Neonatal Resuscitation and Oxygenation Guidelines, Exams of Javascript programming

Download Neonatal Resuscitation and Oxygenation Guidelines and more Exams Javascript programming in PDF only on Docsity! Neonatal Resuscitation Program (NRP) 184 Questions with Verified Solutions. 1. Neonates needing resuscitation usually have normal __________ - ANS heart 2. The need for resuscitation caused by ____________, either before or after birth. - ANS respiratory failure 3. After birth, respiratory failure occurs if baby does not initiate or cannot maintain effective ______________ - ANS breathing effort 4. The focus of neonatal resuscitation is _______________of the baby's lungs - ANS effective ventilation 5. If the baby is in early respiratory failure, ____________ may be enough. - ANS tactile stimulation 6. Fetal lungs do not participate in ____________ - ANS gas exchange 7. Potential alveoli filled with _________ instead of _________ - ANS fluid, air 8. __________ Vessels that will carry blood to alveoli are tightly constricted to prevent blood flow. - ANS pulmonary 9. The __________ vein supplies O2 which diffuses into fetal blood vessels. - ANS umbilical 10.Most blood is shunted right-to-left via patent ___________ and __________ - ANS foramen oval, ducts arteriosus 11.What is the result after the baby breathes and the umbilical cord is clamped? - ANS Newborn uses lungs (instead of placenta) for gas exchange 12.What is the result after the fluid in the alveoli is absorbed? - ANS Air replaces fluid in alveoli, O2 moves from alveoli into pulmonary blood vessels and CO2 moves into alveoli to be exhaled 13.What is the result of air in the alveoli cause blood vessels in lungs to dilate? - ANS Pulmonary blood flow increases and ducts arteriosus gradually constricts. 14. It may take up to __________ get a newborn's SpO2 greater than 90%. - ANS 10 15. Initially in fetal transition, the blood flow is redistributed away from organs to ____________ and __________ - ANS heart, brain 16. If inadequate gas exchange continues, the fetal heart begins to ____________ and blood to all organs ___________ - ANS fail, decreases 17.Clinical findings in the interruption of fetal transition includes apnea, tachypnea, bradycardia, tachycardia, decreased ___________, low ___________, and low __________ - ANS muscle tone, SpO2, BP 18.A prolonged lack of perfusion and oxygenation can lead to ___________. - ANS organ damage 19.What are the three questions to ask during a newborn initial assessment? - ANS - Is the baby term? - Is the newborn breathing or crying? - Does the newborn have good muscle tone? 20.What are the 5 blocks for the steps in newborn evaluation and resuscitation? - ANS - Initial Assessment - Airway - Breathing - Circulation - Drug 21.What is the question to ask for initial assessment? - ANS Can the baby stay with mom or be moved to radiant warmer for further evaluation? 22.When on the airway block, it is important to establish open __________ and support ___________ respirations. - ANS airway, spontaneous 23.When on the breathing block, it is important to use _________ to assist in breathing if apneic or bradycardia (CPAP or O2 is also acceptable). - ANS PPV 24.When on the circulation block, it is important to due __________ for circulation if PPV is not working. - ANS chest compressions 25.When on the drug block, it is important to administer ___________ for severe bradycardia as PPV and check compressions continue. - ANS Epinephrine 26. It is important in neonatal resuscitation to have a pre-resuscitation team ___________ and establish a team __________ - ANS briefing, leader 27.A team leader orders 1 mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent? - ANS closed-loop communication 52. It is important to position the ____________ and ___________ to open the airway - ANS head, neck 53. In order to open the airway, is important to extend the head and neck into the _____________ - ANS sniffing position 54. If suction is needed you need to suction __________, then __________, and finally suction gently with ___________ syringe - ANS mouth, nose, and bulb 55.Suction catheter pressure should be set at ____________ - ANS 80 to 100 mmHg 56. It is important to prevent __________ heat loss and use brief tactile _________ (i.e., rub back/trunk/extremities). - ANS evaporative, stimulation 57. It is important to give __________ for central cyanosis. - ANS O2 58.Polyethylene plastic should be used for babies who are _________ gestation. - ANS less than 32 wks. 59.Newborns should have __________ respirations and a HR __________ within 1 minute after birth. - ANS spontaneous, greater than 100 60.Reassessment for PPV should happen less than or equal to ____________ - ANS 30 sacs 61.PPV should begin in a newborn if they have _________, __________, and ___________ - ANS - Apnea/gasping - Persistent central cyanosis despite 100% supplemental O2 - HR (auscultate) less than 100 BPM 62.Palpating the __________ is not accurate for obtaining pt.’s HR. - ANS umbilici 63._____________ is a common finding in newborns - ANS Acrocyanosis 64.