Neonatal Resuscitation Program (NRP)
practice Study Guide
Questions to ask prior to birth - Answer✔✔-1. what is expected Gestational age, (preterm <38 wks, term
38-41 wks or post-term >41 wks)
2. what is amniotic fluid color (only clear good),
3. what's number of babies expected (twins mebbe more),
4. are any additional risk factors (GDM, miscarriages, preeclampsia, etc.)
When to clamp umbilical cord - Answer✔✔-30-60 seconds after birth for VIGOROUS newborn
Things to look for after birth - Answer✔✔-1. Is the baby term, (if no, bring baby to warmer)
2. does the baby have good muscle tone, (flaccid/extended extremities are bad)
3. is the baby breathing or crying? (if no crying, observe chest for breathing efforts. if vigorous crying,
return to mom)
5 initial steps of care - Answer✔✔-1. Warm,
2. position airway,
3. clear secretions if needed,
4. dry,
5. stimulate
Flow rate for free-flow O2 administration - Answer✔✔-10lpm
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O2 level for free-flow O2 administration - Answer✔✔-30%
Suction setting for newborn - Answer✔✔-80-100mmHg
Antepartum risk factors - Answer✔✔-gestation <36wks or >41wks, pre-eclampsia and eclampsia,
maternal HTN, poly and oligohydramnios, fetal hydrops, macrosomia and IGR, fetal malformations or
anomalies, no prenatal care.
Inpartum - Answer✔✔-Emergency c-section, vacuum assisted delivery, breech or abnormal presentation,
category II or III, maternal anesthesia, mag, or narcs, prolapse cord, shoulder dystocia, meconium
staining, bleeding, placental abruption, chorioamnionitis
Abnormal transition signs and symptoms - Answer✔✔-Apnea, tachypnea, bradycardia, tachycardia,
decreased muscle tone, low SpO2, hypotension
Preductal SpO2 at 1 min - Answer✔✔-60-65%
Preductal SpO2 at 2 min - Answer✔✔-65-70%
Preductal SpO2 at 3 min - Answer✔✔-70-75%
Preductal SpO2 at 4 min - Answer✔✔-75-80%
Preductal SpO2 at 5 min - Answer✔✔-80-85%
Preductal SpO2 at 10 min - Answer✔✔-85-95%
Where to put pulse oximeter on newborn - Answer✔✔-Right hand or wrist (preductal)
Requirements for CPAP on newborn - Answer✔✔-HR >100bpm and spontaneous respirations
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