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355 Cards in this Set
- Front
- Back
|
95% of fetal presentations prior to birth are in what position?
|
Vertex
|
|
What factors cause the closure of the foramen ovale following birth?
|
Left atrial pressures becoming higher than right atrial pressure
|
|
A high level of alpha-fetoprotein found during amniocentesis indicates what?
|
Neural tube defect
|
|
What test is done on amniotic fluid to help determine fetal kidney maturity?
|
Creatinine level
|
|
The most accurate method of measuring fetal heart rate is
|
Fetal scalp electrode
|
|
Less negative pressure is required for breaths subsequent to the first breath. What is the most important reason for this?
|
Establishment of the FRC
|
|
What involves removal of a fetal blood sample while still in utero?
|
Cordocentesis
|
|
Monitoring of the fetal heart rate during labor and delivery is used to detect:
|
Uterine contractions
Rupture of the amniotic sac Compression of the umbilical cord Bradycardia secondary to a vagal stimulus |
|
Which of the following describes the path of blood that is shunted through the foramen ovale?
|
From the right to left atrium
|
|
What blood vessel is a shunt pathway that exits normally in the fetal circulation?
|
Ductus arteriosus
|
|
During which stage of fetal lung development does deposition of cartilage begin?
|
Pseudoglandular period
|
|
What could occur following Cesarean sections?
|
TTN
|
|
Polyhydramnios is:
|
An increased quantity of amniotic fluid
|
|
What cell type is responsible for surfactant production?
|
Alveolar Type II cells
|
|
What is the lower limit of normal of fetal scalp pH?
|
7.25
|
|
Type III decelerations are caused by what?
|
Compression of the umbilical cord
|
|
The heart develops from what germ layers(s)?
|
Mesoderm
|
|
Compared to amniotic fluid, what would be true regarding fetal lung fluid?
|
Fetal lung fluid has a lower protein content.
|
|
The earliest development of the lung begins at:
|
24 days
|
|
What when found in amniotic fluid is the best indicator of fetal lung maturity?
|
PG
|
|
What fetal heart patterns are indicative of fetal hypoxia?
|
Late or Type II decelerations
Variable or Type III decelerations Static or Type IV decelerations |
|
A minimum gas flow of how many liters/minute should be supplied to an oxygen hood.
|
7 L/min.
|
|
Which of the following is true of secondary apnea?
|
The infant will not attempt to breathe
|
|
Effects and characteristics of partial liquid ventilation
|
The concept is to obliterate the air/liquid interface at the alveoli and lower surface tension. use the liquid to recruit atelectic lung and reduce surface tension in the avelolar lining. Used for RSD, aspiration syndromes, persistent pulmonary hypertension of the newborn and pneumonia.
|
|
Discuss conditions associated with delivery by cesarean section
|
Prior cesarean delivery
dystocia breech presentation fetal distress |
|
List the diagnostic uses of obstetric ultrasound
|
Determine fetal gestational age. Detect fetal anomalies. Measure amniotic fluid. Used to guide needles used for amniocentesis, chorionic villus sampling and cordocentesis used to determine lung maturity.
|
|
Discuss the effects of meconium release in the amniotic fluid
|
Aspiration of meconium into the trachea. Involves a complex series of asphyxia induced occurences. Physical presence in the airways can lead to blockage of the airway and air trapping - inflammatory response.
|
|
List and discuss the maternal risk factor for a high-risk pregnancy
|
Previous pregnancy complcations - same outcome
Diabetes mellitus - LGA, congenital malformations, RDS, hypoglycemia |
|
Discuss delivery events causing decreased right heart pressure
|
Umibilical cord is clamped - the neonate begins breathing - this reduces the pumonary artery resistance. The establishment of FRC reduces surrounding pressure. Increase in PaO2 causes pulmonary smooth muscle to relax. The pulmonary pressure drops - leads to a decrease in the pulmonary artery - right ventricle and atrial pressure.
