Certified Extremely Low Birth Weight Exam Review, Exams of Nursing

Download Certified Extremely Low Birth Weight Exam Review and more Exams Nursing in PDF only on Docsity! Certified Extremely Low Birth Weight Exam Review with 100% correct Answers Describe the typical skin characteristics of an ELBW infant. - Correct answer Thin, sticky, transparent/translucent, gelatinous/red, visible vasculature What is the definition of a very low birth weight (VLBW) infant? - Correct answer Infants weighing between 1000 to 1500 grams at birth extremely low birth weight(ELBW) infants weigh less than _______ at birth - Correct answer 1000 grams T/F. The ears of an ELBW infant have flat pinna with no cartilage and will stay folded when pressed together. - Correct answer True T/F: The plantar surfaces of the feet of ELBW infants is smooth with no wrinkles. - Correct answer True ELBW infants will have _____ amount of lanugo. - Correct answer sparse to none T/F: Genitalia of ELBW infants is underdeveloped. - Correct answer True Describe the posture and tone of an ELBW infant. - Correct answer Hypotonic, Flexible, Passive tone Who should be part of the delivery team for an ELBW infant? - Correct answer Neonatologist/NNP, Respiratory Therapist, Minimum of 1 RN (2 RNs is ideal) What steps should be taken in regard to thermoregulation for an ELBW infant at delivery? - Correct answer Pre-warmed sterile blanket, Plastic bag/wrap (do not dry first), Hat, Warming mattress, Warmer in servo mode at 36.5 degrees Celsius, Room temperature at least 78 degrees F for at least 30 minutes prior to birth (if possible) Where should the pulse oximeter be placed on the infant at delivery for the most accurate Oxygen saturation reading? - Correct answer right wrist (preductal) What are the preductal SpO2 target ranges based on minutes of life? - Correct answer 1 minunte 60 - 65% 2 minutes 65 - 70% 3 minutes 70 - 75% 4 minutes 75 - 80% 5 minutes 80 - 85% 10 minutes 85 - 95% What are the benefits of delayed cord clamping? - Correct answer 1. Improved hemodynamics 2. Decreased IVH 3. Decreased risk for NEC 4. Decreased need for blood transfusion 5. Decreased mortality How should delayed cord clamping be accomplished with an ELBW infant? - Correct answer Delayed for 30 - 60 seconds with infant below level of placenta What is the purpose of the Ballard score? - Correct answer The Ballard score is used to assess gestational age based on physical and neuromuscular maturity When should the Ballard score be completed? - Correct answer The physical maturity assessment should be done within 2 his of birth and the neuromuscular assessment should be done within 24 hours What are the 6 categories of the physical assessment for the Ballard score? - Correct answer 1. Skin 2. Lanugo 3. Plantar surface 4. Beast 5. Eye/Ear 6. Genitalia T/F: ELBW infants should be in an isolette with humidified air for at least the first 14 days of life. - Correct answer True What is Insensible Water Loss (IWL)? - Correct answer Loss of water through evaporation What factors affect IWL? - Correct answer Maturity (IWL inversely proportional to GA and BW) IWL increased: 1. Radiant warmer 2. Phototherapy IWL decreased: 1. High humidity 2. Plastic heat shield Transepidermal water loss in extremely premature infants is highest on the _____ day of life. - Correct answer First What is the most common lab test for renal function? - Correct answer Serum creatinine blood urea nitrogen (BUN) level is a(n) _____ measure of kidney function. - Correct answer Indirect What is the definition of oliguria in an ELBW infant? - Correct answer Less than 0.5 ml/kg/hr If renal insufficiency is suspected, the first diagnostic procedure should be a(n) _____. - Correct answer Renal ultrasound What should be included in the Total Parenteral Nutrition (TPN) for an ELBW infant? - Correct answer 1. Glucose 2. Lipids 3. Amino acids 4. Phosphorus 5. Magnesium What is the daily protein requirement of an ELBW infant? - Correct answer 4 g/kg/day What is the primary complication of TPN? - Correct answer Cholestasis What is the difference between Osteopenia of Prematurity and Rickets of Prematurity? - Correct answer Osteopenia is calcium deficiency and Rickets is vitamin D deficiency What is the accepted normal range for sodium? - Correct answer 134 - 145 mEq/L What is the accepted normal range for potassium? - Correct answer 3.5 - 5.5 mEq/L What are the clinical implications and presentation of hypokalemia? - Correct