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 what are the preferred laryngoscope blade sizes for use in a preterm newborn? - 00 and 0 what block of the NRP algorithm helps you determine whether the baby can stay with the mother or should be moved to the radiant warmer? - rapid evaluation after completing rapid evaluation the next initial steps include? - opening the airway and supporting spontaneous respirations what are the indicators for positive pressure ventilation? - apnea gasping heart rate less than 100 before birth is pulmonary resistance high or low in the fetal lungs? - high what is the single most important and effective step in resuscitation? - ventilation what is newborn resuscitation usually the result of? - respiratory failure before birth what can you assess to help identify which newborns are likely to require resuscitation? - perinatal risk what are perinatal risk factors that increase likelihood of resuscitation? - maternal hypertension fetal anemia prolapsed umbilical cord a qualified team have what full resuscitation skills? - chest compressions PPV endotracheal intubation emergency vascular access and med administration when meconium stained fluid is the only risk factor, how many qualified people should present at the delivery? - at least 2 what is included in the NRP quick equipment checklist? - bulb syringe ETT equipment to give free flow oxygen preheat warmer, towels and blankets what should the flowmeter be set to prepare for ventilation? - 10 L how long should umbilical cord clamping be delayed for eligible babies? - 30 - 60 seconds what are the potential benefits of delayed cord clamping for term and late pre term babies? - neurodevelopment outcomes improved early hematologic measurements what are the 3 rapid eval questions? - term good muscle tone breathing / crying when providing PPV, what is the correct ventilation rate? - 40-60 breaths / min when placing orogastric tube, how do you measure the insertion depth? - bridge of nose to the earlobe and from the ear lobe to a point halfway between the xiphoid process and umbilicus what is the most important indicator of successful PPV? - rising heart rate what does PEEP help acheive? - prevents air spaces from collapsing during exhalation removes fluid stable lung inflation when should you considering a cardiac monitor? - when alternative airway is required PPV required heart rate difficult to auscultate pulse oximetry does not work baby is not vigorous · To ensure immediate access to the laryngeal mask, where should it be located? -