____________ may be present in healthy babies for several minutes after birth. - ANS Central cyanosis 65.Persistent cyanosis requires ______________ reading to evaluate oxygenation - ANS pulse dosimeter 66. It is important to not use cyanosis to guide ______________ - ANS supplemental O2 67.The normal intrauterine state is ________ and normal state of air-breathing healthy newborns is _________ - ANS 60%, 90% 68.This is blood to the heart and brain from an artery that attaches to the aorta before the ducts arteriosus - ANS Pre-ductal blood 69.The predictable blood measures SpO2 of blood perusing the __________ and __________ - ANS heart, brain 70.What hand does the pulse dosimeter go on for SpO2 of predictable blood? - ANS right hand 71.Supplemental O2 is given via _____________ for spontaneously breathing neonates with low SpO2 for their age. - ANS free flow O2 72.Some things that can be done to maintain target SpO2 range includes adjusting __________ and using a ____________ - ANS FIO2, blender 73.What flow should be used in free flow O2 delivery? - ANS 10 LPM 74. It is important when administering supplemental O2 to start with _________ and titrate, and if a newborn requires a prolonged use of O2 it needs to be hooked up to ____________ and ___________ - ANS 30%, heat, and humidification 75. If the newborn has labored breathing or low SpO2, then the pt. needs to be placed on ___________ or ___________ - ANS CPAP or PPV 76.This type of ventilation is used to maintain FRC - ANS CPAP 77.CPAP is only used in delivery room if the baby is __________ and has a HR of __________ - ANS breathing, less than 100 BPM 78.CPAP can be done using ______________ and ___________ resuscitator. - ANS flow-inflating bag, T-piece 79.CPAP and free-flow O2 cannot be given via ____________ - ANS self-inflating bag 80.With vigorous newborn, use ___________ while baby is with mom to gently clear mouth and nose of secretions. - ANS bulb syringe 81.A non-vigorous newborn has ___________ respirations or __________ tone. - ANS depressed, poor muscle 82.Non-vigorous newborns need to be placed under a ___________ and perform initial steps, use __________ to clear mouth and nose, and begin PPV for HR ___________ or ___________ - ANS radiant warmer, bulb syringe, less than 100, apnea 83.___________ suctioning no longer recommended immediately after birth. - ANS tracheal 84.____________ is the single most important and effective step of neonatal resuscitation. - ANS Ventilation 85.A ____________ fills with spontaneously with gas - ANS self-inflating bag 86.A ____________ only fills with gas from a compressed source - ANS flow- inflating bag (anesthesia bag) 87.A ___________ directs compressed gas toward the baby when an opening on top is occluded. - ANS T-piece resuscitator 88.Some indications of PPV in a newborn includes __________, _____________, HR less than __________, or SpO2 less than targeted range despite free-flow O2 or CPAP - ANS apnea, gasping, 100 89.When using a T-piece resuscitator, the RT can set a specific ___________ and ________ - ANS PEEP, PIP 90. If the hole on a T-piece resuscitator is not being covered, it is just giving the pt. __________ - ANS CPAP 91.What FIO2 should be used on newborns that are greater than or equal to 35 wks. gestation? - ANS 21% 92.What FIO2 should be used on newborns that are less than 35 wks? gestation? - ANS 21% to 30% 93.All bag-mask ventilation devices should be set at __________ - ANS 10 L/min 94.What should the RR be set at for PPV of a newborn? - ANS 40 to 60 BPM 95.What should the initial PIP be set at in PPV of a newborn? - ANS 20 to 25 cmH20 96.Full term babies may need a PIP of _________, and then gradually decrease. - ANS 30 to 40 cmH2O 97.Why do you want to set PIP at lower pressures for preterm neonates? - ANS If you have a baby less than 25 wks. You want to start with lower pressures and work your way up to prevent a pneumothorax from occurring. 