answer Can affect muscle cells (heart and GI) 1. Cardiac arrhythmias 2. Hypotonia 3. Abdominal distension What is the accepted normal range for calcium? - Correct answer 8.5 - 10.2 mg/dL What are risk factors/clinical manifestations of hypocalcemia? - Correct answer 1. PTB (pre-term birth) 2. Infants of diabetic mothers 3. Perinatal asphyxia 4. Maternal use of anticonvulsants Jitters/Twitching/Seizures What are the risk factors/clinical manifestations of hypercalcemia? - Correct answer Hyperparathyroidism and phosphate depletion 1. Hypotonia 2. Poor feeding 3. Bradycardia What is the accepted normal range for magnesium? - Correct answer 1.5 - 2.5 mg/dL What is the clinical significance of magnesium? - Correct answer Important for hemoglobin formation, wound healing, and host defenses Name several potential causes of hypermagnesemia in an ELBW infant. - Correct answer 1. Maternal administration of magnesium sulfate for preeclampsia 2. Status asthmaticus 3. Enemas 4. Renal failure What is antidote for hypermagnesemia? - Correct answer Calcium gluconate Name several potential causes and clinical presentations of hypomagnesemia in an ELBW infant. - Correct answer Causes: 1. Increased urinary losses 2. Malabsorption 3. Short bowel syndrome 4. Diarrhea Clinical Presentations: 1. Nausea 2. Weakness 3. Hyperreflexia 4. Clonus What is the difference between term and premature human milk? - Correct answer Premature human milk contains: 1. Higher concentrations of protein, sodium, chloride 2. More lipids, trace elements, vitamins, and energy 3. Lower concentrations of phosphorus and calcium 4. Lower osmolality When should breast milk pumping begin after delivery? - Correct answer ASAP (within 6 hours) 4. NAVA 5. HFJV 6 HFOV In caring for an infant on high frequency ventilation, the NICU nurse would do what? - Correct answer Decrease environmental stimuli In caring for an infant on nasal CPAP, the NICU nurse would do what? - Correct answer Assess skin integrity and massage nasal septum every 2 - 4 hours What are the components of a blood gas evaluation? - Correct answer pH pCO2 pO2 HCO2 What is a normal pH for a neonate? - Correct answer 7.35 - 7.45 What is a normal paCO2 for a neonate - Correct answer 35 - 45 What is a normal HCO3 for a neonate? - Correct answer 22 - 26 _____ occurs when there is an increase of CO2 with a normal HCO3. - Correct answer Respiratory acidosis Metabolic acidosis occurs when the CO2 is ______ and the HCO3 is _____. - Correct answer CO2 is normal and HCO3 is decreased A decrease in CO2 (with a normal HCO3) results in _____. - Correct answer Respiratory alkalosis When hydrogen ions are lost and HCO3 is added, but the CO2 remains unchanged, this results in: - Correct answer Metabolic acidosis The following blood gas results are obtained for a 7-hour-old intubated 28- week gestation preterm infant: pH 7.37 pCO2 35 pO2 58 bicarb 22 BE +2 This is _____ - Correct answer Normal blood gas findings The following are blood gas results for an intubated 25-week gestation preterm infant upon admission: pH 7.07 PCO2 75 pO2 58 bicarb 24 BE +4 This is _____ - Correct answer Respiratory acidosis The following are blood gas results for a 3-day-old intubated 25-week gestation preterm newborn: pH 7.27 pCO2 37 pO2 58 bicarb 17 BE -7 This is _____. - Correct answer Metabolic acidosis An infant experiencing acute pain may become tachypneic, which results in _____. - Correct answer Respiratory alkalosis Repetitive unrelieved pain experiences for the neonate can lead to poor outcomes. Research suggests that ELBW and VLBW infants have more pronounced experience due to _____. - Correct answer Incomplete myelination of nerves. Myelination of nerves serves as an insulator for the nerve fiber, thus decreasing the pain experience. What are the most frequently occurring painful procedures in the NICU? - Correct answer 1. Heal sticks 2. Adhesive removal 3. IV sticks 4. Endotracheal and nasal suctioning An infant with renal failure or overwhelming sepsis may result in ______. - Correct answer Metabolic acidosis An infant with a pneumothorax may result in _____. - Correct answer Respiratory acidosis How is the skin of an ELBW infant different from that of a term infant? - Correct answer 1. Immature epidermis and dermis (thin skin) 2. Minimal subcutaneous fat 3. Increased permeability Prevention of skin breakdown in an ELBW infant can be achieved using which techniques? - Correct answer 1. No wrinkles in bedding below