Comprehensive Perinatal & Pediatric Respiratory Care

by Whitaker, Kent

• ISBN13: 9780766813731
• ISBN10: 0766813738
• Edition: 3rd
• Format: Paperback
• Copyright: 2001-02-14
• Publisher: Cengage Learning

Summary

Respiratory students and therapists can learn the latest in respiratory care for newborns and children from this updated book. Readers will study fetal development of the cardiopulmonary system, then learn respiratory care of neonatal and pediatric patients, as well as causes and care of respiratory illnesses. A section devoted to ventilation and oxygenation includes information on both conventional and special techniques. Even topics such as care of parents and home care are discussed in detail. Ten clinical case studies supplement the main text. Key features: ? Corresponds with the new NBRC content outline for the perinatal/pediatric specialty exam ? New section on specialty medical gases ? Practice questions, laboratory exercises, and checklists now located in the book to improve understanding ? Information on conventional and non-conventional ventilators ? Ten clinical case studies support application of content from the main text. (KEYWORDS: respiratory care, respiratory therapy, respiratory therapists, pediatric, perinatal, child respiratory care)

Table of Contents

Preface	xi
Contributing Authors	xiii
UNIT ONE: DEVELOPMENT AND CARE OF THE FETUS: CONCEPTION TO BIRTH	1	(74)
Embryological Development of the Cardiopulmonary System	3	(27)
Embryologic Development of the Fetus	4	(1)
Development of the Pulmonary System	5	(5)
Surface Forces and the Role of Surfactant	10	(5)
Fetal Lung Fluid	15	(1)
Development of the Cardiovascular System	16	(2)
Fetal Circulation	18	(3)
The Development of Baroreceptors and Chemoreceptors	21	(1)
Development and Function of Intrauterine Structures	21	(4)
Summary	25	(5)
Assessment of Fetal Growth and Development	30	(23)
Modalities to Assess Fetal Status	31	(9)
Estimating the delivery Date	40	(1)
Biophysical Tests of Fetal Well-Being	41	(5)
Factors Identifying a High-Risk Pregnancy	46	(1)
Summary	46	(7)
Labor, Delivery, and Physiological Changes After Birth	53	(22)
Parturition	54	(1)
Stages of Normal Labor and delivery	54	(3)
Abnormal Labor and Delivery	57	(10)
Adaptation to Extrauterine Life	67	(4)
Summary	71	(4)
UNIT TWO: CARE OF THE NEONATAL AND PEDIATRIC PATIENT	75	(216)
Techniques of Resuscitation and Stabilization	77	(34)
Overview	78	(1)
When to Resuscitate	78	(6)
Standard Precautions	84	(1)
Steps in Resuscitation	84	(17)
Management of Serum Glucose	101	(3)
Obtaining Umbilical Vessel Blood Samples During Resuscitation	104	(2)
Summary	106	(5)
Assessment of the Neonatal and Pediatric Patient	111	(36)
Anatomic and Physiologic Considerations	112	(1)
Physical Assessment of the Neonate	113	(17)
Physical Assessment of the Pediatric Patient	130	(5)
Neonatal and Pediatric Pulmonary Function Testing (PFT)	135	(6)
Summary	141	(6)
Respiratory Care Procedures	147	(41)
Airway Clearance	148	(8)
Aerosolized Drug Therapy	156	(9)
Suctioning	165	(5)
Oxygen Therapy	170	(13)
Summary	183	(5)
General Considerations of Continuing Care	188	(34)
Thermoregulation	189	(7)
Developmental Needs of the High-Risk Neonate	196	(3)
Skin Care of the Premature Neonate	199	(2)
Fluid and Electrolyte Balance	201	(9)
Neonatal Jaundice	210	(4)
Necrotizing Enterocolitis (NEC)	214	(2)
Summary	216	(6)
Pharmacology in Neonatal and Pediatric Respiratory Care	222	(37)
Introduction	223	(1)
Placental Drug Transfer	223	(2)
Neonatal and Pediatric Pharmokinetics	225	(3)
Medications	228	(7)
Cardiovascular Medications	235	(20)
Effects of Maternal Drug Abuse on the Fetus	255	(1)
Summary	255	(4)
Assessment of Oxygenation and Ventilation	259	(32)
The Basics	260	(1)
Arterial Blood Gas Analysis	260	(6)
Arterial Blood Gas Assessment	266	(7)
