Respiratory Management Flashcards

Which condition is characterized by a persistent right-to-left shunt through the ductus arteriosus and foramen ovale in a term neonate?

Answer: Persistent pulmonary hypertension of the newborn (PPHN)

PPHN involves elevated pulmonary vascular resistance causing right-to-left shunting through fetal channels, bypassing the lungs.

Inhaled nitric oxide (iNO) is used in neonates primarily to:

Answer: Selectively dilate pulmonary vasculature

iNO selectively dilates pulmonary vasculature without systemic effects, reducing pulmonary hypertension and improving oxygenation.

A preterm infant on CPAP has a sudden desaturation with decreased breath sounds on the right. What is the priority action?

Answer: Obtain chest X-ray and prepare for needle decompression

Sudden unilateral desaturation with absent breath sounds suggests pneumothorax, requiring urgent chest X-ray and possible needle decompression.

Which drug is first-line for pharmacologic treatment of apnea of prematurity?

Answer: Caffeine citrate

Caffeine citrate is the preferred first-line methylxanthine for apnea of prematurity due to its superior safety profile and once-daily dosing.

What does a pre-ductal SpO2 greater than post-ductal SpO2 by more than 10% indicate in a neonate?

Answer: Right-to-left ductal shunting consistent with PPHN

A significant pre-to-post-ductal SpO2 gradient indicates right-to-left shunting through the ductus arteriosus, consistent with PPHN.

Bronchopulmonary dysplasia (BPD) in a premature infant is defined by the need for supplemental oxygen at:

Answer: 28 days of life or 36 weeks postmenstrual age

BPD is defined as oxygen requirement at 28 days of life or at 36 weeks postmenstrual age, reflecting chronic lung disease of prematurity.