NRP 8th Edition Questions and Answers Rated A+

NRP 8th Edition Questions and Answers Rated A+ Before birth, the alveoli in the fetal lungs are filled with? Air Before birth, oxygen is supplied to the fetus by? The placenta Before birth, most fetal blood... bypasses the fetal lungs After birth, air in the alveoli causes vessels in the babies lungs to... Relax When resuscitating newborns, chest compressions and medications are ________________ needed. Rearly Members of an effective resuscitation team share _____________ information What are the 4 pre-birth questions to ask the OB before every birth? 1- Expected gestational age 2-Amniotic fluid clear 3-Are there additional risk factor 4- What is the umbilical cord management plan Every delivery should be attended by at least 1 qualified person.... whose only responsibility is the management of the newborn. During the pre-resuscitation team briefing you must.... Anticipate potential complications and discuss how responsibilities are delegated. The equipment check includes.... Checking that all supplies and equipment for a complete resuscitation are readily available and functional for every birth. List the 3 rapid evaluation questions. 1- is the baby term? 2- does the baby have good tone? 3- is the baby breathing and crying List the 5 initial steps of newborn care. 1- Warmth 2- Dry 3- Stimulate 4- Position the head and neck 5- Clear secretions if necessary You count the newborn's hearth beat for 6 seconds and 6 beats as.... 60 BPM Oxygen saturation should be 85% to 95% by the how many minutes of age? 10 minutes of age. You have provided warmth, dried, stimulated, cleared secretions, and positioned the head and neck, the baby is still apneic and limp what is the next step? Start PPV and call for help if alone. If a baby is breathing, the heartrate is greater than 100 bpm, the airway is clear and correctly positioned, but the respirations are labored, you may consider what? CPAP (continuous positive airway pressure) the single most important and most effective in neonatal resuscitation is.. Ventilation of the lungs After the initial steps, PPV (positive-pressure ventilation) is indicated if the baby is ______, or if the the baby is _______ or if the baby's heartrate is less than ______ bpm. 1- Apneic 2- Gasping 3- 100 bpm The baby is born limp and apneic. You place the baby under the warmer, dry and stimulate, position the head and neck to open the airway, and suction the mouth and nose. It has been 1 minute since birth and the baby remain apneic. What is the next step? begin PPV (positive-pressure ventilation) For PPV, adjust the airflow to.... 10 L/min Administer PPV at a rate of .... 40-60 breaths per minute. begin PPV with a inflation pressure of... 20-25 cm H2O Ventilation of the term newborn begins with... 21% oxygen If you are using a device that administers positive-end-expiratory pressure (PEEP), the recommended initial pressure is... 5cm H2O You have started PPV for an apneic newborn. the heart rate is 40 bpm and is not improving. Your assistant dies not see chest movement,. You should do what next? Star the ventilation corrective steps Inflation and aeration of the lungs is suggested by a CO2 detector that turns what color? Yellow You have started PPV for an apneic newborn. The heart rate has remained 40bpm despite preforming all of the ventilation corrective steps and ventilating through an endotracheal tube for 30 seconds. Your assistant sees chest movement with PPV you should do what next? Proceed with chest compressions. A laryngeal mask is inserted into the baby's mouth and advanced into the throat until... Makes a seal over the entrance to the baby's trachea. To insert a orogastric tube, measure the distance from the bridge of the nose to the earlobe and from the earlobe... to a point halfway between the xiphoid process and the umbilicus. A newborn has be receiving face mask ventilation but is not improving. Despite preforming the first 5 ventilation corrective steps, the heart rate is not rising and there is poor chest movement. An alternative airway, such as an endotracheal tube or a laryngeal mask, ___________ be inserted immediately. Should be. For babies weighing less than 1 kg, the recommended endotracheal tube size is what? 2.5 If using a stylet, the tip of the stylet (must)/(must not) extend beyond the endotracheal tube's side and end holes. Must not. The preferred laryngoscope blade size for use in a term newborn is... 1 In the photograph which arrow is pointing at the epiglottis? A. You should try to take no longer than _________ seconds to complete the endotracheal intubation procedure. 30 If a baby's condition worsens after endotracheal intubation, list 4 possible causes. 1- Displaced endotracheal tube. 2- Obstructed endotracheal tube. 3- Pneumothorax. 4- Equipment failure. Which image show the correct way to lift the tongue out of the way and expose the larynx? A You have inserted an endotracheal tube and are giving PPV through it. The CO2 detector does not change color and the baby's heart rate is decreasing. The tube is most likely inserted in the __________ Esophagus The 2 most important indications that the endotracheal tube has been inserted in the trachea are demonstrating exhaled ____________ and observing a rapidly increasing _______________. CO2 and increased heart rate. You have inserted a laryngoscope and are attempting intubation. You see the view depicted in the illustrations. The correct action is to... Advance the laryngoscope further. A newborn is apneic at birth. The baby does not improve with the initial steps, and PPV is started. After 30 secs, the heart rate has increased from 40m bpm. Chest compressions ____________ be started. PPV ____________ continue. Compressions SHOULD NOT be started and PPV SHOULD be continued. A newborn is apneic at birth. The baby does not improve with the initial steps or PPV. An endotracheal tube is inserted properly, the chest moves with ventilation, bilateral breath sounds are present, and ventilation has continued for another 30 secs. The heart rate remains 40 bpm. Chest compressions _____________ be started. PPV __________ continue. Compressions SHOULD be started. PPV Should continue. What area would you apply chest compressions on a newborn? Just below the nipples. The correct depth of chest compressions is approximately.... 