RT 142 Exam 1 > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

What does Gravida refer to?

A

Total number of times a woman has been pregnant, no matter how it ended.

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2
Q

Define Vernix.

A

White, waxy, protective layer on a newborn’s skin; seen at birth.

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3
Q

What is Oligohydramnios?

A

Too little amniotic fluid. AFI < 5 cm or MVP < 2 cm.

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4
Q

What does Polyhydramnios indicate?

A

Too much amniotic fluid. AFI ≥ 25 cm or MVP > 8 cm.

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5
Q

Define Dystocia.

A

Labor that takes too long or doesn’t progress normally.

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6
Q

What is Osteogenesis imperfecta?

A

Genetic disease where bones are weak & break easily due to poor collagen type I.

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7
Q

What is the Foramen ovale?

A

Hole between atriums in babies that should close after birth.

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8
Q

What is the function of the Ductus arteriosus?

A

Connects the pulmonary artery to the aorta, bypassing the lungs.

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9
Q

What does the Ductus venosus do?

A

Carries oxygen-rich blood from the placenta to the inferior vena cava.

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10
Q

Define Molar pregnancy.

A

Cyst-like cells grow instead of a normal placenta/baby.

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11
Q

What is Macrosomia?

A

A baby weighing more than 4500 grams (about 9 lbs 15 oz).

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12
Q

What is Lanugo?

A

Fine hair covering a fetus, starts around 5 months, gone by 9 months.

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13
Q

What does Pulmonary hypoplasia refer to?

A

Lungs are underdeveloped at birth.

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14
Q

Define Diaphragmatic hernia.

A

Hole in the diaphragm causing organs to move into the chest and press on the lungs.

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15
Q

What is Hydrops fetalis?

A

Serious condition where fluid builds up in 2 or more areas of the fetus.

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16
Q

What does Acrocyanosis indicate?

A

Blue hands or feet caused by cold or poor blood flow, common in newborns.

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17
Q

What is Abruptio placenta?

A

Placenta detaches early from the uterus before birth.

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18
Q

What do early decelerations in fetal heart rate indicate?

A

Usually due to fetal head compression and pose little threat to the fetus.

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19
Q

What are variable decelerations associated with?

A

Cord compression and increased risk of fetal hypoxia.

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20
Q

What do late decelerations indicate?

A

Uteroplacental insufficiency and are associated with fetal distress.

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21
Q

What is the normal axillary temperature range for neonates?

A

97.6 + 1˚F.

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22
Q

What is the formula for calculating Adult Mean Blood Pressure (MBP)?

A

MBP = 2 (DBP) + SBP / 3.

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23
Q

What is the L:S ratio for lung maturity?

A

L:S ratio > 2:1 indicates mature lungs.

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24
Q

What are signs of respiratory distress in neonates?

A

Nasal flaring, expiratory grunting, head bobbing, tachypnea, retractions, acrocyanosis, central cyanosis.

