-
is a general term that refers to a disturbance in the conduction of impulses from the atria to the ventricles through the AV node. The block may be level of the AV node, bundle of hos or in the bundle of branches.
AV Heart Block
-
mildest form of heart block. is present when the PR interval is prolonged more than 0.2 sec. all the atrial impulses pass through to the ventricles but are delayed at the AV node. May or may not compromise cardiac output.
First-Degree AV Block
-
Systematic Evaluation: Rate = underlying rhythm rate, Rhythm = regular, P waves = Normal sinus configuration, PR interval = > 0.20 sec. in length and constant, QRS complex = < 0.12 sec in width.
First-Degree AV Block
-
This is the ratio of two phospholipids: lecthin and spingomyelin.
the L/S ratio
-
the presence of PI and PG is usually indictive of?
advancing lung maturation
-
is a continuous graphic method of recording the fetal heart rate and uterine contractions.
Fetal Monitoring
-
is a moethos of evaluating the stability of the fetus's physiology within the uterine enviroment. monitors the acceleration of the fetal heart rate inresponce to fetal movement.
The fetal NST
-
A healthy fetus has a minimum of an increase in heart rate of at least _______.
15 beats/min
-
to be concidered reactive, the fetus needs to have a minimum of 2 accelerations in?
20 mins
-
a fetus is concidered nonreactive when it fails to have heart rate response in two consecutive?
20-min periods
-
is obtained to evaluate the well-being of the infant during the transition from intrauterine to extruterine life.
Labor History
-
the first feces of an infant is called.
meconium
-
should include the method of delivery for the infant: vaginal/cesarean, spontaneous, forcepts, vacuum extraction, ect.
Delivery history
-
Infants loose heat to the enviroment by one of four mechanisms:
Conduction, convection, evaporation, and radiation.
-
Newborns are very prone to heat loss because of their?
high ratio of surface area to mass.
-
Newborns: Is a core temperature of more that 37.5C. Usually caused by enviromental factors.
Hyperthermia
-
Newborns: is a core temperature of less than 36.5C. more common and significantly more serious sign of infection in the newborn than in the older child or adult. Occurs because the infant is iunable to maintain normal heat production.
Hypothermia
-
Infants do not _____ when hypothermic
Shiver
-
What are the most common methods of obtaining the temp. of an infant?
axillary and rectal
-
How far off is the axillary temp. form the actual temp.?
o.5C lower
-
How far off is the rectal temp. from the actual temp.?
0.5C Higher
-
Most sick infants are placed in a ___________, which is the enviromental yemp. at which the infants's metabolic demand and therefore oxygen consumption is the least.
Neutral Thermal Enviroment (NET)
-
The normal pulse rate or an infant is?
100-160 bpm
-
If the newborn has a heart rate greater than 160bpm.
Tachycardia
-
If the newborn has a heart rate less than 100bpm.
Bradycardia
-
Heart issue that can be caused by crying, pain, decrease in the circulating blood volume, drugs, hyperthermia, and heart disease.
Tachycardias
-
Heart issue caused by hypoxia, Valsalva maneuever, heart disease, hypothermia, vagal stimulation, and certain drugs.
Bradycardias
-
Heart issue: a normal variant and resting heart rates between 70 and 100bpm.
Sinus Bradycardia
-
How do you assess the pulse on an infant?
brachial or femoral artery
-
Normal RR for an infant?
30-60
-
Is maintained by the opposition of two forces: outward spring of the chest wall and recoil of the alveoli.
FRC
-
is a respiratory rate greater than 60 bpm
Tachypnea
-
is a respiratory rate less than 30bpm.
Bradypnea
-
The cessation of respiratory effort.
Apnea
-
The cessation of breathing for more than 15-20 sec.
Long apnea
-
The cessation of breathing for more than 6-14 sec.
Short apnea
-
Thye cessation of breathing for less than 6 sec.
periodic breathing
-
Short apneas and spells of periodic breathing are normal in term infants up to?
3 months
-
Hemoglobin present in the fetus in utero; has a higher affinity for oxygen than does adult hemoglobin; allows the fetus to survive and grow in the relatively low oxygen enviroment of the uterus.
