This quiz reviews the material on Neonatal anesthesia for Principles 2. Quizzes come mostly from notes, with some from the book.
Neonate
Infant
Child
Newborn
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90%
70%
80%
60%
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Anterior and Cephalad Larynx
Long Epiglottis
Narrow Nasal Passages
Decreased Right Ventricular Compliance
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10 mg
7.5 mg
5 mg
20 mg
Ductus Arteriosis
Ductus Venosus
Foramen Ovale
Iliac Arteries
Ductus Arteriosus
Ductus Venosus
Foramen Ovale
Pulmonary Artery
Left Atria
Both are equal
Left Ventricle
Right Ventricle
Transient Tachypnea
Persistant Pulmonary Hypertension
Meconium Aspiration
Cesarean Infants are not at an increased for any complications.
Transient Tachypnea of the newborn
Persistant Pulmonary Hypertension
Hyperbilirubinemia
Pneumonitis of infancy
Lower Lung Compliance
Cardiac output dependent on Heart rate
Increased FRC at birth
Higher total body water content
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True
False
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RR 62 HR 145 BP 76/40
RR 10 HR 62 BP 58/30
RR 22 HR 120 BP 135/ 82
RR 28 HR 130 BP 72/40
14 mg
0.14 mg
0.07 mg
0.7 mg
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Can lead the reopening of the Forman Ovale
Due to hyperactive vagal activity it will cause the premature infant to become bradycardic
Due to size of the airway we are more likely to cause severe damage to the esoaphagus and vocal cords.
May lead to HTN and rupture of intracerebral vessels.
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A child with pyloric stenosis who has been persistently vomitting
1 day old child born to a diabetic mother, weighing 13 lbs.
A child born with hydrocephalus going in for emergent Shunt placement
A newborn with Meningomyelocele going in for repair, NPO for 6 hours.
By increasing SVR and HR to constrict peripheral vessels and direct blood to their core
Through metabolism of brown fat.
Through Shivering to generate heat and energy within tissues.
All The Above.
Sux 10mg IV
Glyco 0.05mg IV
Lidocaine 7.5 mg IV
Nitrous oxide 70%
When the child is still drowsy, but maintaining an adequate RR and Todal Volume.
When the child can lift their head off the bead for 5 seconds and grasp your finger.
When the child begins to move, regardless of eye opening (babies just aren’t cooperative here)
When the child is attempting to cry, grab tube and their eyes are open
90 ml
110 ml
50 ml
185 ml
160
180
120
40
Sux 32 mg IM
Rocuronium 8mg IV
Pavulon 0.8 mg IV
Cisatracurium 4mg IV
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Administer Sux 2mg/kg IV
Give racemic epinephrine treatment
Give 100% Oxygen via facemask and apply jaw thrust
Flick bottom of childs feet to stimulate vagal nerve.
True
False
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Because of their immature respiratory control center which will cause apnea if arterial O2 tension becomes too high
Because of the risk of retinopathy of prematurity
Because of the risk of causing the Ductus Arteriosis & Forman Ovale to reopen
Because you don’t feel like it.
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Desflurane
Propofol
Ketamine
Pancuronium
Higher
Lower
Roughly Equal
Immediately so you can give pre-op meds
This child does need an IV for a minor procedure
Give Midazolam PO and then start the IV before induction
After induction when the patient is asleep, hunt for an IV
Stimulate the angle of the jaw
Pick up the child and shake them
Call for a crash cart and begin chest compressions
Reintubate the child and take them to PACU to be extubated later.
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As soon as I wheel her out of the OR you can take her!
We will most likely keep her overnight on a pulse oximeter just to watch her.
We will watch her in the PACU for 2-3 hours after the procedure and then she may go home.
NEVER!! She isn’t really expected to survive this. You may want to call Goodwill to take the crib now.
3-3.5
2-2.5
4-4.5
None of above
TE Fistula repair
Shunt procedure for hydrocephalus
Intestinal Obstruction Repair
Omphalocele repair
CNS disorders
GI Disorders
Cardiac Defects
GU disorders
Tracheoesophageal fistula
Gastroschisis
Pyloric Stenosis
Congenital diaphragmatic Hernia
Due to abnormal gastric anatomy, NG tubes should NOT be placed prior to surgery.
N2O is contraindicated in these cases, due to ability to expand the bowel in the chest.
High levels of positive pressure are necessary to maintain oxygenation in hypoplastic lungs.
The patient may easily be extubated immediately post-op when the pressure within the chest is relieved.
Omphalocele
Congenital Diaphragmatic Hernia
Gastroschisis
Tracheoesophageal Fistula
A
B
C
D
Congenital Diaphraghmatic Hernia
Intestinal Obstruction
Gastroschisis
Tracheoesophageal Fistula
An NG tube should be inserted to decompress the stomach and decrease risk of aspiration
The ETT should be placed between the fistula and the carina
Surgical retraction commonly causes a main stem bronchi to collapse, and the surgeon should redraw retractors.
Post-op ventilation is considered the norm as patients are still at risk for complications.
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Sevoflurane
Etomidate
Ketamine
Propofol
Positive pressure ventilation
Antibiotic therapy to treat sepsis
The need for deep sedation with VAA’s and adequate paralysis.
The need for early and aggressive fluid therapy.
It is absolutely contraindicated for the patient to be positioned supine (even with a donut) for induction and intubation due to the risk of causing damage.
No muscle relaxants should be used during surgery.
No nitrous oxide should be used during surgery.
Due to cerebral disease these patients are more prone to apnea and respiratory arrest post-op and should be monitored in a NICU.
Meningomyelocele
CVP placement
Pyloric Stenosis
Necrotizing Enterocolitis
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Hypovolemia and Metabolic Acidosis
Hypernatremia and Respiratory Acidosis
Hyperkalemia and Respiratory Alkalosis
Hypochloremia and Metabolic Alkalosis
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True
False
Chloroprocaine 1% 0.75 ml/kg
Bupivacaine 0.25% 1.25 ml/kg
Lidocaine 2% 0.25 ml/kg
Mepivacaine 1% 0.5 ml/kg
Necrotizing Enterocolitis
Hydrocephalus
Patent Ductus Arteriosus
Bacterial Pneumonia
Make the surgeon aware and ask him to remove retractors until patient BP returns to acceptable levels.
Administer fluid bolus of 10-15 ml/kg of NS or LR to augment volume
Give ephedrine 0.15 mg/kg to raise BP
Place the patient into trendelenburg position to increase venous return.
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Standard Inhalational Induction
Cancel procedure until child is more stable
Rapid Sequence induction
Induce with vecuronium and fentanyl
Quiz Review Timeline (Updated): Mar 21, 2023 +
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