RSPT 2353 Neonatal Pediatric Respiratory Care.ppt

* * * * * * * * * * * * * * * * * * * Respiratory Function Assessment Apnea Periodic breathing Grunting Nasal flaring Retractions Silverman score Stridor X-ray Nasal Flaring and Sub-sternal Retractions Nasal Flaring and Substernal Retractions Silverman score Cardiac Assessment Heart, how is it working? HR, RR,BP Cardiac murmur – PDA Weak pulse Coarctation of Aorta Hypo plastic Left heart syndrome Adequate MBP= gestational age + 5 Abdomen Diaphramatic hernia Omphalocele Gastroschisis Umblical cord A single umblical artery Congenital anomalies Thin cord Thick cord-diabetics Head and Neck Assessment Microstomia-small mouth Micrognathia-small jaw T-E fistula Pierre robin syndrome Choanal Artesia Macroglossia Assess an Infant’s Cry Loud and vigorous- healthy infant Grunting cry- RDS Hoarse cry-laryngeal edema Cat like cry- chromosme abnormality High-pitched cry- neurological deficit Pediatric Assessment Pedi assessment is focused on different indications: History and assessment Chief complaint Medical history Family history Environmental history Elements of Pediatric Physical Assessment Assessment Inspection RR Retractions AP diameter Digital clubbing Palpation Tactile fremitus Position of trachea Percussion Auscultation * * * * * * * * Cardiac development occurs between the 4th and 7th week of gestation. The foramen ovale is a one-way flap in the atrial septal wall. Blood bypasses the lungs because of the high right sided pressures. The ductus arteriosis shunts blood away from the lungs. Fetal PVR is high, within 24hr after birth, PVR should fall to 1/2 SVR The ductus should close within 10-24 hrs after birth. Fetal CO is very high, therefore tissue hypoxia usually does not occur, even when oxygen saturations are 60-70% * * * * * * * * * * * Blood flows into the RA via the SVC, then to the RV, to the PA, to the lungs. Blood flows into the LA via the pulmonary veins, into the LV, through the Aorta to the rest of the body. * * * RSPT 2353 Neonatal Pediatric Res