Transcutaneous Monitoring	273	(5)
Pulse Oximetry	278	(2)
Capnography/Capnometry	280	(5)
Summary	285	(6)
UNIT THREE: CAUSES AND CARE OF ILLNESS IN PERINATAL AND PEDIATRIC PATIENTS	291	(154)
Perinatal Lung Disease and Other Problems of Prematurity	293	(42)
Consequences of Premature Birth	294	(16)
Processes of Intrauterine Origin	310	(6)
Barotraumatic Diseases: Air Leak Syndromes	316	(3)
Other Respiratory Diseases of the Neonate	319	(8)
Summary	327	(8)
Causes of Persistent Perinatal Illness	335	(27)
Infections	336	(7)
Fetal Immunities	343	(2)
Congenital Anomalies	345	(11)
Respiratory Care of the Patient with Cardiac Defects	356	(1)
Summary	357	(5)
Pediatric Diseases Requiring Respiratory Care	362	(46)
Ventilatory Diseases	363	(15)
Neuromuscular Disorders	378	(8)
Infectious Lung Diseases	386	(3)
Diseases of the Upper Airways	389	(6)
Inhalation of Noxious Gases	395	(2)
Sudden Infant Death Syndrome (SIDS)	397	(1)
Summary	397	(11)
Interpretation of Chest X-Rays	408	(37)
Basic Concepts	409	(2)
Method of Interpretation	411	(10)
Radiographic Findings in Neonatal Lung Pathology	421	(16)
Radiographic Findings in Pediatric Lung Pathology	437	(3)
Summary	440	(5)
UNIT FOUR: MANAGEMENT OF VENTILATION AND OXYGENATION	445	(132)
Concepts of Mechanical Ventilation	447	(27)
Goals of Mechanical Ventilation	448	(1)
Definitions	448	(10)
Clinical Applications	458	(2)
Pressure-Volume Relationships (Compliance)	460	(5)
Pressure-Flow Relationships (Resistance)	465	(2)
Time Constants (Kt)	467	(7)
Management of the Patient-Ventilator System	474	(38)
Indications for Ventilatory Support of the Neonate and Child	474	(2)
Modes of Mechanical Ventilation	476	(1)
Partial Ventilatory Support (PVS)	476	(8)
Full Ventilatory Support	484	(2)
Setting Initial Ventilator Parameters	486	(7)
Volume Versus Pressure-Controlled Ventilation	493	(3)
Changing Ventilator Parameters in Volume and Pressure Ventilation	496	(3)
Hazards of Mechanical Ventilation and How to Avoid Them	499	(2)
Weaning and Extubation	501	(1)
Neonatal Patient	502	(2)
Pediatric Patient	504	(2)
Summary	506	(6)
Common Ventilators and Monitors	512	(45)
Common Neonatal Ventilators	513	(34)
Ventilator Monitors	547	(5)
Summary	552	(5)
Special Procedures and Ventilatory Techniques	557	(20)
Introduction	558	(1)
Surfactant Replacement Therapy	558	(2)
High-Frequency Ventilation (HFV)	560	(4)
Specialty Medical Gases	564	(2)
Extracorporeal Life Support (ECLS)	566	(3)
Partial Liquid Ventilation (PLV)	569	(1)
Negative Pressure Ventilation (NPV)	570	(1)
Summary	571	(6)
UNIT FIVE: TRANSPORT, HOME CARE, AND CARE OF THE PARENTS	577	(80)
Perinatal Transport	579	(19)
History	580	(1)
Types of Transport	581	(5)
Personnel	586	(1)
Equipment	586	(4)
Infant Preparation and Transportation	590	(1)
Special Needs	591	(3)
Summary	594	(4)
Home Care	598	(24)
Overview	599	(2)
Patient Selection	601	(1)
Home Care of the Ventilator-Dependent Child	602	(3)
Home Aerosol Therapy	605	(1)
Chest Physiotherapy and Suctioning	606	(1)
Apnea Monitoring	607	(1)
Oxygen Therapy	608	(5)
Discharge Planning	613	(3)
Discharge	616	(1)
The Effects of Home Care on the Family	616	(1)
Failure of Home Care	617	(1)
Summary	618	(4)
Care of the Parents	622	(13)
Overview	622	(1)
Bonding	623	(1)
Causes of Parental Stress	624	(3)
Understanding Grief	627	(3)
Summary	630	(5)
Clinical Case Studies	635	(22)
Clinical Case Study 1	635	(3)
Clinical Case Study 2	638	(2)
Clinical Case Study 3	640	(2)
Clinical Case Study 4	642	(2)
Clinical Case Study 5	644	(3)
Clinical Case Study 6	647	(2)
Clinical Case Study 7	649	(2)
Clinical Case Study 8	651	(2)
Clinical Case Study 9	653	(2)
Clinical Case Study 10	655	(2)
Appendix A	657	(84)
Appendix B	741	(43)
Appendix C	784	(1)
Appendix D	785	(1)
Appendix E	786	(1)
Appendix F	787	(1)
Appendix G	788	(1)
Appendix H	789