Lecture 11 – High-Risk Neonate: RDS, Jaundice, FAS, NAS

Vocabulary flashcards covering RDS, jaundice, FAS, NAS, and related management from the notes.

Respiratory Distress Syndrome (RDS)

Pathophysiology in premature infants due to immature lungs and insufficient surfactant, leading to alveolar collapse, hypoxia, and acidosis.

Surfactant

A lipoprotein that reduces alveolar surface tension; deficiency leads to RDS; replacement therapy improves survival and reduces severity.

Tachypnea

Rapid breathing in a neonate, defined as >60 breaths per minute.

Nasal flaring

Nostrils widen during inspiration, indicating respiratory distress.

Expiratory grunting

Audible grunting during expiration, signaling airway resistance and distress.

Retractions

Inward pulling of the chest wall during inspiration (intercostal or substernal).

Central cyanosis

Bluish discoloration of the lips and tongue due to hypoxemia.

Peripheral cyanosis

Bluish discoloration of the extremities due to poor perfusion.

Ground-glass appearance

Hazy radiographic pattern of the lungs seen in RDS.

Metabolic acidosis

Lowered blood pH due to acid accumulation or bicarbonate loss, often accompanying respiratory distress.

Neutral thermal environment

Maintaining a stable body temperature to prevent cold stress.

Oxygenation

Provision of adequate oxygen to tissues; monitored continuously in neonates.

Parenteral nutrition

Intravenous nutrition used to meet caloric needs and avoid aspiration during feeding.

Surfactant replacement therapy

Administration of exogenous surfactant to improve lung function and survival.

Prevention of RDS

Primary strategy is preventing preterm birth.

Jaundice (Hyperbilirubinemia)

Yellowing of skin and sclera due to elevated bilirubin in the blood.

Physiologic jaundice

Normal jaundice appearing after 48 hours; due to increased RBC breakdown and immature liver; resolves in 7–10 days; bilirubin excreted via stool.

Pathologic jaundice

Jaundice appearing before 48 hours; often due to Rh or ABO incompatibility; infants may be anemic and hypoxic; treated with phototherapy and bilirubin monitoring.

Phototherapy

Light therapy to convert bilirubin into water-soluble forms for excretion.

Fetal Alcohol Syndrome (FAS)

Disorder from excessive maternal alcohol use during pregnancy; growth restriction, CNS dysfunction, and facial anomalies.

FAS facial features

Small palpebral fissures, thin upper lip, flat midface, smooth philtrum.

Neonatal Abstinence Syndrome (NAS)

Withdrawal syndrome in a newborn exposed to drugs in utero.

NAS causes

Maternal use of opioids, cocaine, methadone, benzodiazepines, or other drugs.

NAS manifestations

Tremors, jitteriness, irritability, high-pitched cry, poor feeding, vomiting, diarrhea, sleep disturbances, restlessness, hypertonia, seizures.

Neonatal Abstinence Scoring System

Tool used to monitor withdrawal severity and guide treatment.

Pharmacologic therapy for NAS

Morphine, methadone, or phenobarbital depending on substance and severity.

Nonpharmacologic NAS care

Supportive measures: swaddling, decreased environmental stimuli, frequent small feedings.

Prevention of RDS

Prevent preterm birth as the most effective strategy.