|
|
List the steps of neonatal resuscitation
|
Before chest compressions, ventilate optimally
Chest compressions delivered on lower 1/3 of the anteroposterior diameter of the chest Or Use 2 finger technique 120/min. After every 3rd compression - the neonate should receive a breath of 100% O2 coordinated with compressions |
|
List the ID for entotracheal tubes based on the weight of a premature infant
|
Less than 1000g ETT 2.5
1000 to 2000g ETT 3 2000 to 3000g ETT 3.5 more than 3000g ETT 4 |
|
Discuss the use of these drugs for a drug user's depressed neonate: Epinephrine, Sodium bicarbonate, Naloxone hydrochloride, and Dopamine
|
Epinephrine - increases HR, improves strength of heart contractions. Naloxone hyrdorchloride (Narcan) when there is a history of maternal narcotic use within the previous 4 hrs. Sodium bicarbonate should only be given when there is adequate ventilation
|
|
List normal serum glucose levels
|
below 45 mg/dl or greater than 125 mg/dl are abnormal after 3 days of age
|
|
Discuss the characteristics of a typical premature male infant
|
At 25-26 wks the male scrotum is hardly recognizable - it has no rugae and the tesiticles have not descended
|
|
Compare and contrast modalities of aerosol therapy for the patient who is too young to coordinate breathing with medication delivery
|
SVN does not require patient coordination
MDI with a spacer and mask helps with coordination of medication delivery |
|
At what stage of embryologic development does the oven enter the uterus?
|
Morula
|
|
List the suction pressure ranges for pediatric patients and neonates
|
Suction pressures for neonates -60 to -80 mmHg
|
|
The respiratory system arises from which germ layer(s)?
|
Endoderm
|
|
A fetus suffering prolonged hypoxia will demonstrate what?
|
A negative NST and positive CST
|
|
During resuscitation, what should be evaluated first?
|
Color
Heart Rate Respirations |
|
Discuss the beta-lactam antibiotic drugs
|
Penicillins are beta-lactam antibiotics. There are 4 classifications of penicillins available.
|
|
Discuss the use of drugs for congenital heart defects
|
Patent Ductus Arteriosus (PDA) - Lasix or Indocin
|
|
What is Ribavrin (Virazole) used for?
|
Used for RSV treatment
|
|
What is Ciproflexacin used for?
|
A
|
|
What is Pentamindine (Pentam) used for?
|
PCP Prophylaxis
(Antiinfectives) |
|
What is Tobraycin (TOBI) used for?
|
Used for pseudomonal infection of the lungs.
|
|
What is Frosemide used for?
|
A
|
|
What is Nifedipine used for?
|
A
|
|
what is Amoxicillin used for?
|
A
|
|
What is Theophylline used for?
|
A
|
|
Discuss the preductal and postductal placement of transcutaneous oxygen electrodes to detect right-to-left shunting
|
A
|
|
What are possible complications of umbilical artery catheters?
|
Thombus formation
Perforation of the vessel wall Hemorrhage Vasospasm |
|
The correct concentration and dosage of epinephrine during a resuscitation is?
|
1:10,000 concentration given 0.1 to 0.3 ml/kg
|
|
A serum glucose level in premature neonates below what level indicates hypoglycemia?
|
35 mg/dl
|
|
Clinical signs and symptoms for mechanical ventilation in a premature infant with respiratory distress syndrome
|
When patient's condition deteriorates indicated by a PaCO2 greater than 60 mmHg and pH less than 7.25 or worsening of clinical signs, such as grunting, flaring and retracting.
|
|
Discuss the prevention of bronchopulmonary dysplasia
|
Use the lowest possible airway pressures, rates and FIO2s that maintain the PaO2 at 50 to 70 mmHg and PaCO2 at 45 to 55 mmHg
|
|
Discuss the features of meconium aspriation syndrome
|
It is predominantly a disease of the term or postterm neonate who has experienced some degree of asphyxia before or after the onset of labor.
|
|
Discuss the diagnostic tests for persistent pulmonary hypertension of the newborn
|
a
|
|
Clinical definition of apnea for different age groups
|
a
|
|
Discuss the Cytomegalovirus and the developing fetus
|
A
|
|
Discuss the birth defect associated with pulmonary hypoplasia of the newborn
|
A
|
|
What is Laryngotracheobronchitis?
|
Laryngotracheobronchitis - LTB is a type of croup
it is a less common manifestation seen in pediatric populations |
|
Discuss the role of Balloon septostomy to improve blood mixing
|
Balloon septostomy is required during the cardiac catherization to improve the mixing of the two blood flows
|
|
What is Epiglottitis?
|
It is an acute inflammatory disease that affects not only the epiglottis, but also surrounding aryepiglottic folds and arytenoid cartilages. It is a life-treatening disease that requires prompt diagnosis and appropriate treatment.
|
|
What is Asthma?
|
Asthma is an airway disorder in which a patient's hyperractive airways spasm and constrict, swell and pour secretions into the lumen, in response to various stimuli. The result is severe airway obstruction that may be life threatening.
|
|
What is cystic fibrosis?
