Newborn and Early Childhood Respiratory Disorders RT 265
Newborn and Early Childhood Respiratory Disorders RT 265 Chapter 33
Childhood Definitions v Neonate v Birth to 1 month (first 28 days) v Infant v 1 month to 1 year (some texts use until 3 rd year) v Pediatric v 1 year to 12 years (some texts use until 21 st year)
Development of the Respiratory System
Lung Growth
Transition at Birth v Clear lung fluid v High transpulmonary pressures to open lungs v Breathing must be stimulated v Pulmonary vasodilation, decreased PVR v Constriction of the ductus arteriosus v Closure of umbilical blood supply closes ductus venousus v Increased SVR v Closure of the foramen ovale
Pathophysiological Differences v Flexible compliant thorax v Low lung compliance v High negative intrapleural pressures during inspiration
Clinical Manifestations of Distress v Retractions v Flaring nostrils v Expiratory grunting v Apnea of prematurity v Persistent pulmonary hypertension of the newborn
Arterial Blood Gases v Acute alveolar hypoventilation with hypoxemia v Acute ventilatory failure with hypoxemia v Low oxygen levels due to …… v Pulmonary shunting and venous admixture v PPHN v Infant fatigue
Apgar Score v Scores: v 0 -3 – severe distress v 4 -6 – moderate distress v 7 -10 – absence of difficulty in adjusting to extrauterine life v The 5 minute score should be higher than the 1 minute score
Pediatric Patients v Not “little adults” v Differences in physiology affect drug dosing v Requires equipment and techniques tailored to size, weight, and age
Newborn and Pediatric Assessment v Systematic collection v Utilizing: of clinical data v Objective data v Assessment of the v Assessments data v Formulation of an appropriate treatment plan v Treatment plans v Apgar Score
- Slides: 16