NRP 8TH EDITION UPDATED EVALUATION EXAM
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔what happens in the drug phase? - ✔✔administer epinephrine if HR remains < 100
✔✔what is the pulmonary resistance in fetal lungs? - ✔✔high pulmonary vascular
resistance (high PVR, low SVR)
✔✔blood bypasses the lungs and passes into the aorta via ____ in the neonate? -
✔✔ductus arteriosis
✔✔What is the single and most important step in the neonatal resuscitation? -
✔✔ventilation:
Newborn arrest r/t respiratory failure
Very few newborns will require chest compressions or medication
Learning how to provide PPV is the foundation of NRP
✔✔What 3 questions will you ask to help determine if the baby will need resuscitation? -
✔✔what is the expected gestational age, is the amniotic fluid clear, what is the umbilical
cord management plan
✔✔risk factors for resuscitation? - ✔✔§ Gestational age < 36 0/7 weeks
§ Gestational age > or = to 41 0/7 weeks
§ Preeclampsia or eclampsia
§ Maternal hypertension
§ Multiple gestation
§ Fetal anemia
§ Polyhydramnios
§ Oligohydramnios
§ Fetal hydrops
§ Fetal macrosomia
§ IUGR
§ Significant fetal malformation or anomalies
§ No prenatal care
§ Emergency cesarean delivery
§ Forceps or vacuum-assisted delivery
§ Breech or other abnormal presentation
§ Category 2 or 3 fetal heart rate pattern
§ Maternal general anesthesia
§ Maternal Magnesium therapy
§ Placental abruption
§ Intrapartum bleeding
§ Chorioamnionitis
§ Opioids administered to mother w/in 4 hours of delivery
§ Shoulder dystocia
, § Meconium-stained amniotic fluid
§ Prolapsed umbilical cord
✔✔Who should attend a normal birth? - ✔✔At every birth, at least ONE qualified
provider skilled in initial steps of newborn care and PPV
✔✔Who attend birth if RISK FACTORS are present? - ✔✔If risk factors are present, at
least TWO qualified providers to solely manage baby
✔✔Who should be present for every neonate resuscitation? - ✔✔Qualified team with full
resuscitation skills be immediately available for every resuscitation (FOUR or more
providers)
✔✔Who should be present for birth when meconium-stained fluid is the only risk factor?
- ✔✔When meconium-stained fluid is the only risk factor, at least TWO qualified
providers must be present from time of birth to manage baby. Provider with intubation
skills be immediately available.
✔✔What should you use when checking supplies and equipment before every birth? -
✔✔standardized equipment checklist
✔✔identify items on the standardized checklist for essential supplies - ✔✔Warm:
preheated warmer, warm towels or blankets, temperature sensor and sensor cover for
prolonged resuscitation, hat, plastic bag or warm and thermal mattress for < 32 weeks'
gestation
Clear airway: bulb syringe, 10F or 12F suction catheter with wall suction set to 80-100
mm Hg, tracheal aspirator
Auscultate: stethoscope
Ventilate: flowmeter set to 10L, oxygen blender set to 21% (21-30% if < 35 weeks'),
PPV device, term- and preterm-sized masks, 8F orogastric tube and mL syringe,
laryngeal mask (size 1) and 5-mL syringe, 5F or 6F orogastric tube if insertion port
present on laryngeal mask, access to cardiac monitor and leads
Oxygenate: equipment to give free-flow oxygen, pulse ox, target oxygen saturation table
Intubate: laryngoscope with size-0 and 1 straight blades (size 00 optional), stylet
(optional), ETT (size 2.5, 3.0, and 3.5), CO2 detector, measuring tape and/or ETT
insertion depth table, tube securement tape/device, scissors
Medicate: 0.1 mg/mL epinephrine, normal saline for volume expansion and flush (100 L
or 250 mL bag) or prefilled syringes, supplies for placing emergency umbilical venous
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔what happens in the drug phase? - ✔✔administer epinephrine if HR remains < 100
✔✔what is the pulmonary resistance in fetal lungs? - ✔✔high pulmonary vascular
resistance (high PVR, low SVR)
✔✔blood bypasses the lungs and passes into the aorta via ____ in the neonate? -
✔✔ductus arteriosis
✔✔What is the single and most important step in the neonatal resuscitation? -
✔✔ventilation:
Newborn arrest r/t respiratory failure
Very few newborns will require chest compressions or medication
Learning how to provide PPV is the foundation of NRP
✔✔What 3 questions will you ask to help determine if the baby will need resuscitation? -
✔✔what is the expected gestational age, is the amniotic fluid clear, what is the umbilical
cord management plan
✔✔risk factors for resuscitation? - ✔✔§ Gestational age < 36 0/7 weeks
§ Gestational age > or = to 41 0/7 weeks
§ Preeclampsia or eclampsia
§ Maternal hypertension
§ Multiple gestation
§ Fetal anemia
§ Polyhydramnios
§ Oligohydramnios
§ Fetal hydrops
§ Fetal macrosomia
§ IUGR
§ Significant fetal malformation or anomalies
§ No prenatal care
§ Emergency cesarean delivery
§ Forceps or vacuum-assisted delivery
§ Breech or other abnormal presentation
§ Category 2 or 3 fetal heart rate pattern
§ Maternal general anesthesia
§ Maternal Magnesium therapy
§ Placental abruption
§ Intrapartum bleeding
§ Chorioamnionitis
§ Opioids administered to mother w/in 4 hours of delivery
§ Shoulder dystocia
, § Meconium-stained amniotic fluid
§ Prolapsed umbilical cord
✔✔Who should attend a normal birth? - ✔✔At every birth, at least ONE qualified
provider skilled in initial steps of newborn care and PPV
✔✔Who attend birth if RISK FACTORS are present? - ✔✔If risk factors are present, at
least TWO qualified providers to solely manage baby
✔✔Who should be present for every neonate resuscitation? - ✔✔Qualified team with full
resuscitation skills be immediately available for every resuscitation (FOUR or more
providers)
✔✔Who should be present for birth when meconium-stained fluid is the only risk factor?
- ✔✔When meconium-stained fluid is the only risk factor, at least TWO qualified
providers must be present from time of birth to manage baby. Provider with intubation
skills be immediately available.
✔✔What should you use when checking supplies and equipment before every birth? -
✔✔standardized equipment checklist
✔✔identify items on the standardized checklist for essential supplies - ✔✔Warm:
preheated warmer, warm towels or blankets, temperature sensor and sensor cover for
prolonged resuscitation, hat, plastic bag or warm and thermal mattress for < 32 weeks'
gestation
Clear airway: bulb syringe, 10F or 12F suction catheter with wall suction set to 80-100
mm Hg, tracheal aspirator
Auscultate: stethoscope
Ventilate: flowmeter set to 10L, oxygen blender set to 21% (21-30% if < 35 weeks'),
PPV device, term- and preterm-sized masks, 8F orogastric tube and mL syringe,
laryngeal mask (size 1) and 5-mL syringe, 5F or 6F orogastric tube if insertion port
present on laryngeal mask, access to cardiac monitor and leads
Oxygenate: equipment to give free-flow oxygen, pulse ox, target oxygen saturation table
Intubate: laryngoscope with size-0 and 1 straight blades (size 00 optional), stylet
(optional), ETT (size 2.5, 3.0, and 3.5), CO2 detector, measuring tape and/or ETT
insertion depth table, tube securement tape/device, scissors
Medicate: 0.1 mg/mL epinephrine, normal saline for volume expansion and flush (100 L
or 250 mL bag) or prefilled syringes, supplies for placing emergency umbilical venous