|
Cystic fibrosis is a hereditary disease that effects all exocrine glands and leads to dysfunction in their secretions. It is clinically observable by pulmonary disease, pancreatic insufficiency, and elevated sweat chloride concentrations.
|
|
What is Bronchiolitis?
|
bronchiolitis is a viral infection that leads to inflammation, swelling, and constriction in the bronchioles. The most causative organisms are RSV, causing approx. 75% of all cases and the parainfluenza virus.
|
|
What is Croup?
|
Croup is the name given to a group of inflammatory diseases that affect the subglottic area of the larynx. The most common manifestation of croup is laryngotracheitis.
|
|
|
|
|
Discuss the cause of epiglottis
|
The most common cause is type b Hemophilus influenzae
|
|
Discuss the treatment for smoke inhalation and/or carbon monoxide poisoning
|
Immediate application of 100% oxygen - preferably under pressure.
|
|
Signs and symptoms of transient tachypnea of the newborn
|
Respiratory distress including tachypnea, nasal flaring, retractions, and grunting. The patient may be cyanotic when in room air. Blood gases are usually normal but may show varying degrees of hypoxia.
|
|
Following the poisitioning, suctioning, stimulation, and drying of a neonate, what is the next step in resuscitation?
|
Respirations
|
|
Parameters directly affecting tidal volume on an an infant ventilator
|
Peak inspiratory pressure (PIP) and
Positive end expiratory pressure (PEEP) |
|
Chest compressions are started when:
|
The heart rate is below 80 bpm
|
|
Range of PEEP to be achieved when weaning a neonate
|
a
|
|
Compare and contrast available surfactants
|
A
|
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List the advantages of using a helicopter for neonatal transport
|
A
|
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Calculate cylinder flow time based on psi and liter flow
|
A
|
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Length of time for normal delivery of fetus
|
A
|
|
List and describe tocolytic drugs
|
A
|
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Causes of Dystocia
|
A
|
|
List and describe the various presentations of vaginal delivery
|
A
|
|
Define placental-cervical obstruction
|
A
|
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Define partial placental previa
|
A
|
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Define total placenta previa
|
A
|
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Define abrupti placentae
|
A
|
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Describe how the placenta separates from the uterus
|
A
|
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Indication for a cesarean delivery
|
A
|
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Factors explaining increased mortality rate of multiple gestations
|
A
|
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Influences on the initial breath
|
A
|
|
Reasons that each additional breath after the first require less negative pressure
|
A
|
|
Results of clamping the umbilical cord
|
A
|
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Influences on the initial breath
|
A
|
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Event causing blood flow through the foramen ovale to stop
|
A
|
|
Route of blood through the ductus arteriosus shunt
|
A
|
|
Elements of traditional CPT
|
A
|
|
Indications for aerosolized medication therapy
|
A
|
|
Advantages to the mainstream nebulizer
|
A
|
|
Effects of placing a nebulizer between the humidifier and the distal temperature probe
|
A
|
|
Hazards of aerosol drug therapy
|
Infection
Medication side effects Drug reconcentration Overhydration |
|
Advantages and disadvantages of MDI therapy
|
A
|
|
Hazards associated with aerosolization of ribavirin
|
When aerosolized into a ventilator circuit: precipitation and accumulation of the drug on vent tubing and ETT
|
|
Actions to take when a patient becomes bradycardic while suctioning the endotracheal tube
|
A
|
|
Indications for oxygen administration
|
Hypoxemia
|
|
Properties of gaseous oxygen
|
It supports and intensifies combustion
|
|
Describe the characteristics and uses of the Thorpe tube
|
A
|
|
Describe the characteristics and uses of the Bourdon gauge
|
This type of flow meter would be found on cylinder regulators
|
|
Describe the characteristics and uses of a dual reducing valve
|
A
|
|
Describe the characteristics and uses of a Wilkinson tube
|
A
|
|
Oxygen device used with bubble humidifier
|
Cannula
|
|
FiO2 rates delivered by cannula
|
A
|
|
FiO2 rates delivered by nonrebreathing mask
|
A
|
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FiO2 rate delivered by venturi mask
|
A
|
|
Describe the effects of glucocorticoids
|
A
|
|
Drug inhibiting mast cell degrandulation
|
A
|
|
Drug of choice in sedating a neonate following surgery
|
A
|
|
Interpretation of restlessness, irritability, tremors, high-pitched cry, and vomiting
|
A
|
|
Indications for obtaining a blood gas sample
|
A
|
|
common sites used to obtain arterial blood in neonates