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25
What is Spina Bifida?
Birth defect from neural tube not closing, affecting spine, skin, nerves, and brain.
26
What are the reflexes present in newborns?
Grasp reflex, plantar grasp reflex, Moro reflex, stepping reflex.
27
What are respiratory 'Red Flags' in neonates?
RR > 60 bpm, grunting or retractions, cyanosis, apnea.
28
What are cardiac 'Red Flags' in neonates?
HR > 170 bpm, HR < 90 bpm, new heart murmur, cyanosis, hypotension, decreased or no pulse.
29
What steroids are used for lung maturity before birth?
Betamethasone & Dexamethasone.
30
What is the main function of Type I Pneumocytes?
Form the structure of the alveoli and allow gas exchange between air and blood.
31
What is the main function of Type II Pneumocytes?
Produce, store, and secrete surfactant.
32
What is the role of surfactant in the lungs?
Reduces surface tension in alveoli, increases lung compliance, stabilizes alveoli, decreases work of breathing.
33
What does the Shake Test assess?
Lung maturity by mixing amniotic fluid with ethanol and shaking. 1:2 dilution, no/short lasting bubbles = lung immaturity. Bubbles that last more than 15 mins = lung maturity
34
What is the purpose of the Ductus venosus before birth?
Carries oxygenated blood from placenta to IVC, bypassing liver.
35
What happens to the Foramen ovale after birth?
Closes functionally due to decreased right atrial pressure.
36
What is the function of the Ductus arteriosus?
Shunts blood from pulmonary artery to aorta, bypassing the lungs.
37
What is the biological threshold
canalicular phase- 22wks. respiratory bronchioles are formed allowing the airways to participate in gas exchange.
38
What is the APGAR
created by Virginia Apgar. performed twice, one minute after birth and five minutes after birth. Indicator of neonatal mortality and neurological/developmental outcome. Based on five factors HR, respiratory effort, muscle tone, reflex irritability, skin color.
39
Physical Exam of the infant
Vital signs, general inspection, respiratory system, chest and cardio system, abdomen, head/neck, musculoskeletal system, spine and extremities, cry
40
Normal vital Signs of an Infant
Weight. BP. MBP. Temp >600g. 45/20. 25. axillary 97.6 F >1000g. 48/25. 35 rectal 99.6 >2000g. 50/30. 40. >3000g. 50/35. 45 >4000g. 65/40. 50 RR (30-60) HR (120- 170)
41
Silverman's System
highlights important respiratory observations during physical exam
42
Calculating Adequate Neonate MBP
gestational age (weeks) + 5
43
Umbilical Cord
2 arteries, one vein, pulsates until no flow
44
Canalicular Stage
17 to 26 weeks, vascular bed and framework for acinus (gas exchange regions) develop. Smooth muscle develops in conducting airways. Type 1 and 2 cells can be identified around 20-22wks. Blood border is thin enough for gas exchange.
45
Saccular Stage
26 to 36 weeks, formerly though of as the last stage of lung development. Saccules form at beginning of stage and are cylindrical and smooth-walled. Saccules are subdivided by ridges (secondary crests) forming sub saccules.
46
Alveolar Stage
week 36 to 8yrs. alveolar development begins at birth ~50 million alveoli present only 15-20% of adult number present at birth most postnatal alveoli develop first 1.5 years
47
five stages of fetal lung development in order
embryonic, pseudo glandular, canalicular, saccular, alveolar
48
L:S ratios
L:S ratio > 2:1 = mature lungs L:S ratio <1.0 = severe lung immaturity L:S ratio 1.5 to 2.0, lung disease may or may not develop L:S ratio unreliable with gestational diabetes or Rh incompatibility amniocentesis is contaminated = falsely high L:S
49
Phosphotidylglycerol (PG)
direct measurement of PG in amniotic fluid detectable beyond 35 weeks
50
fetal circulation
mother's lungs + liver perform most of the functions required by fetus, blood flow is shunted around by these organs in fetal circulation. Fetal heart pumps fetal blood to placenta.
51
Pulmonary Vascular Resistance
determined by O2 and CO2. Increased O2 (vasodilator) = decreased PVR, increased CO2 (vasoconstrictor) = increased PVR in a fetus, physical compression and decreased O2 = increased PVR
52
INFANT FIRST BREATH
birth canal squeezes out lung fluid, first breath increases O2 which dilates the airways and decreases PVR
53
Intrauterine to Extrauterine
Pressure on right side of heart decrease, pressure on left increase, closing the foramen vale pressure in aorta increases greater than pressure in pulmonary artery, so DA shunt decreases.
54
Ductus arteriosus closure
constriction occurs at birth, 20% closed at 24 hours, 100% closed at 96 hours. By 2-4 wks, blood flow is normal
55
antenatal steroids (betamethasone and dexamethasone)
max benefit occurs 48 hours after initiation of therapy and lasts 7 days. Induces proteins that regulate the production of Type two cells in fetal lungs. Decreases RDS and neonatal morbidity by 50%. Decreases ICH
56
Tocolytics
Mag. Sulfate - decreases ca+ ions = decrease in electrical potential of cell B-mimetic (terbutaline and ritodine)= decrease electrical potential of cell
57
58
Neonatal Hemoglobin (Hgb) levels
14–24 g/dL (higher than adults)
59
Neonatal Hematocrit (Hct) levels
44–64% (higher than adults)
60
Neonatal White Blood Cell (WBC) count at birth
9,000–30,000/mm³ (much higher than adults)
61
Neonatal Platelet (Plt) count
150,000–400,000/mm³ (similar to adults)
62
Neonatal Sodium (Na⁺) levels
135–145 mEq/L (same as adults)
63
Neonatal Potassium (K⁺) levels
3.5–6.0 mEq/L (higher than adults)
64
Neonatal Calcium levels
8.5–10.5 mg/dL (lower than adults)
65
Neonatal Glucose levels
40–60 mg/dL; 50–90 mg/dL after 24 hours (lower than adults)
66
Neonatal Creatinine levels
0.3–1.0 (varies)
67
Neonatal BUN levels
5–15 mg/dL (lower than adults)
68
Neonatal arterial blood gas pH
7.35–7.45 (same as adults)
69
Neonatal arterial blood gas PaCO₂
35–45 mmHg (same as adults)
70
Neonatal arterial blood gas PaO₂
60–80 mmHg (lower than adults)
71
Function of the placenta
Gas/nutrient exchange
72
Umbilical vein function
Carries oxygenated blood from placenta to fetus
73
Ductus venosus function
Bypasses liver, carries oxygenated blood into IVC (~30-50%)
74
Inferior vena cava (IVC) function
Carries mixed blood to right atrium
75
Foramen ovale function
Bypasses lungs, carries oxygenated blood to left heart
76
Right ventricle function
Pumps some blood to pulmonary artery; ~13%-25% reaches lungs
77
Ductus arteriosus function
Bypasses lungs, carries deoxygenated blood to descending aorta
78
Aorta function
Receives mixed blood and delivers it to the body
79
Umbilical arteries function
Carries deoxygenated blood from fetus to placenta
80
Best site for arterial draw
Radial: Best collateral flow, easy access, safest option
81
Alternative site for arterial draw if radial fails
Dorsalis Pedis / PT: Backup option
82
Indications for Capillary Blood Gases (CBGs)
Alternative to ABG when no arterial line is available, less invasive
83
Contraindications for CBGs
When accurate oxygenation is required, neonates < 24 hours old
84
Potential complications of CBGs
Burns from heel warmers, infection, scarring
RT 142 Exam 1
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