Fetal hemoglobin (Hb F)
-
The half life for RBS with Hb F is?
45 days
-
An infant who is not tansfused will have a significant portion of the RBC population with Hb F until?
60-90 days of life
-
Normal pH for newborn
7.25-7.35
-
Normal PaCO2 for newborn
26-40
-
Normal PaO2 for newborn
50-70
-
normal HCO3 for new born
17-23
-
Normal BE for newborn
-10 - -2
-
Normal pH if infants after 24 hrs.
7.30-7.40
-
Normal PaO2 in infants after 24 hrs
60-80
-
Normal PaCO2 in infants after 24 hrs.
26-40
-
Normal HCO3 in infants after 24 hrs
18-25
-
Normal BE in infants after 24 hrs
-4 - +2
-
Normal pH for 2 days - 1 month old
7.32-7.43
-
Normal PaO2 for 2 days - 1 month old
85-95
-
Normal PaCO2 for 2 days - 1 month old
30-40
-
normal HCO3 for 2 days - 1 month old
16-25
-
normal BE for 2 days - 1 month old
-6 - +1
-
Normal pH for 1 month - 2 yrs old
7.34-7.46
-
Normal PaO2 for 1 month - 2 yrs
85-105
-
Normal PaCO2 for 1 month - 2yrs
30-45
-
Normal HCO3 for 1 month -2 yrs
20-28
-
Normal BE for 1 month - 2 yrs
-4 - +2
-
Normal values in infants depend on?
the age
-
Because babies will cry and change their ventilation patterns while getting and arterial stick, what will happen to those values?
They are inaccurate
-
The placement of an ___________ allows the clinitian to obtaon arterial blood amples without altering th infant's physiology in the immediate newborn period.
Umbilical Arterial Catheter
-
Because of the risk and technical experience involved in obtainign ABG samples, many place do this instead on infants.
Capillary puncture
-
Capillary punctures are obtain by?
puncturing the warmed heel. (finger and earlobes can be used)
-
When compaired capillary PcCO2 and pH is how different from aterial?
PcCO2 is 2-5 mmHG higher and pH is 0.01-0.03 lower
-
There is no fixed ratio for FaO2/PcO2. So the only statment that can be made is that the PaO2 is?
no lower than PcO2
-
A capillary sample must be obtained from a warmed extremity. Skin temp should be?
102F
-
Capillary blood samples from the infant usually reflect pcO2 and pH values reasonably close to those or arterial blood; however, the pO2 of capillary blood is often significantly blow that of?
Arterial Blood
-
these samples can also be obtained for gas analysis. Useful in computing the O2 extraction or CO2 production of tissues. However, the values obtained by the method may be very misleading.
Venous Blood Gases
-
Another method of monitoring sick patients. give caregivers up to date info. that would otherwise be unavailable. For infants they are being used around the clock.
Noninvasive monitors
-
these noninvasive monitors measure electrical current that is directly proportional to the number of O2 molecules present in the electrode. Approximates PaO2 and is slightly lower than PaO2.
Transcutaneous Oxygen Monitors (tcPO2)
-
The person obtaing the sample should note the tcPO2 values three times :
before disturbing, at the begining of blood flow, and 40-60 secs. after completion of collecting sample
-
This is another noninvasive monitor that measures the PCO2.
Transcutaneous Carbon Dioxide Monitors
-
tcPO2 and tcPCO2 measure the gas present in the skin and not gas present in?
Blood
-
Both tcPO2 and tcPCO2 must be repositioned every ______.
2-4 hrs
-
the heater in the electrode of the tcPO2/PCO2 can do what? Also, what can the tape used to hold them is place do?
Burn the skin. Tear the skin.
-
A useful monitoring tool. measures the changing transmission of red and infrared light through pulsating capillary bed to identify the saturation of hemoglobin with O2. Overcomes problems of transcutaneous monitors and are not heated.
Pulse Oximeters.
-
is a monitoring techniques that has been evaulated for assessing tissue oxygenation. measures the oxidation reduction state of sytochrome aa3, which is thought to be a marker of tissue oxygenation status. Being used clinically and should have a wider presence in the next few years in operating/ intensive care units.
Near-infrared Spectroscopy (Niroscopy)
|
|