1/3 of the interior posterior diameter of the chest. The ration of chest compression to ventilation is..... 3 compressions to 1 ventilation What phrased is used to achieve the correct rhythm for coordinating chest compressions and ventilation? 1 and 2 and 3 and breath. You should briefly stop compressions to check the baby's heart rate response after (30 seconds)/(60 seconds) of chest compressions with coordinated ventilations. 60 seconds. Chest compressions can be discontinued when the heart rate is greater than.... 60 bpm Ventilation that moves the chest has be preformed through and endotracheal tube for 30 secs, followed by coordinated chest compressions and 100% O2 for an additional 60 secs. Epinephrine is indicated if the baby's heart rate remains less than..... 60 bpm The preferred route for epinephrine is..... Intravenous. Your team is resuscitating a baby at term. The baby's heart rate is 40 bpm after 30 secs of ventilation through an endotracheal tube and an additional 60 secs of coordinated chest compressions and ventilation using 100% O2. You determine that epinephrine is indicated. Your team should.... Insert an unbiblical venous catheter. The recommended concentration of epinephrine for newborns is.... 0.1 mg/ml The suggested initial intravenous does of epinephrine is... 0.02 mg per kg Intravenous epinephrine should be administered __________________, followed by a _______________ normal saline flush. as quickly as possible/3mL If a baby's heart rate remains below 60 beats per minute, you can repeat the dose of epinephrine every: 3-5 minutes If an emergency volume expander is indicated, the initial dose is... 10 mL per kg You have turned on the radiant warmer in anticipation of the birth of a baby at 27 weeks gestation. List 4 additional steps that will maintain this baby's temperature. 1- Wrap in plastic. 2- Increase room temperature 3- Prepare a thermal mattress 4- Pre-warm a transport incubator. The baby is born at 26 weeks gestation the initial steps of care, including gentle stimulation, have been completed and the baby is nearly 1 min old. The baby is not breathing and the heart rate is 80 bpm. You should start ________________ PPV A baby is delivered at 30 weeks gestation. At 5 mins of age, the baby is breathing, has a heart rate at 140 bpm, and is receiving a CPAP with 30% O2. A pulse ox is reading 95% and is increasing. You should _______________ Decrease the O2 concentration. A self inflating bag or a t-piece resuscitator can provide CPAP for a spontaneously breathing baby. T-Piece You are preparing for the birth of a baby of 34 weeks gestation. You set the PPV so that the peak inflation pressure is __________ and PEEP is __________. 20-25 cm H2O 5 cm H2O Initiate resuscitation of the pre-term baby <35 weeks gestation age with ____________ O2 21-30% You may decrease the risk of neurologic injury in a premature newborn during and after resuscitation by adjusting the baby's bed so that the legs are_________ than the head. Even Compared with term newborns, preterm newborns have a _________ risk of developing hypoglycemia shortly after resuscitating. higher A baby born at 36 weeks gestation received PPV and O2 supplementation in the delivery room. This baby _____________ need frequent evaluation of respiratory effort and oxygenation during the immediate neonatal care. Does If a newborn requires admission to a neonatal intensive care unit, the parent(s) (should)/(should not) be encouraged to see and touch the baby. Should A full term newborn has significant birth depression and required a complex resuscitation. The baby has continued respiratory failure with CO2 retention and metabolic acidosis. Sodium bicarbonate ________________ be infuse immediately after resuscitation. Should not. Among babies who required complex resuscitation and have signs of neurologic injury, aggressive warming and hypothermia ________________ the outcome and should be ____________ Worsens the outcome and should be avoided. A newborn's heart rate is 50 bpm and has not improved with ventilation through a face mask or properly inserted endotracheal tube. The baby's chest is NOT moving either PPV. You should Suction the trachea using a 5F to 8F suction catheter or tracheal aspirator. A newborn has respiratory distress after birth. Baby has a smaller lower jaw and a cleft pallet. The baby's respiratory distress my improve if you insert a small endotracheal tube in the nose, advance it into the pharynx, and position the baby supine on the back or prone on the stomach. Prone. You attended the birth of a baby that received PPV during the first minutes of life. The baby improved and has been monitored in the nursery. A short time later, the baby developed acute respiratory distress. You should suspect a pneumothorax or a congenital heart defect and should rapidly prepare a needle aspiration devices or epinephrine. Pneumothorax Prepare a needle aspiration You attend the birth of a baby with antenatally diagnosed congenital diaphragmatic hernia. Promptly after birth you should: Intubate the trachea and insert an orogastric tube in the stomach. A mother received and opioid for pain relief one hour before delivery. After birth, the baby does not have spontaneous respirations and does not improve with stimulation. Your first priority is to: Start PPV After birth, position a newborn with myelomeningocele on their: Stomach or side. After birth, place a newborn with gastroschisis in a sterile, clear plastic bowel bag and position the baby on their: Right side In conditions associated with a high risk of mortality or significant burden of morbidity for the baby, parents _____________ participate in the decision whether attempting resuscitation is in their baby's best interest: They should The ethical principles of neonatal resuscitation are the _____________ as those followed in resuscitating an older child or adult. Same