Test Your Neonatal Critical Care Knowledge - page 4

by SteveNNP

15,776 Views | 52 Comments

So, by popular demand..... here is a thread dedicated to questions posed to help increase one's knowledge base in regards to the acute care NICU population. If anyone desperately wants a separate thread dedicated solely to the... Read More


  1. 0
    Well, you want to know if there is any history or suspected history of narcotic abuse. The Narcan would be an antagonist not only to the narcotic from the general anesthesia but also drugs of abuse in the baby's system, sending him into immediate and abrupt withdrawal.
  2. 0
    Giving narcan to a baby that has illegal drugs in their system can cause seizures and in a 29-weeker, then a head bleed. When I did L&D, they always told us never to give narcan to a mom with no prenatal care (may be an illegal drug user). Am I close?
  3. 0
    Abruption can possibly be a result of drug abuse in the mother so Narcan would not be indicated.
  4. 0
    Very good! You guys know your stuff!

    Here's another one.

    Why do we start babies on vanilla TPN or clear IV fluid without electrolytes for the first few days of life?....and what do we look for when getting ready to add electrolytes to TPN?
  5. 0
    Kidney function, right? And also the existing electrolyte balance before giving electrolytes. The first set of lab values is mostly mom's. We wait for more accurate labs within the first 24 hours to have a better look at the BABY's electrolyte balance.
  6. 0
    Never heard it called "vanilla TPN"!! haha
  7. 0
    We start them on vanilla TPN because the kidneys don't have the ability to concentrate urine initially. We look for increased diuresis during the 48-72 hour window before adding electrolytes into the mix.
  8. 0
    Hmm...when we get admits of brand new infants, we give them D10 with calcium...there's also this new thing we're trying out giving them special types of protein for the <1500 gram infants within the first two days of life; something about better brain development.
  9. 0
    Since it's been a year I thought it was time to bring this thread back! I'll start..

    Your patient is a one-week old boy presenting with six episodes of non-bilious vomiting within the last 2 days and reduced urine output for the last 12 hours. He is also lethargic and is feeding poorly. There is no history of fever or diarrhea. His antenatal history is uncomplicated, with a birth weight of 3.2 kg. He was breastfed from birth.

    1. What do you think could be going on?
    2. How should this be treated?
  10. 0
    Sounds like pyloric stenosis. Stabilization with IV fluids is first. Treatment is surgical - pyloromyotomy.


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