RNC-NIC Questions and Answers (2023/2024) (Certified Solutions)

RNC-NIC Questions and Answers (2023/2024) (Certified Solutions) Correct ETT placement T1-T2 level of clavicles Correct UVC placement T 8-9 0.5-1 cm above diaphragm Tip in inf. vena cava Correct UAC placement Low-L3-4 Below renal arteries High-T6-10 Correct PICC placement T3-5 Lower 1/3 of s. Vena cava Normal weight loss of preterm infant 10-15% Healthy term infant requires how many kcal/kg/day for normal growth? 100-120 kcal/kg/day Formula to calculate GIR ml/kg/day x %dextrose 1.44 Normal GIR 4-6 ml/kg/min initially May go as high as 12 Anomalies associated with esophageal atresia SGA VATER synd. -vertebral -imperf anus -renal dysplasia Increased risk of mec plug? -premature -IDM -small left colon -cystic fibrosis Signs of pyloric stenosis Distended stomach on x-ray with little or no gas below duodenum Can palpate "olive" Present at 2 to 3 weeks of life with Bile stained vomiting Normal temp range axillary 36.5 to 37.4°C TTN vs RDS Usually requires less than 40% FI O2 Improves quicker Larger lung volumes Natural diuresis occurs at_____________ hours of age as condition improves 48-72 hours Prolonged rupture of membranes Greater than 18 hours Difference in PaO2 of________ or greater documents ductal shunting 15% With PPHN goal is to keep PaO2 ________or 50 Signs and symptoms of MAS Chest hyperinflated on x-ray Low PaO2 with O2 given Air leaks Prone to PPHN Treatment of micrognathia Prone positioning Oral airway placement Trach in rare cases Generally mandibular growth "catches up" by 6 to 12 months Surgery if significant compromise Micrognathia associated with Pierre Robin syndrome Trisomy 18 Trisomy 21 Cri-du-chat syndrome Causes of pulmonary hemorrhage Prematurity Erythroblastosis Intracranial hemorrhage Asphyxia Aspiration Heart diagnosis, PDA Sepsis Hypothermia Surfactant replacement Treatment of pulmonary hemorrhage Vent and use PEEP to decrease bleeding Transfused PRBC's as needed Treat clotting problems Assess and treat PDA Treat underlying disease processes Apneic event Cessation of respiration for 20 seconds, or less if accompanied by cyanosis, pallor, decreased tone, bradycardia 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