infant 2. Use positioning devices 3. Rotate medical devices 4. Pad the IV hub 5. Reposition q 3-4 hours 6. Hydrocolloids/hydrogels 7. Gentle removal of adhesives What is the definition of neonatal sepsis? - Correct answer Systemic bacterial, viral, or fungal infection that occurs in the first 28 days of life with hemodynamic changes that result in significant morbidity or mortality. What organisms are typically associated with neonatal sepsis? - Correct answer 1. E. coli 2. GBS (Group B streptococcus) 3. CoNs (Coagulase-negative staphylococci) 4. Hib (Haemophilus influenzae type b) _____ onset sepsis is usually associated with _____ transmission from mother to infant. - Correct answer Early, Vertical EARLY onset sepsis is usually associated with VERTICAL transmission from mother to infant. List potential maternal and neonatal risk factors for early onset sepsis. - Correct answer Maternal: 1. Intrapartum fever 2. Chorioamnionitis 3. PROM > 18 hours 4. Maternal GBS 2. Hand hugs 3. Use rolls/positioning devices to reduce flexed position 4. Hold infant's hand (stimulates the grasp reflex) 5. Offer pacifier What are some ways to prevent IVH? - Correct answer 1. Avoid sudden or abrupt movements 2. Cluster care/adjust touch times based on sleep cycles 3. Avoid frequent suctioning 4. Avoid lifting legs and hips above the level of the abdomen during diaper changes to reduce increasing intracranial pressure 5. Indomethacin in first 12 hours 6. Slowed IV pump rates What are some maternal factors that could lead to an ELBW infant? - Correct answer 1. Gestational/chronic HTN 2. HELLP 3. Antenatal corticosteroids 4. Magnesium sulfate 5. Maternal analgesia/anesthesia 6. Maternal medications 7. PROM 8. Diabetes 9. Multiple gestation What is the difference between gestational and chronic hypertension? - Correct answer Gestational HTN is diagnosed after 20 weeks gestation Chronic HTN is diagnosed before 20 weeks gestation or before pregnancy What is HELLP? - Correct answer A complication of preeclampsia characterized by: Hemolysis of RBC Elevated Liver enzymes Low Platelets What is the purpose of giving antenatal steroids to the mother? - Correct answer Promote fetal lung maturity in the case of a preterm delivery When can antenatal steroids be administered? - Correct answer 24 - 37 weeks Why is magnesium sulfate given to mothers in preterm labor? - Correct answer Magnesium sulfate has been shown to provide neuroprotection to premature infants to prevent the incidence of CP T/F: All antibiotics are antimicrobials. - Correct answer True T/F: All antimicrobials are antibiotics. - Correct answer FALSE. All antibiotics are antimicrobials but not all antimicrobials are antibiotics. When is it recommended for a mother to receive antibiotics in labor? - Correct answer 1. GBS positive or unknown 2. PROM > 18 hours 3. Temp >100.3 degrees F What are the different types of diabetes in pregnancy? - Correct answer 1. Gestational 2. Type I (insulin dependent) 3. Type II Gestational diabetes is diagnosed between _____ weeks gestation. - Correct answer 24 - 28 weeks What are some potential complications for infants born to diabetic mothers? - Correct answer 1. Fetal death 2. Macrosomia 3. Shoulder dystocia 4. Birth trauma 5. RDS-slower fetal lung maturity 6. Hypoglycemia 7. Heart defects 8. Open neural tube defects 9. Childhood obesity List the different modes of delivery. - Correct answer 1. Vaginal 2. Operative delivery: a. Forceps b. Vacuum c. Cesarean 3. VBAC (vaginal birth after cesarean) Explain the significants of the Patent Ductus Arteriosus (PDA). - Correct answer 1. Diverts fetal blood from pulmonary artery to aorta 2. Post-delivery shunt shifts to a left to right pattern 3. Closure dependent upon oxygen tension and decreasing prostaglandins (should close on its own) 4. Hemodynamically significant if HR > 170, RR > 70, bounding pulses, hepatomegaly, and oxygen requirement What is Persistent Pulmonary Hypertension of the newborn (PPHN) - Correct answer 1. Disruption of the normal transition to extrauterine circulation characterized by persistent increased PVR 2. 