|
A
|
|
Characteristics of arterial blood in the presence of right-to-left shunt through the ductus arteriosus
|
A
|
|
Blood gas access site associated with necrotizing enterocolitis
|
A
|
|
Conditions necessary for reliable values obtained from a capillary sample
|
A
|
|
When measuring maternal estriol levels, fetal distress is indicated when:
|
estriol levels decrease to 50 to 60% in maternal urine
|
|
Define alveolar ventilation
|
A
|
|
Describe the formation of Carbonic acid
|
A
|
|
Potential hazards of administering NaHCO3
|
A
|
|
Explain why skin is heated at the attachment site of the TCM
|
A
|
|
Factors causing PtCO2 to measure lower than actual arterial PO2
|
A
|
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Hazards associated with transcutaneous monitoring
|
A
|
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Causes of erroneous pulse oximetry readings
|
A
|
|
Advantages of a mainstream end-tidal CO2 monitor
|
A
|
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Disadvantages of using mainstream end-tidal CO2 monitor
|
A
|
|
Disease process exerting the greatest effect on the end-tidal CO2
|
A
|
|
Clinical interpretation of an increasing PetCO2
|
A
|
|
Clinical signs of an esophageal-tracheal anomaly
|
A
|
|
Clinical diagnosis based on polyhydramnios, a flat abdomen, and respiratory distress
|
A
|
|
Condition indicated by a higher systolic blood pressure in the right arm over that in either leg
|
A
|
|
Heart defect tha must have an abnormal opening between the right and left heart to support life
|
A
|
|
Cardiac anomalies resulting in increased lung compliance
|
A
|
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Phases of ARDS
|
A
|
|
Strategies for the treatmen of ARDS
|
A
|
|
Branch(es) of the CNS primarily responsible for inhibiting bronchial smooth muscle contraction
|
A
|
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Drug of choice during the inflammatory stage of asthma
|
A
|
|
Elements of the diagnosis of cystic fibrosis
|
A
|
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Treatements for patients with cystic fibrosis
|
A
|
|
Diseases inherited as autosomal-recessive traits
|
A
|
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Clinical uses of Edrophonium (Tensilon)
|
A
|
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Nerve innervating the diaphragm
|
A
|
|
Clinical manifestations of secondary brain injuries
|
A
|
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Plan of treatment for a head injury based on arterial blood gas values
|
A
|
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Factors increasing survival rate in near-drowning patients
|
A
|
|
Indication of Reye's syndrome
|
A
|
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Characteristics of in utero fetal pneumonia
|
A
|
|
Primary cause of bronchiolitis
|
A
|
|
Action indicated with the presentation of severe sore throat and muffled voice
|
A
|
|
Signs of chlorine inhalation
|
A
|
|
Factors increasing the incidence of SIDS
|
A
|
|
Factors that limit chest x-ray interpretation
|
A
|
|
Characteristics of a correctly exposed chest x-ray
|
A
|
|
Interpret undervascularization of the hilar region
|
A
|
|
Action when noting the tip of the endotracheal tube to be near the carina
|
A
|
|
Diagnosis based on the abdomen being scaphoid, with a mediastinal shift to the right
|
A
|
|
Interpret an air pocket on the right lateral heart border of a chest radiograph
|
A
|
|
Describe the 5 stages of BPD
|
A
|
|
Disease diagnosed with a decubitus film
|
A
|
|
Characteristics of the chest radiograph of an asthma patient
|
A
|
|
Drug used when treating croup
|
A
|
|
Gases released during a fire involving furniture
|
A
|
|
Carbon monoxide levels producing a coma
|
A
|
|
Classification of neonatal mechanical ventilation
|
A
|
|
Characteristics of hypercapnic respiratory
|
A
|
|
Effect of pressure controlled ventilation on tidal volume
|
A
|
|
Describe PEEP adjustment and location on the Babybird ventilator
|
A
|
|
Characteristics of the Babybird 2 ventilator
|
A
|
|
Possible cause of vent mop alarm while using the VIP Bird ventilator
|
A
|
|
Ventilator best for transport
|
A
|
|
Requirements for the proper functioning of the BEAR Cub pneumatic control system
|
A
|
|
List the elements of the MMV mode of ventilation when using the Hamilton Veolar ventilator
|
A
|
|
Alarm indicating a blocked inspiratory tube on the Infant Star ventilator
|
A
|
|
What is the meaning of the pressure manometer pulled below 0 on each spontaneous breath on a Newport Breez ventilator
|
A
|
|
Ventilator having the option of providing a sine-wave inspriatory flow pattern
|
A
|
|
Formula to use on a Servo 300 ventilator to provide the set tidal volume
|
A
|
|
List the monitors that are able to measure tidal volumes
|
A
|
|
What is the function of the continuous flow button on the Partner volume monitor
|
A
|
|
What does an increase in the rse time, as displayed on a Sechrist Model 600 airway pressure monitor indicate?
