NRP Lesson 3 Questions and Answers Rated A+

NRP Lesson 3 Questions and Answers Rated A+ Flow-inflating bags (will) (will not) work without a compressed gas source. Flow-inflating bags will not work without a compressed gas source. A baby is born apneic and cyanotic. You clear her airway and stimulate her. Thirty seconds after birth, she has not improved. The next step is to (stimulate her more) (begin positive-pressure ventilation). The next step is to begin positive-pressure ventilation. The single most important and most effective step in neonatal resuscitation is (stimulation) (ventilating the lungs). Ventilating the lungs is the most important and effective step in neonatal resuscitation. Label these bags "flow-inflating," "self-inflating," or "T-piece resuscitator." A. flow-inflating; B. self-inflating; C. T-piece resuscitator Masks of different sizes (do) (do not) need to be available at every delivery. Masks of different sizes do need to be at every delivery. Self-inflating bags require the attachment of a(n)_______________ to deliver a high concentration of oxygen. Self-inflating bags require the attachment of an oxygen reservoir to deliver a concentration of oxygen greater than approximately 40%. T-piece resuscitators (will) (will not) work without a compressed gas source. T-piece resuscitators will not work without a compressed gas source. Neonatal ventilation bags are (much smaller than) (the same size as) adult ventilation bags. Neonatal ventilation bags are much smaller than adult ventilation bags. List the principal safety feature for each of the following devices: Self-inflating bag: ___________ and ______________ Flow-inflating bag: ____________________________ T-piece resuscitator: __________ and _____________ -Self-inflating bag: Pop-off valve and pressure gauge -Flow-inflating bag: Pressure gauge -T-piece resuscitator: Maximum pressure relief control and pressure gauge Free-flow oxygen can be delivered reliably through the mask attached to a (flow-inflating bag) (self-inflating bag) (T-piece resuscitator). Free-flow oxygen can be delivered reliably with a flow-inflating bag and T-piece resuscitator, but not through the mask of a self- inflating bag. When giving free-flow oxygen with a flow-inflating bag and mask, it is necessary to place the mask (securely) (loosely) on the baby's face to allow some gas to escape around the edges of the mask. When giving free-flow oxygen, place the mask loosely on the baby's face to allow some gas to escape around the edges of the mask. Before an anticipated resuscitation, the ventilation device should be connected to a(n) ____________, which enables you to provide oxygen in any concentration, from room air up to 100% oxygen. The device should be connected to a blender to enable adjustment of inspired oxygen from 21% to 100%. Resuscitation of the term newborn may begin with ___________% oxygen. The inspired oxygen concentration used during resuscitation is guided by the use of a(n) _____________, which measures oxygen saturation. Resuscitation of the baby born at term may be started with 21% oxygen. Subsequent oxygen concentration should be guided by an oximeter, which measures oxygen saturation. Which baby is positioned properly for positive-pressure ventilation? Position A is the correct position. B and C are overextended and under extended, respectively. Which illustration(s) shows the correct position for assisting positive-pressure ventilation? Illustrations A and B are both correct. You must hold the resuscitation device so that you can see the newborn's __________________ and ____________________. You should be able to see the newborn's chest and abdomen. An anatomically shaped mask should be positioned with the (pointed) (rounded) end over the newborn's nose. An anatomically shaped mask should be positioned with the pointed end over the newborn's nose. If you notice that the baby's chest looks as if he is taking deep breaths, you are (overinflating) (underinflating) the lungs, and it is possible that a pneumothorax may occur. You are overinflating the lungs, and there is danger you will produce a pneumothorax. When ventilating a baby, you should provide positive-pressure ventilation at a rate of ______________ to _____________ breaths per minute. Squeeze the resuscitation bag at a rate of 40 to 60 breaths per minute. Begin positive-pressure ventilation with an initial inspiratory pressure of ___ cm H2O. Begin positive-pressure ventilation with an initial inspiratory pressure of 20 cm H2O. "MR SOPA" stands for: M = __________________ R = __________________ S = __________________ O = __________________ P = __________________ A = __________________ M = Mask adjustment R = Reposition airway S = Suction mouth and nose O = Open mouth P = Pressure increase A = Airway alternative Your assistant assesses effectiveness of positive-pressure ventilation by first assessing the __________ and _________ along with listening for _____________ _______________. If these signs are not acceptable, you should look for __________ movement. Your assistant should note improvement in heart rate and oximetry and listen for breath sounds. You should look for chest movement. Which mask is correctly placed on the newborn's face? Mask A is positioned correctly. You have started positive-pressure ventilation on an apneic newborn. The heart rate is not rising, oxygen saturation is not improving, and your assistant does not hear bilateral breath sounds. List 3 possibilities of what may be wrong. 1. _____________________________________________ 2. _____________________________________________ 3. _____________________________________________ 1. There may be an inadequate seal of the mask on the face, 2. the head may need to be repositioned to open the airway, or 3. secretions may need to be suctioned. If, after performing the ventilation corrective sequence and making appropriate adjustments, you are unable to obtain a rising heart rate or bilateral breath sounds or see chest movement with positive- pressure ventilation, you usually will have to insert a(n) _____________________ or a(n) ________________________. You usually will have to insert an endotracheal tube or a laryngeal mask airway. You have administered positive-pressure ventilation (with bilateral breath sounds and chest movement) for 30 seconds. What do you do if the baby's heart rate is now - Below 60 beats per minute? ___________________________ - More than 60 beats per minute and less than 100 beats per minute but steadily improving with effective positive-pressure ventilation? ____________________________ - More than 60 beats per minute and less than 100 beats per minute and not improving with effective positive-pressure ventilation? ________________________________ - Below 60 beats per minute: Begin chest compressions and consider intubation. - Between 60 beats per minute and 100 beats per minute and improving: Adjust oxygen, gradually decrease pressure as heart rate improves, insert orogastric tube, continue monitoring. - Between 60 beats per minute and 100 beats per minute and not improving: Repeat MR SOPA and consider intubation. Assisted ventilation may be discontinued when 1. _____________________________________________ 2. _____________________________________________ Discontinue assisted ventilation when 1. the heart rate is above 100 breaths per minute and 2. the baby is breathing. If you must continue positive-pressure ventilation with a mask for more than several minutes, a(n) ___________________________ should be inserted to act as a vent for the gas in the stomach during the remainder of the resuscitation. An orogastric tube should be inserted to act as a vent for the gas in the stomach. How far should this orogastric catheter be inserted? ________ cm The orogastric catheter should be inserted 22 cm (10 cm + 12 cm).