1-2/1000 live births, mostly term and post term 3. Perinatal risk factors include: MAS, asphyxia, abnormal pulmonary development 4. Causes: RDS, PDA, sepsis, or pneumonia 5. Diagnosed by Echo How is PPHN managed? - Correct answer Management goal is to correct hypoxia and acidosis: 1. Pulmonary vasodilation with oxygen (paO2 >90) 2. High frequency ventilation to prevent barotrauma a. Oxygen b. Mechanical ventilation c. iNo d. ECMO e. Sedation/analgesia f. Metabolic alkalosis g. Hemodynamic support What is cor pulmonale? - Correct answer Right sided heart failure: An enlargement of the right ventricle due to high blood pressure in the arteries of the lungs caused by chronic lung disease What is the definition of apnea? - Correct answer Absence of breathing for 20 seconds Typically bacterial or fungal What is NEC - Correct answer Necrotizing Enterocolitis What are the three mechanisms related to NEC? - Correct answer 1. Intestinal ischemia 2. Bacterial colonization 3. Volume feedings What would you expect to find on assessment of an infant with NEC? - Correct answer 1. Abdominal assessment: distention, visible loop patterns, tenderness, discoloration, diminishing peristalsis 2. Clinically: residuals, lethargy, apnea, bradycardia, blood in stool, temp instability, diminished urine output, poor perfusion What is short gut syndrome? - Correct answer 1. Malabsorption and malnutrition resulting from a surgical bowel shortening 2. Incidence is 2 per million per year 3. Associated with atresia, malrotation, abdominal wall defects, perforations 4. Amount of gut removed and location determines outcomes What is hematopoiesis? - Correct answer The formation, production, and maintenance of blood cells The _____ is the most frequently ordered test in the NICU. It is a simple, accurate, and sensitive method to screen for hematological disorders. - Correct answer Complete Blood Count (CBC) What is the difference between immature and mature neutrophils? - Correct answer Immature neutrophils include promyelocyte, myelocyte, metamyelocyte, and bands Mature neutrophils include polymophonuclear neutrophils What is thrombocytopenia? - Correct answer Acquired disease with serious loss of platelets Platelet destruction can be autoimmune from mother, infection, asphyxia at birth, or neonatal alloimmune (similar to Rh incompatibility) Management -- treat underlying problem, platelet transfusions, IVIG, steroids What is hyperbilirubinemia? - Correct answer Excess of bilirubin in the blood Elevated bilirubin level > 5 mg/dL What is the difference between physiologic and pathologic hyperbilirubinemia? - Correct answer Physiologic develops in 3 - 5 days after birth. - Resolves in 7 days for term and 9-10 days for preterm - Unconjugated bilirubin level <12.9 mg/dL Pathologic is present at birth or develops within 24 hours - Persists beyond 7 days - Bili > 12.9 mg/dL term - Bili > 15 mg/dL preterm How is hyperbilirubinemia managed? - Correct answer 1. Phototherapy - light and blanket 2. Use of eyeshield 3. Expose as much skin as possible 4. Ensure adequate fluid intake T/F: Natural passive immunity occurs through breastmilk. - Correct answer True What is the difference between natural and artificial active immunity? - Correct answer Natural active immunity occurs as an immune response to an antigen or infection Artificial active immunity occurs via inoculation wiht an antigen (vaccine) What are key aspects of the nurse's role in infection prevention in the NICU? - Correct answer 1. Hand washing practices 2. Visitors and illnesses 3. Infant assessment for early, subtle signs of infection 4. Vigilant cleaning of environment What are the most common forms of neonatal infection? - Correct answer 1. Sepsis 2. Meningitis 3. Pneumonia 4. UTI 5. Neonatal conjunctivitis 6. GI T/F: GBS, staphylococcus aureus, and listeria are examples of gram- positive pathogens. - Correct answer True Give six examples of gram-negative organisms - Correct answer 1. E. coli Haemophilus influenzae 3. Klebsiella pneumoniae 4. Pseudomonas aeruginosa 5. Serratia marcescens 6. Enterobacter cloacae List 6 viral pathogens common in neonatal infection. - Correct answer 1. Rubella 2. CMV 3. RSV 4. Herpes 5. HIV 6. Hepatitis B Cytomegalovirus (CMV) is often transmitted to humans via _____. - Correct answer Infected cat feces What is the I/T ratio? - Correct answer Immature/Total neutrophil ratio Increase in I/T ratio or left shift reflects an increase in immature neutrophils I/T ratio > 0.2 suggests infection T/F: Septic shock is typically associated with gram-negative organisms. - Correct answer True 4. Bulging fontanel What are the functions of the thyroid gland? - Correct answer 1. Concentrate and store iodide 2. Synthesize thyroglobulin 3. Synthesize and release thyroid hormones What is transient hypothyroxinemia of prematurity? - Correct