|
A
|
|
When to use rescue surfactant
|
A
|
|
Best route of Artificial surfactant administration
|
A
|
|
Major advantage to HFV
|
A
|
|
Type of ventilation that achieves a convective movement of tidal volume that is larger than dead space
|
A
|
|
Hazards of HFV
|
A
|
|
How to correct a decreased PaO2 while managing a patient receiving HFOV
|
A
|
|
HFV method requiring the use of an adapted ETT
|
A
|
|
Describe the venoarterial route of ECLS
|
A
|
|
Criteria used to determine potential ECLS
|
A
|
|
Complications of ECLS
|
A
|
|
Advantages to the use of negative pressure ventilation
|
A
|
|
What is Polyhydraminos?
|
An increased quantity of amniotic fluid
|
|
What could occur following Cesarean section?
|
TTN
|
|
What is the lower limit of normal for fetal scalp pH?
|
7.25
|
|
Type III decelerations are caused by what?
|
compression of the umbilical cord
|
|
The heart develops from which germ layer(s)?
|
Mesoderm
|
|
Which stage of fetal lung development does deposition of cartilage begin?
|
Pseudoglandular period
|
|
The earliest development of the lung begins at:
|
24 days
|
|
What, when found in amniotic fluid, is the best indicator of fetal lung maturity?
|
PG
|
|
What is part of the biophysical profile?
|
Nonstress test
Fetal movement Amniotic Fluid volume |
|
What type of receptors are Baroreceptors?
|
They are actually stretch receptors.
|
|
What fetal heart patterns are indicative of fetal hypoxia?
|
Late or Type II decelerations
Variable or Type III decelerations Static or Type IV decelerations |
|
A minimum gas flow of_____liters/minute should be supplied to an oxygen hood.
|
7 LPM
|
|
Oxygen running through tubing at 5L/min, held 2 inches from the neonate's mouth and nose, acheives what approximate FiO2?
|
0.40
|
|
What is true of secondary apena?
|
The infant will not attempt to breath.
|
|
What is one of the signs seen in a term infant?
|
Entire sole of foot is covered with deep creases.
|
|
An infant in secondary apnea will not begin spontaneous ventilation unless positive pressure ventilation is provided first. T or F?
|
True
|
|
What techniques may be used to promote clearance of airway secretions?
|
Positive expiratory pressure (PEP)
Autogenic drainage Flutter valve therapy Postural drainage |
|
What are indications for CPT?
|
Asthma
Atelectasis Cystic fibrosis Prolonged bed rest Ventilator care |
|
What are some factors indicating the need to intubate?
|
Prolonged positive pressure ventilation is required
Bag and mask ventilation is ineffective Thick meconium is present |
|
The persistence of fetal circulation in the presence of asphyxia is secondary to?
|
Pulmonary hypertension
|
|
A sunken or flat (scaphoid) abdomen may be significant for:
|
Diaphragmatic hernia
|
|
When should positive-pressure ventilation be given to a newborn infnat with spontaneous respirations?
|
Heart rate < 100 beats per minute
|
|
When assessing a pediatric patient, you discover that the patient has a rapid bounding pulse, confusion, and muscular twitching. What would be suspected?
|
Hypercarbia
|
|
What could cause fetal asphyxia?
|
Maternal asphyxia
Placental insufficiency Occlusion of the umbilical cord |
|
What is done during the quiet examination?
|
Assess skin color
Assess patient movement Overall visual inspection |
|
What is the proper depth of chest compressions in resuscitation of a newborn infant?
|
1/2 to 3/4 inch
|
|
What are some of the complications of umbilical artery catheters?
|
Thrombus formation
Perforation of the vessel wall Hemorrahage Vasospasm |
|
Attempts at intubation should be limited to____seconds to minimize hypoxemia.
|
20 seconds
|
|
What rate of ventilations should be administered to a newborn infant requiring positive pressure ventilation by bag-mask ventilation?
|
40 to 60 breaths per minute
|
|
What signs are included in the Ballard assessment of gestational age?
