Neonatal Resuscitation Program (NRP)
practice Question with Verified Correct
Answers
Questions to ask prior to birth
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
30-60 seconds after birth for VIGOROUS newborn
Things to look for after birth
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
1. Warm,
2. position airway,
3. clear secretions if needed,
4. dry,
5. stimulate
Flow rate for free-flow O2 administration
,10lpm
O2 level for free-flow O2 administration
30%
Suction setting for newborn
80-100mmHg
Antepartum risk factors
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
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
Apnea, tachypnea, bradycardia, tachycardia, decreased muscle tone, low SpO2, hypotension
Preductal SpO2 at 1 min
60-65%
Preductal SpO2 at 2 min
65-70%
Preductal SpO2 at 3 min
70-75%
, Preductal SpO2 at 4 min
75-80%
Preductal SpO2 at 5 min
80-85%
Preductal SpO2 at 10 min
85-95%
Where to put pulse oximeter on newborn
Right hand or wrist (preductal)
Requirements for CPAP on newborn
HR >100bpm and spontaneous respirations
Best way to determine HR
Listen with stethoscope on left side chest for 6 seconds, multiply by 10
If suctioning, do you suction the mouth or nose first?
Mouth
Indications for PPV
Apnea, gasping, HR<100bpm, SpO2 low despite free-flow O2 or CPAP
Preparation for PPV
Clear secretions, position yourself at baby's head, position baby's head and neck
Rate for administering PPV breaths
40-60bpm or "breathe, two, three, breathe..."
practice Question with Verified Correct
Answers
Questions to ask prior to birth
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
30-60 seconds after birth for VIGOROUS newborn
Things to look for after birth
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
1. Warm,
2. position airway,
3. clear secretions if needed,
4. dry,
5. stimulate
Flow rate for free-flow O2 administration
,10lpm
O2 level for free-flow O2 administration
30%
Suction setting for newborn
80-100mmHg
Antepartum risk factors
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
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
Apnea, tachypnea, bradycardia, tachycardia, decreased muscle tone, low SpO2, hypotension
Preductal SpO2 at 1 min
60-65%
Preductal SpO2 at 2 min
65-70%
Preductal SpO2 at 3 min
70-75%
, Preductal SpO2 at 4 min
75-80%
Preductal SpO2 at 5 min
80-85%
Preductal SpO2 at 10 min
85-95%
Where to put pulse oximeter on newborn
Right hand or wrist (preductal)
Requirements for CPAP on newborn
HR >100bpm and spontaneous respirations
Best way to determine HR
Listen with stethoscope on left side chest for 6 seconds, multiply by 10
If suctioning, do you suction the mouth or nose first?
Mouth
Indications for PPV
Apnea, gasping, HR<100bpm, SpO2 low despite free-flow O2 or CPAP
Preparation for PPV
Clear secretions, position yourself at baby's head, position baby's head and neck
Rate for administering PPV breaths
40-60bpm or "breathe, two, three, breathe..."