answer Caused by immaturity of thyroid hormone metabolism Low T4 and free T4, normal to low TSH level What are the adrenal glands? - Correct answer Located at the superior poles of the kidneys Composed of two organs: 1. Adrenal medulla produces and stores catecholamines 2. Adrenal cortex produces steroids (glucocorticoids, mineralocorticoids, and adrogens) What is adrenal insufficiency of prematurity? - Correct answer A limited ability of the adrenal glands to maintain cortisol homeostasis in the early days of life resulting in low serum cortisol and normal, or exaggerated pituitary response What skin precautions should be taken with an ELBW infant? - Correct answer 1. Use adhesive remover approved for ELBW infants 2. Use sterile saline to remove any chlorhexidine or betadine/iodine following procedures to avoid risk of chemical burns 3. Emollient should not be used routinely 4. First few weeks of life ELBW infants should be bathed in warm sterile water What is a hemangioma? - Correct answer Raised, soft, bright red tumor located on the head, neck, trunk, or extremities Caused by proliferation of capillaries occupying the dermal and subdermal layers in association with endothelial proliferation T/F: Hemangiomas are more common in preterm infants. - Correct answer True (10 - 15%) T/F: It is normal for hemangiomas to increase in size over the first 6 months. - Correct answer True What is periventricular/intraventricular hemorrhage (IVH)? - Correct answer Occurs once subependymal germinal matrix hemorrhage extends into lateral ventricles What are some risk factors for IVH? - Correct answer 1. Prematurity 2. Arterial blood pressure swings 3. Low 5-minute APGAR 4. Acidosis 5. Rapid administration of sodium bicarb or volume expanders 6. RDS requiring ventilation What is the incidence for IVH in ELBW infants? - Correct answer 40 - 60% Describe the clinical presentation of IVH. - Correct answer 1. Sudden deterioration 2. Oxygen desaturation 3. Bradycardia 4. Metabolic acidosis 5. Tense fontanelle 6. Shock What is post hemorrhagic hydrocephalus? - Correct answer Progressive dilation of the ventricles after IVH caused by injury to the periventricular white matter Can be acute or chronic Develops in 50% of surviving infants with IVH May resolve spontaneously or remain spastic List the treatment options for post-hemorrhagic hydrocephalus? - Correct answer Treatment depends on severity. 1. Serial lumbar punctures 2. Administer Lasix and Diamox to reduce CSF production 3. Consider VP shunt 4. Provide family support What is periventricular leukomalacia (PVL)? - Correct answer Ischemia and necrosis of periventricular white matter in the 'watershed' area of the brain Number, size, and location of lesions determine outcome which is frequently spastic dysplasia How is hip dislocation assessed in a neonate? - Correct answer 1. Assess for asymmetrical creases of buttocks and thighs due to shortened adductor muscles 2. Uneven knee levels when positioned supine with feet flat and knees flexed (positive Galeazzi sign) 3. Ortolani Maneuver and Barlow Maneuver determine hip dislocation Describe the Barlow and Ortolani maneuvers. - Correct answer Barlow: Pressure form front causes palpable dislocation of the femoral head Ortolani: When the femoral head is relocated to the hip joint, an audible 'clunk' confirms developmental dysplasia of the hip (DDH) What is the treatment for developmental dysplasia of the hip (DDH)? - Correct answer Pavlik harness to immobilize infant in flexed position How is acute renal failure defined? - Correct answer Abrupt and severe decrease in urine output, rise in BUN & creatinine Prerenal failue--hypoperfusion of nromal kidney Postrenal failure--obstruction to urine flow Intrinsic--renal cellular damage due to prerenal condition, use of nephrotoxic drugs, or congenital anomalies What is a common management protocol of acute renal failure? - Correct answer 1. Identify and treat cause 2. Strict I&O 3. Daily weight 4. Monitor BP, electrolytes, nutrition What are risk factors for ROP? - Correct answer 1. Prematurity 2. Supplemental oxygen 3. Patent Ductus Arteriosus 4. Ventilatory support 5. Hyperglycemia 6. More common in males When should ROP exams be performed for ELBW infants? - Correct answer 1. Should be performed at 4 weeks of life or 31 weeks (whichever is the latest) 2. Repeat every 2 weeks if no ROP 3. Repeat weekly if ROP is present 4. Repeat twice weekly if pre ROP or rapidly progressing