|
Ear recoil
Presence of lanugo |
|
Wrapping a baby in a blanket and placing a cap on his or her head will reduce heat loss by_____
|
Radiation
|
|
Teratogenic drugs generally have their greatest effect during:
|
The first trimester
|
|
Premature newborns have a decreased ability to maintain body heat. What are some reasons for that decreased ability?
|
Large body surface area
Thin skin layer Reduced ability to intake calories |
|
What are biochemical reactions of drug metabolism in the liver?
|
Conjugation
Reduction Hydrolysis |
|
What would indicate a fluid deficit in a neonate?
|
Decreased skin turgor
Sunken anterior fontanelle Increase in suture overlap |
|
Capillary blood gas samples are for determining?
|
pH
PaCO2 HCO3- |
|
What drug would be most appropriate to treat congestive heart failure?
|
Digoxin
|
|
What may cause abnormalities of fluid and electrolyte balance in neonates?
|
Maternal IV therapy
Asphyxia Sepsis Endocrine disorders |
|
Neonatal apenea is treated with what drug?
|
Caffeine
|
|
Which arterial blood access method has necrotizing enterocolitis as a possible complication?
|
Umbilical artery catheter
|
|
What characteristics does a lipid soluble drug have?
|
Readily cross cell membranes
High affinity for protein bonding |
|
What is a disadvantage to mainstream capnometry?
|
Additional deadspace in circuit
|
|
A patient with a diminished clotting mechanism would possibly have an imbalance in which electrolyte?
|
Calcium
|
|
What would increase insensible water loss?
|
The presence of RSD
|
|
What penicillin is considered useful against Pseudomonas aeruginosa?
|
Piperacillin
|
|
What is involved in nonshivering thermogenesis?
|
Norepinephrine
Lipase Nonesterified fatty acids |
|
What types of fluid loss would be considered insensible water loss?
|
Evaporation from the skin
Evaporation from the respiratory tract |
|
What is the most common treatment for hyperbilirubinemia?
|
Phototherapy
|
|
A neonate appears clinically with jitters, irritability, apnea, and seizures. The probable cause is:
|
Hypocalcemia
|
|
What is an advantage to using an open warmer?
|
Ease of patient access
|
|
A patient is suspectect of having PPHN. What is the most accurate test to make the diagnosis?
|
The hyperoxia-hyperventilation test
|
|
A fetus receives immunity from the mother by what antibody?
|
IgG
|
|
What condition is likely to present if the PaO2 in an arterial blood sample obtained from the right radial artery is significantly higher than one obtained from an umbilical artery?
|
Persistent pulmonary hypertension of the newborn.
|
|
What radiographic features characterize RDS?
|
A retigulogranular pattern
Air bronchograms extending into the lung periphery |
|
Prevention of retinopathy of prematurity is based on:
|
Cautious use of oxygen
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What problems are most typically seen in term and postterm infants?
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Meconium aspiration syndrome
Persistent pulmonary hypertension (PPHN) of the new born |
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PIE can best be treated by:
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Low ventilatory pressures
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A ventilator patient's status suddenly worsens with bradycardia, cyanosis, retractions, and apnea - what would you do first?
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Check for signs of extubation followed by transillumination of the chest
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What bacterial species is most often implicated in recurring cycles of pulmonary infections, especially in the later stages of cystic fibrosis?
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Pseudomonas aeruginosa
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What birth defect might be present in a normal-appearing baby who exhibits excess salivation and drooling and displays episodes of choking, gagging, and dyspnea associated with attempts at feeding?
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Esophageal atresia
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What therapies are often used in the treatment of BPD?
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Supplemental oxygen
Diuretics Chest physical therapy Bronchodilators |
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What are indicators of TTN?
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Tachypnea
Cyanosis Normal PaO2 and PaCO2 |
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What is a risk of treating PPHN with NO?
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Methernoglobinemia
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Oxygen toxicity, barotrauma, PDA, and fluid overload are all linked to the development of:
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BPD
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Meconium passage into the amniotic fluid is precipitated by:
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Asphyxia
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Bleeding in the brain ventricles, without evidence of ventricular dilation describes:
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Grade II hemorrhage
Grade II IVH |
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Pulmonary hypoplasia is a common complication with which birth defect?
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Congenital diaphragmatic hernia
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What disease has its greatest incidence in children ages 2 to 6 years?
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Epiglottitis
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What disease typically accompanied by a high fever?
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Epiglottitis
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What conditions may trigger apnea in a neonate?
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Hypothermia
Hyperthermia Suctioning Necrotizing enterocolitis |
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Pathophysiologic manifestations of RDS include:
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Decreased V/Q ratios
Increased work of breathing Atelectasis |
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The cystic fibrosis gene occurs most frequently in which race?
