NRP Exam Questions with Verified
Solutions8
how to confirm correct placement of endotracheal tube? - ANSWERS-- CO2 monitor turns
yellow
- vapor in tube
- no gastric ditaention
- chest movement and breath sounds
- tip o lip measurement- add 6 to newborns estimated weight
- chest x ray
when would you use laryngeal mask. what are its limitations - ANSWERS-- when facial or upper
airway malformation render ventialtion ineffective (ie- cleft palate large tongue, small jaw)
- PPV and intubation not working
- Limitations- cant aspirate meconium, high pressures may lead to air leak, medications may
leak, too big for very preterm babt
what if you are unsuccessful in endotracheal intubation - ANSWERS-- remove larygyscope,
venitlate with PPV, try again.
what should you do if you hear breath sounds over the R side of chest not left after
endotracheal intubation - ANSWERS-- withdraw the tube a little, and listen with stethescope
again.
How do you know the neonate is having secondary apnea? what actions should be taken? -
ANSWERS-If initial stimulation does not lead to increase in heart rate(warming, dry, clearing
airway, stimulate). Continue to further resucitative steps (assisted ventilation (PPV))--> chest
compressions --> medications
, - Heart rate should recover rapidly upon establishing adeqate ventilation
Why are premature babies at increased risk for needing resuscitation measures - ANSWERS--
thin tissues- prone to injury oxygen injury
- fragile brain capillaries that may bleed
- immature organs such as lungs with no surfactant, making ventilation difficult
- higher liklihood of infection
What is evaluation based on when deciding which resucitative steps should take place? -
ANSWERS-- heart rate- (easiest way is through base of umbilical cord)
- oxygenation (color, SpO2 monitoring)
- respirations (breath sounds, chest movement)
What are the first things to assess when a baby is born - ANSWERS-- is the baby term?
- good tone?
- breathing or crying
Describe the basic reuscitation steps - ANSWERS-1) assess- is baby term, good tone, breathing
and crying? if not then bring to warmer and resucitate
2) provide warmth, stimulate, position head and clear airway if necessary, dry, replace wet
towels, evaluate respirations, hear rate and oxygenation (connect spO2 monitor)
3)
a) if heart rate below 100 bpm --> PPV (assited ventilation), if not responding then check if PPV
is being done correctly (MRSOPA)
b) if heart rate is above 100 but labored breathing and cyanotic, monitor with spO2 to confirm
cynaosis, consider CPAP and supplemental oxygen
4) if heart rate below 60- initaite chest compression (3:1 ratio) while also continuing PPV
Solutions8
how to confirm correct placement of endotracheal tube? - ANSWERS-- CO2 monitor turns
yellow
- vapor in tube
- no gastric ditaention
- chest movement and breath sounds
- tip o lip measurement- add 6 to newborns estimated weight
- chest x ray
when would you use laryngeal mask. what are its limitations - ANSWERS-- when facial or upper
airway malformation render ventialtion ineffective (ie- cleft palate large tongue, small jaw)
- PPV and intubation not working
- Limitations- cant aspirate meconium, high pressures may lead to air leak, medications may
leak, too big for very preterm babt
what if you are unsuccessful in endotracheal intubation - ANSWERS-- remove larygyscope,
venitlate with PPV, try again.
what should you do if you hear breath sounds over the R side of chest not left after
endotracheal intubation - ANSWERS-- withdraw the tube a little, and listen with stethescope
again.
How do you know the neonate is having secondary apnea? what actions should be taken? -
ANSWERS-If initial stimulation does not lead to increase in heart rate(warming, dry, clearing
airway, stimulate). Continue to further resucitative steps (assisted ventilation (PPV))--> chest
compressions --> medications
, - Heart rate should recover rapidly upon establishing adeqate ventilation
Why are premature babies at increased risk for needing resuscitation measures - ANSWERS--
thin tissues- prone to injury oxygen injury
- fragile brain capillaries that may bleed
- immature organs such as lungs with no surfactant, making ventilation difficult
- higher liklihood of infection
What is evaluation based on when deciding which resucitative steps should take place? -
ANSWERS-- heart rate- (easiest way is through base of umbilical cord)
- oxygenation (color, SpO2 monitoring)
- respirations (breath sounds, chest movement)
What are the first things to assess when a baby is born - ANSWERS-- is the baby term?
- good tone?
- breathing or crying
Describe the basic reuscitation steps - ANSWERS-1) assess- is baby term, good tone, breathing
and crying? if not then bring to warmer and resucitate
2) provide warmth, stimulate, position head and clear airway if necessary, dry, replace wet
towels, evaluate respirations, hear rate and oxygenation (connect spO2 monitor)
3)
a) if heart rate below 100 bpm --> PPV (assited ventilation), if not responding then check if PPV
is being done correctly (MRSOPA)
b) if heart rate is above 100 but labored breathing and cyanotic, monitor with spO2 to confirm
cynaosis, consider CPAP and supplemental oxygen
4) if heart rate below 60- initaite chest compression (3:1 ratio) while also continuing PPV