ROP is diagnosed What are the treatment options for ROP? - Correct answer 1. Laser therapy 2. Cryotherapy 3. Medications: Bevacizumab (Avastin)--stops overgrowth of retinal blood vessels What is the difference between laser therapy and cryotherapy for ROP? - Correct answer Laser therapy: 1. Burns away the area around the edge of the retina 2. Saves sight in the middle visual field by may reduce peripheral vision Cryotherapy: 1. Freezes the specific part of the eye that extends beyond the edges of the retina 2. Destroys some peripheral vision What is antibiotic stewardship? - Correct answer Antibiotics should be discontinued if cultures are negative at 48 hours. If positive, antibiotics should be narrowed to treat specific microbes and used for the minimum amount of recommended time. How can the nurse encourage family-partnered care in the NICU? - Correct answer 1. Share all information with the parents beginning with the prenatal consult 2. Ensure parents are present at rounds and are willing to participate 3. Encourage parents to participate in all cares 4. Let parents make decisions whenever possible Why is the parental role attainment difficult to achieve early on with ELBW infants? - Correct answer ELBW infants that are in very critical condition and at the beginning, parent's participation in care is limited. This can make it challenging for parents to 'feel included' in the care of their ELBW infant. What parent-infant attachment behaviors should be encouraged? - Correct answer 1. Touching 2. Looking at infant 3. Talking to the infant and calling by its name 4. Participating in cares How do the needs of teen parents with an ELBW infant differ from those of other parents? - Correct answer Teen parents have unique needs due to being in a situation that forces them to mature quickly. All will cope differently and may depend heavily on support systems What challenges may be unique to teen parents with an ELBW infant? - Correct answer Teen parents often experience: 1. Loss of their peer support group 2. Disruption with their parents and extended family 3. Suffer emotional distress as they have poor coping skills _____ between the parents and the NICU care team is essential. - Correct answer Shared decision making What is PKU? - Correct answer PKU is phenylketonuria, a rare disorder that prevents the body from properly breaking down a substance called phenylalanine What is the newborn screen (PKU test)? - Correct answer The newborn screen (PKU test) is a blood test done 24 - 72 hours after birth that screens for 21 different metabolic disorders (including PKU) What is the car seat test/challenge? - Correct answer A recommendation of the AAP for infants born less than 37 weeks How is the car seat test/challenge performed? - Correct answer Infant should be observed positioned properly in their car seat for 90 to 120 minutes or length of travel home if longer. If significant desaturation, apnea, or bradycardia is noted, interventions must be performed which may delay discharge What should be included in education to parents regarding car seat safety? - Correct answer 1. All infants should ride rear-facing until age 2 (or they reach ht/wt limits set by manufacturer) 2. Time in car seat should be minimized and used only for travel 3. Parent should observe infant in car seat when possible (use mirror or sit in backseat) 4. Car seat should not be expired What is the purpose of the infant hearing screening? - Correct answer To detect early hearing loss to prevent speech, language, and cognitive delays How is the infant hearing screening performed? - Correct answer Evokes otoacoustic emissions--measures sound waves generated in the inner ear in response to tone bursts generated by small speakers placed in the baby's auditory canal Auditory brainstem response--uses 3 scalp electrodes, measures brain waves generated in response to mechanically generated ticks What is Critical Congenital Heart Defect (CCHD)? - Correct answer A cardiac defect in which surgical or catheter interventional therapy within the first year of life is mandatory to achieve survival Approximately ____ infants per 1,000 live births will be affected by CCHD (Critical Congenital Heart Defects). - Correct answer 1.3 How is the CCHD screening performed? - Correct answer 1. Screen at 24 - 48 hours of life 2. Obtain oxygen saturation readings in right hand and left foot Normal reeding: >95% with < 3% difference between upper and lower extremity