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Caucasian
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Prevention of ROP is based on:
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Cautious use of oxygen
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RDS lowers lung compliance by:
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increasing alveolar surface forces
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Normal lung compliance in a newborn is:
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2.5 to 5ml/cmH2O
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According to the FDA, high-frequency ventilation is any form of mechanical ventilation delivering rates higher than____ breaths per minute?
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150
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What aspects of mechanical ventilation will affect mean airway pressure?
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Peak inspiratory pressure
PEEP Respiratory rate |
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What would indicate a failure of CPAP?
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PaO2<50mmHg with an FIO2 of 0.8 to 1.0 and CPAP of 10 to 12 cm H2O
Marked retractions on CPAP Frequent apneic spells |
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What is the usual range of PEEP settings used for mechanically ventilating newborn infants?
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4 ro 6 cm H2O
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The normal airway resistance in a spontaneous breathing neonate is:
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20 to 30 cm H2O/L/sec.
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With overexpansion of the lungs caused by air trapping, lung compliance is:
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Reduced
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What best describes wasted ventilation?
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The ratio of physiologic deadspace to tidal volume.
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Which of the surfactant preparations currently available does not include surfactant proteins?
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Exosurf
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As volume is extracted from the thorax at its unstressed volume, the ribs:
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recoil outward
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What are clinical signs of a failure to wean?
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Bradycardia
Retractions Tachycardia Pallor |
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What expression is for calculating time constant (Kt)?
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Compliance x resistance
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What is the most common devices used to apply CPAP to the neonate?
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Nasal prongs
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The main advantage in using volume-cycled ventilation with neonates is:
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Delivery of a constant tidal volume
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What parameter has the greatest influence on mean airway pressure?
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PEEP
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What are some of the hazards of mechanical ventilation?
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Barotrauma
Infection Intracranial hemorrhage |
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What would be an advantage to using negative pressure ventilation over positive pressure ventilation?
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Decreased risk of cardiopulmonary complications.
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What is normal compliance in a newborn infant?
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2.5 to 5 ml/cm H2O
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To maintain the same PaO/IN(2) for a patient during air transport, hypobaric conditions would generally require what adjustment to the FiO\IN(2)?
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Increase
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What can help thermoregulate the infant during transport?
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Warmed IV bags wrapped in a blanket
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The family member who begins making promises is in the pahse of:
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bargaining
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There are three basic models for pediatric home care: the hospital based, community based, and bureaucratic models? T or F
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True
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Helicopter transport is most effient when distances are greater than 100 miles but less than 250. T or F
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True
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What are some advantages to home care?
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Allows more normal family interaction.
Patients get infections less frequently. Cost savings |
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What are some disadvantages to air transport?
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Space limitations.
Adverse weather can interfere Vibrations and turbulence during transport |
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When the death of a loved one appears likely, grief felt by the family is termed:
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Anticipatory
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What disorder presents the greatest potential thermoregulation problem during transport?
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Gastroschisis
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How long will an E cylinder of oxygen last with a gauge pressure of 1900 psi running at 5 lpm?
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1 hour 46 minutes
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What is a common problem with come apnea monitoring?
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Frequent false alarms
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Ground transport is usually selected for neonatal transport if the referring hospital is less than____ miles from the level III NICU.
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100 Miles
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An infant with_________should not be bag-and-mask ventilated.
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Diaphragmatic hernia
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What are possible hazards of home aerosol therapy?
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Fluid overload
Burns |
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A visit to the NICU prior to delivery of a high-risk infant may reduce which of the following stages of grief?
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Shock
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Studies have shown that the highest source of stress in mothers of sick neonates is:
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Alteration of the parental role
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The main advantage to liquid oxygen systems is:
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They hold a large quantity of gas.
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Edrophonium (Tensilon) is used to diagnose what?
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Myathenia gravis
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What could limit the interpretation of a chest x ray?
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Artifact
Patient movement Improper technique |
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A clinical definition of apnea in an infant is:
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Any cessation of breathing lasting longer than 20 seconds or any cessation of breathing accompnied by bradycardia and/or cyanosis
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Development of atelectasis, edema, inflammation, and plugging of the bronchi occur during which phase of chlorine inhalation?
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Phase 2
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The purpose of heating the skin at the attachment site of the TCM is to:
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increase the perfusion to the area.
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What factors explain why the mortality rate of mulitple gestations is increased?
