Advanced Neonatal Resuscitation Procedures: A Comprehensive Guide, Exams of Nursing

Download Advanced Neonatal Resuscitation Procedures: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! NRP - advanced What are the 2 primary methods of confirming ETT placement within the trachea? - demonstration of exhaled CO2 and a rapidly rising heart rate What steps are done by the person assisting the intubation? - check tip-to-lip insertion depth check that stylet does not protrude beyond end of ETT listen for increasing heart rate and observe CO2 color change attach leads and begin cardiac monitoring if not already done What is the DOPE mnemonic? - D-displaced tube O- obstructed tube P-pneumothorax E-equipment failure When are chest compressions indicated? - When the heart rate remains less than 60 beats per minute after 30 seconds of positive-pressure ventilation that moves the chest, preferably through an alternative airway (ETT or LMA) What is the depth of chest compressions? - 1/3 of the anterior-posterior diameter of chest What is the preferred way to assess the heart rate when chest compressions are required? - cardiac monitor reassess every 60 seconds for delivery room resuscitation, how do you give epinephrine? - umbilical vein dosage: 0.1 mg/mL or 1 mg/10mL Volume of saline flush after epinephrine? - 3 mL when is administration of volume expander indicated? - baby is not responding to steps of resuscitation and there are signs of shock or a history of acute blood loss what is the dose for the volume expander? - 10 mL/kg how far should the catheter be inserted into the umbilical vein? - 2-4 cm, until you get free flow of blood when the syringe is gently aspirated what is a reasonable time frame after birth for considering cessation of resuscitation efforts when absence of heart rate is confirmed after all appropriate interventions? - 20 minutes why do preterm babies have a higher risk of complication than term babies? - limited metabolic reserves contribute to the risk of hypoglycemia after birth what steps are important for maintaining thermoregulation for all pre term babies? - preheat warmer well before birth place a hat on baby's head maintain axillary temp between 36.5 and 37.5 C set temp in room from 23-25 C ETT sizes for pre term babies - > 28 weeks: 2.5 mm 28-34 weeks: 3 mm 34 weeks gestation PPV settings - PIP: 20-25cm PEEP: 5cm Transillumination for pneumo - light on the side of the pneumo will glow brighter than the opposite side what interventions may alleviate respiratory distress of a baby with robin sequence? - position baby prone insert small ETT into nose, advance into pharynx what is a congenital diaphragmatic hernia? - most common on left side, identified by antenatal ultrasound intestines, stomach and liver can enter chest - prevents lungs from developing normally delivery room management of congenital diaphragmatic hernia - avoid mask PPV - can cause pneumo promptly intubate and insert orogastric tube at birth, presents with scaphoid abdomen, respiratory distress and hypoxemia what special care is required for myelomeningocele (spina bifida)? - involves lower back (lumbar area) - prepare a donut with towels in case baby must be positioned on their back use latex free equipment after birth, place baby on side or stomach to avoid pressure on fluid sac what care is required for abdominal wall defect - gastrochisis? -