119. Stop intubation attempt for severe __________ or decreased ___________, and try to decrease the amount of attempts taken. - ANS bradycardia, SpO2 120. What is the equation for ETT insertion depth? - ANS ETT insertion depth = weight in kg + 6 121. Why cuffed ETT not used in the intubation of newborns? - ANS Using a cuffed ETT can cause damage to the baby's trachea due to excessive pressure 122. Laryngeal mask airways do not require _________ against face, bypasses _________, and does not require visualization of _________ for placement. - ANS tight seal, tongue, vocal cords 123. Some limitations when it comes to the use of LMA includes _____________ secretions, high ventilation pressures, __________, intratracheal measurements, and use in neonates less than ___________ - ANS suctioning, chest compressions, 1500 g 124. Newborns with congenital anomalies involving mouth, lip, tongue, palate, or neck, cannot get a good _________ - ANS seal 125. An indication of chest compressions in a neonate includes a HR less than __________ after greater than ________ of PPV - ANS 60, 30 126. Chest compressions should be performed on the lower ______ of the sternum with the thumbs. - ANS 1/3rd 127. Compressions should depress the sternum about _______ AP diameter. - ANS 1/3 128. How many compressions should be done per minute? - ANS 90 129. _____ Compressions: _____ ventilation - ANS 3, 1 130. How much FIO2 should be used during chest compressions? - ANS 100% 131. Assess fetal HR after initial ________ seconds of chest compressions, chest compressions should be stopped for HR greater than ________ BPM - ANS 60, 60 132. How many events should be done per minute during neonatal chest compressions? - ANS 120 133. With a HR less than 60 BPM after 60 seconds of compression, you should continue compressions, see is the chest is moving, listen for _____________, use of __________ O2, ensure compression depth and rate, and administer _________ - ANS bilateral BS, 100%, epinephrine 134. Epinephrine is a _________ and __________ stimulant - ANS cardiac, vascular 135. Epinephrine causes blood vessels to ___________ and will increase blood flow to restore cardiac function. - ANS constriction 136. Epinephrine increases rate and strength of __________ contractions - ANS cardiac 137. When is the use of epinephrine indicated in the resuscitation of the newborn? - ANS If the patient has a HR of less than 60 BPM after greater than 30 sacks of PPV with chest movement and 60 seconds of coordinated compressions and ventilation 138. A need for meds occurs when blood flow into __________ is severely decreased, resulting in such a low O2 delivery to newborn's heart that it can't contract effectively - ANS coronary arteries 139. Epinephrine improves coronary artery _________ and _______ delivery. - ANS perfusion, O2 140. What is the concentration of Epinephrine? - ANS 0.1 mg/mL 141. What are the two ways to administer epinephrine? - ANS IV (or intraosseous) or Endotracheal 142. What is the dosing for epinephrine when used through an IV or intraosseous? - ANS 0.1 to 0.3 mL/kg (0.01 to 0.03 mg/kg) 143. What is the dosing for epinephrine when used through an endotracheal? - ANS 0.5 to 1 mL/kg (0.05 to 0.1 mg/kg) 144. Epinephrine needs to be administered _________ and ___________ route is the most preferred route of epinephrine - ANS rapidly, IV 145. It is important to follow ETT route of epinephrine with several ___________ breaths. - ANS PPV 146. After the administration of epinephrine, it is important to continue coordinated ___________ and PPV with _______ O2 and assess HR 1 minute after administration. - ANS compressions, 100% 147. If the HR is still less than 60 seconds after the administration of epinephrine, it is important to repeat the dose every _____________ - ANS 3 to 5 minutes 148. If the HR is still less than 60 seconds after the administration of epinephrine, it is important to consider ____________ subsequent doses, other problems (i.e. hypovolemia and tension pneumothorax), check ____________, ETT, ___________, and minimize interruption in compressions. - ANS increase, ventilations, chest compression depth 149. Some causes of hypovolemic shock includes acute fetal-maternal ____________, bleeding vasa prevail, extensive ___________, placental laceration, petal trauma, umbilical cord ________, and blood loss from umbilical cord. - ANS hemorrhage, vaginal bleeding, prolapse 150. Some symptoms of hypovolemic shock includes ___________, __________ capillary refill, and _________ pulses. - ANS pale, delayed, weak 151. Some indications for volume expansion includes no response to resuscitation and signs of __________ or history of acute _____________ - ANS shock, blood loss 152. What are two types of expanders used? - ANS - Crystalloid fluid - RBCs 153. What is the dose for volume expanders? - ANS 10 mL/kg 154. Volume expanders are administered via ____________ or ___________ needles. - ANS Umbilical vein catheter, IO 155. Volume expanders are infused over _________ to __________ minutes. - ANS 5 to 10 minutes 156. If the fetal blood has not been cross matched, it is important to use non- cross matched, type ______, Rh __________ RBCs. - ANS O, negative 157. In preterm babies, rapid volume administration may increase risk of __________ - ANS Intraventricular hemorrhage 158. If HR remains absent after ____________ of resuscitation, considerations to stop resuscitative efforts need to be addressed. - ANS 10 minutes 159. In postnatal care, normal physiologic transition continues for several ____________ - ANS hours