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An increased incidence of premature labor.
An increased incidence of congenital abnormalities. An increased incidence of bacterial infections. An increased incidence of hypoglycemia |
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Dense cystic patches arranged in generalized patters that gradually increase in size and number describe what stage of BPD?
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Stage 3
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What is BPD
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Bronchopulmonary dysplasia (BPD)
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Proper function of the Bear Cub pneumatic control system requires what?
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The use of 3/16" proximal airway pressure tubing.
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Secondary brain injuries include what?
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Hematoma
Hypoxia Hypotension |
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The greatest hazard associated with transcutaneous monitors is:
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Thermal injury
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Reye's syndrome is diagnosed by:
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Liver biopsy
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Flattened diaphragms seen on a chest x-ray indicate:
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Air trapping
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What best describes PaO2?
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The pressure of oxygen dissovled in plasma.
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What is the most accurate classification of neonatal mechanical ventilation?
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Pressure controlled, pressure limited, time cycled.
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A doctor orders a pediatric patient to be on an FiO2 of 0.35. What device would best deliver the ordered FiO2?
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Venturi mask
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coma is possible at carbon monoxide levels greater than?
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40%
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What levels of PEEP are recommended for neonatal patients being mechanically ventilated?
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4 to 6 cm H2O
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As respiratory rate increases at a static tidal volume, which of the following occurs?
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PaCO2 decreases
Alveolar ventilation increases |
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The most reliable diagnosis of cystic fibrosis involves:
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Sweat/chloride levels
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The complication of necrotizing enterocolitis is most prevalent in which blood gas access site?
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Umbilical artery
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What conditions will decrease insensible water loss in a newborn?
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Increased ambient humidity
Humidification of inspired gases Heat shields |
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_______is typically manifested by early involvement of the pancreas with pumonary problems developing later?
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Cystic fibrosis
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Two criteria used to determine potential ECLS patients are:
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A-a gradient and oxygen index.
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Chorioamnionitis is caused by:
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Bacterial infection
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What are the routes of HIV infections in the fetus and neonate?
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Transplacentally
Breast Milk Contact with maternal secretions |
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Hepatitis, jaundice, hepatosplnomegaly, and neurologic abnormalities are symptoms of which fetal infection?
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Disseminated herpes simplex
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Under what circumstances should propylactic broad-spectrum antibiotics be administered to a neonate?
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Amniotic sac rupture over 24 hours before delivery.
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A fetus receives immunity from the mother by what antibody?
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IgG
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What are clinical signs of an espophageal-tracheal anomaly?
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Accumulation of oral secretions
Sporatic respiratory distress Regurgitation of feedings |
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The probable diagnosis of a neonate delivered with polyhydraminos, a flat abdomen, and respiratory distress is:
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Diaphragmatic hernia
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A higher systolic blood pressure in the right arm over either leg would indicate which of the following?
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Coarctation of the aorta
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Which of the following heart defects is not compatible with life when an abnormal opening between the right and left heart does not exist?
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Transposition of the great vessels
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The underlying etiology of RDS is:
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Surfactant deficiency
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What are complications of RDS?
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DIC
Intraventricular hemorrahage Infection PDA |
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Oxygen toxicity barotrauma, PDA, and fluid overload are all linked to the development of:
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BPD
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What is least likely to be used when treating BPD?
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ECMO
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The radiographic picture of Wilson-Mikity syndrom appears similar to:
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BPD
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What best defines vaso-obliteration?
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Necrosis of retinal vessels
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Prevention of ROP is based on:
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Cautious use of oxygen
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Intraventricular hemorrhage in premature neonates occurs most often in the:
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Germinal matrix
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Bleeding in the brain ventricles, without evidence of ventricular dilation, describes:
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Grade II IVH
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One of the initial signs of fetal asphyxia is:
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Bradycardia
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Meconium passage into the amniotic fluid is precipitated by:
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Asphyxia
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Intubation of the trachea, followed by suction applied to the endotracheal tube while it is being removed is indicated when:
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thick meconium is present in the amniotic fluid
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A ventilator patient's status suddenly worsens with bradycardia, cyanosis, retractions, and apnea, The immediate reation of the respiratory care practitioner would be:
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Check for signs of extubation followed by transillumination of the chest.
|
|
PIE can be best be treated by:
|
Low ventilatory pressures
|
|
A patient is suspected of having PPHN. Which of the following is the most accurate test to make the diagnosis?
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The hyperoxia-hyperventilation test
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What is a risk of treating PPHN with NO?
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methemoglobinemia
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