxygen exchange |
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|
Infant born via CS Birth |
Where does TTN mostly occurs? |
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Close observation |
Priority in TTN |
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Difficult of establishing respiration Tachypnea Retractions Cyanosis APGAR low |
Assessment |
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Difficult of establishing respiration Tachypnea Retractions Cyanosis APGAR low |
Assessment |
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Barrel chest |
Air trapping that causes enlargement of anteroposterior diameter |
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Pulse Oximetry / blood gas ⬆️ PO2 ⬇️PCO2 |
Reveal the poor gas exchange evidence by______&_____ |
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Pulse Oximetry / blood gas ⬆️ PO2 ⬇️PCO2 |
Reveal the poor gas exchange evidence by______&_____ |
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Amniofusion |
Used to dilute the amount of meconium in the amniotic fluid |
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Pulse Oximetry / blood gas ⬆️ PO2 ⬇️PCO2 |
Reveal the poor gas exchange evidence by______&_____ |
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Amniofusion |
Used to dilute the amount of meconium in the amniotic fluid |
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Antibiotic Theraphy |
Prescribed to forestall dv of pneumonia dt. MAD |
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Pulse Oximetry / blood gas ⬆️ PO2 ⬇️PCO2 |
Reveal the poor gas exchange evidence by______&_____ |
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Amniofusion |
Used to dilute the amount of meconium in the amniotic fluid |
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Antibiotic Theraphy |
Prescribed to forestall dv of pneumonia dt. MAD |
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Chest physiotherapy |
Helps to encourage the removal of remnants from the lungs dt MAS |
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Pulse Oximetry / blood gas ⬆️ PO2 ⬇️PCO2 |
Reveal the poor gas exchange evidence by______&_____ |
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Amniofusion |
Used to dilute the amount of meconium in the amniotic fluid |
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Antibiotic Theraphy |
Prescribed to forestall dv of pneumonia dt. MAD |
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Chest physiotherapy |
Helps to encourage the removal of remnants from the lungs dt MAS |
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Observe infant closely Maintain temp/ neutral environ Chest physiotherapy Maintain ecmo |
Mgt for MAS |
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Pulse Oximetry / blood gas ⬆️ PO2 ⬇️PCO2 |
Reveal the poor gas exchange evidence by______&_____ |
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Amniofusion |
Used to dilute the amount of meconium in the amniotic fluid |
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Antibiotic Theraphy |
Prescribed to forestall dv of pneumonia dt. MAD |
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Chest physiotherapy |
Helps to encourage the removal of remnants from the lungs dt MAS |
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Observe infant closely Maintain temp/ neutral environ Chest physiotherapy Maintain ecmo |
Mgt for MAS |
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Apnea Bradycardia/cyanosis |
Lasting longer than 20 secs, accompannied by ____\_____ |
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Preterm infants |
These babies have periods of apnea dt fatigue and immature respiratory mechanism |
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Preterm infants |
These babies have periods of apnea dt fatigue and immature respiratory mechanism |
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Gently stimulate an infant or flicking the sole |
MGT for Apnea |
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Preterm infants |
These babies have periods of apnea dt fatigue and immature respiratory mechanism |
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Gently stimulate an infant or flicking the sole Apnea monitors with sound warning Maintain neutral environment Suction gently After feeding observe the infant |
MGT for Apnea |
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Babies with secondary stresses (infection, hpbrnm, hypoglycemia, hypotherima |
Babies with this kind of stresses tend to have high incidence |
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Rectal, temp |
What part should be avoided in taking the temp? |
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Rectal, temp |
What part should be avoided in taking the temp? |
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Caffeine/theophylline |
Prescribed for Apnea of prematurity to stimulate breathing |
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Carbon dioxide |
Stimulate respiratory functions, |
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Carbon dioxide |
Stimulate respiratory functions, |
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Infants who had have an apneic episodes |
Require resuscitation and high risk for SIDS |
