newborn and early childhood respiratory disorders
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Newborn and Early Childhood Respiratory Disorders. RT 265 Chapter 33. Childhood Definitions. Neonate Birth to 1 month (first 28 days) Infant 1 month to 1 year (some texts use until 3 rd year) Pediatric 1 year to 12 years (some texts use until 21 st year).

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