RNC NIC EVALUATION EXAM ACTUAL UPDATED
QUESTIONS AND SOLUTIONS RATED A+
✔✔Causes pulmonary hypoplasia - ✔✔1) conditions that limit lung growth (CCAM, DH)
2) oligohydramnios (thoracic compression)
3) associated congenital malformations (Potters, phrenic nerve absence)
✔✔Normal blood gas results - ✔✔ph 7.35-7.45
PaCO2 35-45
PaO2 50-80
HCO3 22-26
BE -2 to +2
✔✔Vent Setting VT (tidal volume) - ✔✔-Primary factor affecting oxygenation and
ventilation
-should be 4-5 ml/kg
✔✔Vent Settings
-To increase ventilation - ✔✔Increase rate
✔✔Vent settings
-to increase oxygenation - ✔✔Increase FiO2, PEEP, or VT
✔✔Inclusion criteria for ECMO - ✔✔1) GA > 34 weeks
2) BE > 2000 grams
3) reversible lung disease
4) no lethal anomalies or brain injuries
5) IVH Gr 2 or <
6) no significant bleeding issues
✔✔Vent Setting Rate - ✔✔Set rate at 30-40/minute for respiratory failure
Set rate at 20-30/minute for no respiratory failure
Adjust to maintain PCO2 40-50
Rate >40/minute can lead to air trapping
✔✔Vent setting PIP - ✔✔Determines VT and affects PaO2
Determined by weight, GA, lung compliance, & airway resistance
20 is appropriate for most preterm infants
Look at chest wall movement
✔✔Vent Setting PEEP - ✔✔Physiologic PEEP is about 2cm
, Usually set at 4-7cm
>7 can cause air leaks
Aids maintaining FRC
Stabilizes and recruits atelectatic areas
Increase compliance and V/Q mismatch
✔✔Vent setting MAP - ✔✔Average distending pressure throughout complete respiratory
cycle
Major determinant of oxygenation
Increased MAP causes barotrauma
✔✔HFOV parameters - ✔✔1) MAP
2) Amplitude-volume delivered
3) Frequency-3-15 Hz (1 Hz=60 breaths)
✔✔Lasix dose - ✔✔1-2mg/kg IV or po
✔✔Digoxin works by - ✔✔Increasing intracellular calcium leading to a +inotropic effect
which increases contractility
✔✔Beta-lactam antibiotics include and work by - ✔✔PCN & cephalosporins
Lysing bacterial cell walls
✔✔Dexamethasone adverse effects - ✔✔-increased glucose levels
-increase blood pressure
-Poor weight gain
-Increased risk of sepsis
✔✔iNO effects - ✔✔Smooth muscle relaxant.
Promotes relaxation of the pulmonary smooth muscles to facilitate perfusion of the lung
in gas exchange
✔✔iNO side effects - ✔✔May cause methemoglobinemia
& decreased platelet aggregation
✔✔Suggested vent settings for extubation - ✔✔IMV- 10-20/"
PIP- 14-18
Vt - 3.5-5ml/kg
FIO2- 21-30%
✔✔Boot shaped heart on x-ray is diagnostic of - ✔✔Tetrology of Fallot
✔✔CHD's with increased pulmonary bloodflow - ✔✔1) PDA
2) VSD
3) ASD
QUESTIONS AND SOLUTIONS RATED A+
✔✔Causes pulmonary hypoplasia - ✔✔1) conditions that limit lung growth (CCAM, DH)
2) oligohydramnios (thoracic compression)
3) associated congenital malformations (Potters, phrenic nerve absence)
✔✔Normal blood gas results - ✔✔ph 7.35-7.45
PaCO2 35-45
PaO2 50-80
HCO3 22-26
BE -2 to +2
✔✔Vent Setting VT (tidal volume) - ✔✔-Primary factor affecting oxygenation and
ventilation
-should be 4-5 ml/kg
✔✔Vent Settings
-To increase ventilation - ✔✔Increase rate
✔✔Vent settings
-to increase oxygenation - ✔✔Increase FiO2, PEEP, or VT
✔✔Inclusion criteria for ECMO - ✔✔1) GA > 34 weeks
2) BE > 2000 grams
3) reversible lung disease
4) no lethal anomalies or brain injuries
5) IVH Gr 2 or <
6) no significant bleeding issues
✔✔Vent Setting Rate - ✔✔Set rate at 30-40/minute for respiratory failure
Set rate at 20-30/minute for no respiratory failure
Adjust to maintain PCO2 40-50
Rate >40/minute can lead to air trapping
✔✔Vent setting PIP - ✔✔Determines VT and affects PaO2
Determined by weight, GA, lung compliance, & airway resistance
20 is appropriate for most preterm infants
Look at chest wall movement
✔✔Vent Setting PEEP - ✔✔Physiologic PEEP is about 2cm
, Usually set at 4-7cm
>7 can cause air leaks
Aids maintaining FRC
Stabilizes and recruits atelectatic areas
Increase compliance and V/Q mismatch
✔✔Vent setting MAP - ✔✔Average distending pressure throughout complete respiratory
cycle
Major determinant of oxygenation
Increased MAP causes barotrauma
✔✔HFOV parameters - ✔✔1) MAP
2) Amplitude-volume delivered
3) Frequency-3-15 Hz (1 Hz=60 breaths)
✔✔Lasix dose - ✔✔1-2mg/kg IV or po
✔✔Digoxin works by - ✔✔Increasing intracellular calcium leading to a +inotropic effect
which increases contractility
✔✔Beta-lactam antibiotics include and work by - ✔✔PCN & cephalosporins
Lysing bacterial cell walls
✔✔Dexamethasone adverse effects - ✔✔-increased glucose levels
-increase blood pressure
-Poor weight gain
-Increased risk of sepsis
✔✔iNO effects - ✔✔Smooth muscle relaxant.
Promotes relaxation of the pulmonary smooth muscles to facilitate perfusion of the lung
in gas exchange
✔✔iNO side effects - ✔✔May cause methemoglobinemia
& decreased platelet aggregation
✔✔Suggested vent settings for extubation - ✔✔IMV- 10-20/"
PIP- 14-18
Vt - 3.5-5ml/kg
FIO2- 21-30%
✔✔Boot shaped heart on x-ray is diagnostic of - ✔✔Tetrology of Fallot
✔✔CHD's with increased pulmonary bloodflow - ✔✔1) PDA
2) VSD
3) ASD
