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RNC-NIC. Respiratory Questions Graded A+
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RNC-NIC. Respiratory
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RNC-NIC. RespiratoryWhat type of cells produce surfactant? - answer type II pneumocytes
What moms should receive antenatal steroids? How are they dosed? - answer-all moms
<35 weeks gestation when delivery is imminent
-give 2 doses 24 hours apart
Which is worse, right to left or left to right shunting? Why? - answer-right to left is worse
-deoxygenated blood is entering the aorta and being sent out to the body
What PaO2 values on a hyperoxia test indicate that the likely cause of cyanosis is
PPHN vs. CHD? - answer-PaO2 >150mmHg: likely PPHN
-PaO2 <100mmHg: likely CHD
What is normal pH on an ABG? - answer7.35-7.45
What is normal PaCO2 on an ABG? - answer35-45 mmHg
What is normal PaO2 for term/preterm infants on an ABG? - answer-term: 50-70 mmHg
-preterm: 45-65 mmHg
What is normal HCO3 on an ABG? - answer22-26 mEq/L
Which compensation occurs faster, respiratory or metabolic? - answerrespiratory
What vent changes do we make if CO2 is high on ABG? - answer-increase PIP
-increase rate
-increase tidal volume
-increase amplitude
-decrease frequency
What vent changes do we make if CO2 is low on ABG? - answer-decrease PIP
-decrease rate
-decrease tidal volume
-decrease amplitude
-increase frequency
-extubate?
What vent changes do we make if PaO2 is low on ABG? - answer-increase FiO2
-increase PEEP
-increase PIP
, -increase MAP
What vent changes do we make if PaO2 is high on ABG? - answer-decrease FiO2
-decrease PEEP
-decrease PIP
-decrease MAP
What are some risk factors for respiratory distress syndrome? - answer-decreased birth
weight
-decreased GA
-male
-maternal diabetes
-birth asphyxia
-c/s without labor
What is the pathophysiology of RDS? - answeroverly compliant chest wall but lungs
themselves aren't compliant (often due to surfactant deficiency)
What are the symptoms of RDS? - answer-tachypnea (often first sign)
-grunting
-nasal flaring
-retractions
-cyanosis
-may progress to pallor, delayed cap refill, peripheral edema
What CXR findings are seen with RDS? - answer-ground glass appearance
-decreased lung volumes
-air bronchograms
-alveolar atelectasis
How do we manage RDS? - answer-PEEP (CPAP or mechanical ventilation)
-antibiotics
-surfactant
-decrease stimulation
How does surfactant work? - answerreduces surface tension and prevents alveoli from
collapsing
What is bronchopulmonary dysplasia? - answer-chronic lung disease that develops in
newborns as a consequence of treatment of RDS with oxygen and positive pressure
ventilation
-babies born <32 weeks on O2 after 36 weeks CGA or at discharge or babies born >32
weeks on O2 at >28 days or discharge
How can we prevent BPD? - answer-surfactant
-antenatal steroids
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