NEONATAL RESUSCITATION PROGRAM (NRP) PRACTICE QUESTIONS AND ANSWERS ALREADY PASSED

NEONATAL RESUSCITATION PROGRAM (NRP) PRACTICE QUESTIONS AND ANSWERS ALREADY PASSED 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?