Quiz 2 (Ken).txt

larger; less; omega

Horizontally

• The past pregnancy history of the mother and is a representation of the number of total prior pregnancies, premature deliveries, abortions/miscarriages, and living children.
• Example: If a women was in her fourth pregnancy, has had one miscarriage, one premature delivery and two living children, it would be written as PARA 3-1-1-2

system uses 11 physical signs and 10 neurologic signs, each sign evaluated is assigned a score from 1 to as many as 5 points. The points are added up and the total corresponds to the gestational age. The Dubowitz system is accurate within 2 weeks and has consistent results when used in the first five days of life

within 2 weeks and has consistent results when used in the first five days of life

Ballard score

Ballard score in 1979

system assesses six neurologic signs and six physical signs; 1st 40 hours of life with ideal time between 30 and 42 hours after delivery

• help to determine if the neonate has made a successful transition to extrauterine life and the effects of labor and delivery
• can also help determine the need for resuscitation (especially for exam observed within 1 min of life)

• Vernix:
• - Vernix is white cream cheese-like substance that covers the fetus
• - It appears around 20 to 24 weeks and remains on the fetus until week 36, at which point it starts to disappear
• - It is usually gone by week 41 to 42
• Skin Maturity:
• - At 25 - 26 weeks, the skin is gelatinous and transparent and the blood vessels are visible
• - As gestation advances, the skin becomes pink and less transparent and the vessels become less visible
• Lanugo:
• - Lanugo is the fine, downy hair that covers the neonates body
• - It appears around week 26, beings to thin by week 28 and disappears around week 32
• - The term neonate may have Lanugo on the shoulders and forehead. This is a more common sign with dark complexioned neonates
• - Lanugo most of the time will disappear around week 40
• Ear recoil:
• - The external portion of the ear (pinna) at week 25 to 26 will remain folded if doubled over
• - Cartilage starts to form at around weeks 27 to 28 and will recoil slowly at this age
• - As the weeks pass the pinna looks more adult-like and will recoil faster
• Breast tissue:
• - At 25 to 26 weeks, the breasts are barely perceptible, if at all
• - At week 27, the breast becomes a red circle, the areola, but there is no palpable tissue behind it
• - Around week 30, a 1 to 2 mm diameter breast bud forms
• - The breast bud is a firm tissue that forms behind the areola and is easily felt during palpation
• - At term the breast bud is approximately 5 to 10 mm in diameter, raised, and the areola is fully developed
• Genitalia:
• - At weeks 25 to 26 the male scrotum is hardly recognizable. It has no wrinkles (rugae) and the testicles have not descended
• - In females at weeks 25 to 26 the inner portion of the external genitalia, the labia minora and the clitoris, are very pronounced
• - Around weeks 30 to 32 the outer portion, the labia majora, becomes equal in prominence
• - The labia majora continue to grow until, at term, the clitoris and labia minora are completely covered
• Sole creases:
• - At week 26 creases appear as faint red lines on the upper sole (near the toes) of the feet
• - At week 30 the creases have covered the upper portion of the feet
• - By week 34 two thirds of the sole are covered with creases
• - By term the entire sole is covered by deep creases

Adult

• skin color:
• - Light complexed neonates should be pinkish
• - In darker complexed neonates it may be difficult to assess cyanosis. Assessment of the color of the mucus membranes would be helpful in these cases
• Activity:
• - The healthy neonate will usually be in the fetal position, with the legs drawn to the abdomen, arms flexed, tight to the body and will move extremities symmetrically
• Head to toe inspection:
• - Note any malformations or anomalies
• - Compare head size to body size
• - Look for abnormal bumps or bulges
• Respiration:
• - 30 to 60 is normal

The Silverman-Andersen

• Ultrafiltration
• Simple diffusion
• Facilitated diffusion
• Active transport
• Breaks in the placental villi

drugs that have been known to cause physical and/or mental developmental abnormalities in the embryo or fetus.

• Spontaneous abortion
• congenital malformations
• intrauterine growth retardation
• mental retardation
• carcinogenesis

• Dose the fetus is exposed to
• The length of exposure
• Age of the fetus
• Other drug interactions

first

• Used to describe the absorption, distribution, metabolism, and excretion of drugs
• "What the body does to drugs"

• Ribavirin
• RSV-IGIV
• Palivizumab (Synagis
• Terbutaline sulfate (Brethine, Bricanyl, Brethaire)

• Fried�s rule:
• Infant dose = infant age (months) x (adult dose)
• ______________________________
• 150 months

• Young�s rule:
• Child dose = child age (years) x (adult dose)
• ___________________________
• child age + 12 years

• Clark�s rule:
• Child dose = child weight (lbs.) x (adult dose)
• _____________________________
• 150 lbs.

broad spectrum antiviral drug that is specifically used in the neonatal and pediatric population for the treatment of bronchiolitis caused by the respiratory syncytial virus (RSV).

SPAG2

a sterile liquid formulation of immunoglobulin G (IgG) containing neutralizing antibody to RSV.

RSV-IGIV

50ml vials, containing 2500 mg of RSV immunoglobulin. It is administered as a monthly intravenous infusion of 750 mg/kg

Palivizumab (Synagis)

• 50 and 100 mg/ml solutions for injection
• recommended doseage is: 15 mg/kg, given IM once a month throughout the season

decrease inflammation of the airways

• Alburterol = 20 ml at 5mg/ml or .5%, 3 ml at 0.083% or 2.5 mg in 2.5 ml NSS
• Metaproteronol = 5%, normal dosage 0.3ml of 5% diluted w/ 2.5 NSS
• Terbutaline sulfate = 1 mg/ml or a 0.1% solution, subcutaneously at a dosage of 0.01 mg/Kg, metered dose inhaler, giving a dose of 0.2 mg/puff
• Racemic Epinephrine = 2.25%, normal dosage .5 ml diluted w/ 2.5 to 3 ml NSS
• Atropine = 1 mg/0.5ml or 0.2%, also 2.5mg/0.5ml or 0.5%, dosage .05ml/kg 3-4 times per day
• Ipratropim bromide (Atrovent) = 2.5ml of 0.025% 3-4 times a day for adults
• Glycopyrrolate (Robinul)
• Beclomethasone (Vanceril,Steroid) = Dosage 1 to 2 puffs MDI 3-4 times per day. 1 puff is 42 micrograms
• Flunisolide (Aerobid, Steroid) = Dosage 1 to 2 puffs MDI BID
• Dexamethasone (Respihaler, Steroid) = Dosage 2 to 3 inhalations MDI 3-4 times per day
• Triamcinolone (Azmacort, Steroid) = Dosage 1 to 2 inhalations MDI 3-4 times per day
• Cromolyn Sodium (Intal) = Cap 20mg, Neb 20mg in 2ml
• Pentamidine Isethonate (Nebupent, Pentam 300) = Prevent PCP, used w/ Respigard II, 300 mg Q4 weeks

Aerosolize Antibiotics