neo exam 2/1

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neo exam 2/1
2011-03-04 18:39:12
neo exam

neo exam 2/1
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  1. whats the major underlying cause of RDS
    surfactant deficiency
  2. what are some complications associated w/ RDS
    • ICH (intraventricular hemorrhage)
    • Barotrauma (trauma from high pressure)
    • NEC (necrotizing enterocolitis)
    • PIE (pulmonary intertistial emphysema)
    • ROP (retinopathy of prematurity)
  3. how is rds treated
    • if needed assistance w/ resp rate use CPAP non invasive bc u want to minimize barotrauma
    • lower vt strategy
    • HFOV -- high freq oscillation ventilation
    • SRT -- surfactant replacement therapy -- dec surface tension
  4. what is BPD/CLD
    • bronchopulmonary dysplasia/ chronic lung disease
    • --it is a result from the adverse effects of mech vent
  5. what are the adverse effects of mech ventilation
    • extensive lung injury by barotrauma (which is caused by pressure)
    • volume trauma (which is from excessive volumes)
  6. how do you treat BPD
    • prevention/ treatment is low vt strategy -minimize barotrauma
    • surgactant replacement therapy
    • close PDA is the number one (patent ductus arteriosus)
    • oscillator
    • ECMO -- having severe oxygenation issues
    • nitric oxide
    • hydration
    • vitamin A
  7. what are the typical blood gases you will see in a pt w/ BPD (chronic lung disease
    • copd gases of
    • - inc paco2
    • -inc bicarb
    • -dec paco2
  8. what is ROP
    it is the constriction of the blood vessels -- too much oxygen causing the retina blood vessels to contrict. the blood vessels die and form a scar in the lens of the eyes and this is how the blindness occurs
  9. how can you prevent ROP
    • use very cautious oxygen -- the more premature they are the higher the incidense of ROP
    • (need to set spo2 high alarm)
  10. which neonate are at the greatest risk for developing ICH/IVH? (intraventricular hemorrhage/intracranial hemorrhage)
    less than 32 weeks gestation and less than 1500 grams
  11. what is the most common cause of IVH/ICH
    prematurity of the CNS (central nervous sys--meaning the head)
  12. what is PIE
    pulmonary interstitial emphysema --this is an air leak syndrome -- where the air escapes into the pulmonary interstitium
  13. how do you treat PIE
    • HFOV-- high freq oscillation ventilation
    • --done by using lower vt strategy bc inc pressure will worsen it. this is what caused PIE in the 1st place
  14. what are the complications associated w/ o2 administration
    • knocking out the respiratory drive
    • nitrogen washout (need to know) --leads to absorption atelectasis
    • ROP
  15. what is a quick method used to diagnose pneumothorax in neonates and young infants