Respiratory
Describe the timing and purpose of surfactant in fetus
after 34w, stabilizes walls of the alveoli so they don’t collapse on exhale
3 circulatory changes at birth
foramen ovale closure, ductus arteriosus and ductus venosus
What should you assess in infant that is hypothermic?
Glucose
Steps to correct PPV. M-Adjust Mask /R- Reposition head to open airway/ S- Suction mouth then nose/ O- Open mouth / P- Pressure Increase until chest rise /A- Artificial Airway
What gestational age is considered late preterm?
34w0d-36w6d
Describe the Normal breathing RR, o2sat and characteristics of term infant >10min old
40-60 br/min, Diaphragmatic breathing, Obligate nasal breathing, No retractions, 02 95-100
What 2 things help close the foramen ovale
Cord clamping INCREASES systemic vascular resistance 2 First breaths DECREASES pulmonary vascular resistance
Name 3 factors that put an infant at risk for hyglycemia
GDM/Macrosomia, Instrumental delivery, Hypothermia, SGA, PTB, Resuscitation
What are the 4 NRP questions to determine management?
TERM 2. TONE 3. BREATHING 4. CORD PLAN
What gestational age is considered post term?
42w0d and beyond
3 large changes in lungs with respiration at birth
Clearance of alveolar fluid, Lung expansion, increase pulmonary perfusion, decrease pulmonary artery pressure
What causes constriction of ductus arteriosus at birth
Decrease in placental prostaglandins
What is a normal newborn white count
10-30
What is the apgar: acrocyanosis, HR 95, breathing w no cry, active motion, +grimace
6
What is the definition of macrosomia?
Birth weight >4000g
Name 3 behaviors that show an infant may need respiratory support after 10 mins of life
<40 or >60 br/min; apnea, Grunting, nasal flaring, retractions, 02 sat < 95
1. Foramen ovale: immediate 2. ductus arteriosus within 48 hours (shunts blood from heart to aorta), 3. Then ductus venosus closes in a few days
What is a normal infant hematocrit
43-63 HIGHER
3 purposes of vernix for transition to life
(thermoregulation, prevention of infection and moisturizing the skin)
What is the definition of LGA?
greater than 90%ile for GA
What is a normal o2sat in first 5 mins of life
60-90%
What is the purpose of CCHD screen
Screening identifies infants with perfusion abnormalities (preductal right hand) and (postductal left hand)
What type of immunity does the newborn receive from the mother getting the tdap vaccine in pregnancy
Passive immunity
4 types of heat loss important for thermoregulation
1.Conduction-contact heat loss 2.Convection 3.Evaporation 4.Radiation
What of the following is NOT a risk factor for impaired lactation: hypothyroid, DM, CS, Close interval pregnancy, or Smoking
Close interval pregnancy