NICU RN A V1 SET QUESTIONS AND ANSWERS
SURE A+
✔✔What is the transmission of sepsis - ✔✔-transplacental
-ascending infection
-amniotic fluid exposure
-postnatal exposure
✔✔What are the risk factors for sepsis in the neonate - ✔✔-chorioamniotitis
-premature rupture of membranes
-maternal GBS
-Maternal UTI
-lower socioeconomic
-prematurity
-low birth weight
-central line placement
-endotracheal tube
✔✔What are the labs that we would get for sepsis management - ✔✔-CBC with diff
-blood cultures- 2 in case one is contaminated
-urine culture - late onset (after 3 days)
-glucose
-CSF studies- late onset (after 3 days)
-CRP
✔✔What are the antibiotics we would use for sepsis management - ✔✔-start with
broad-spectrum coverage prior to culture results available
-then change for organism coverage
✔✔What else do we need to do for the management of sepsis - ✔✔-support
hemodynamic status
-support respiratory status
-consider viral or fungal infection
, They get very shock like symptoms
✔✔What is hypoxic-ischemic encephalopathy - ✔✔Perinatal asphyxia (APP-ACOG):
-profound umbilical artery acidosis <7
-5 minute APGAR score <3
-neurologic sequela of sometype: seizures, hypotonia, coma
-multiple organ dysfunction
✔✔What are the risk factors for hypoxic-ischemic encephalopathy - ✔✔-cord
compression- no blood flow
-placental abruption
-difficult delivery: failure to progress, shoulder distocia, need forceps
✔✔What is the management for hypoxic-ichemic encephalopathy (HIE) - ✔✔-
therapeutic hypothermia - has to be started within 6 hours
-seizure management
-maintain normal electrolytes and glucose
-monitor intake and output closely due to potential renal impairment
-MRI- day 7
-educate and support family- many times this happens when they expected a healthy
baby so they need a lot of support - look like healthy term newborns
✔✔What are the types of intracranial hemorrhages - ✔✔-subdural
-subarachnoid
-cerebellar
-intraventricular- most common
✔✔What is an intraventricular hemorrhage - ✔✔-germinal matrix hemorrhage (collection
of blood vessels in preterm baby)- interloops overtime
-higher risk with prematurity - term babies dont have this- lose around 32-34 weeks
-grade 1-4- 1 is least bad and 4 is bad
-90% of hemorrhage occurs in the first 72 hours of life
✔✔What are fetal anomalies - ✔✔an abnormality of structure, function or metabolism
whether genetically determined or a result of environmental interference during
embryonic or fetal life
✔✔What are some fetal anomalies - ✔✔-Trisomies (13, 18, 21)
-cleft lip and palate
-VATER association
✔✔What does neuromotor maturation follow - ✔✔follows a predictable sequence as
premature infant progresses to 40 weeks of age
✔✔What is the actual timing of neuromotor maturation - ✔✔actual timing is individual
SURE A+
✔✔What is the transmission of sepsis - ✔✔-transplacental
-ascending infection
-amniotic fluid exposure
-postnatal exposure
✔✔What are the risk factors for sepsis in the neonate - ✔✔-chorioamniotitis
-premature rupture of membranes
-maternal GBS
-Maternal UTI
-lower socioeconomic
-prematurity
-low birth weight
-central line placement
-endotracheal tube
✔✔What are the labs that we would get for sepsis management - ✔✔-CBC with diff
-blood cultures- 2 in case one is contaminated
-urine culture - late onset (after 3 days)
-glucose
-CSF studies- late onset (after 3 days)
-CRP
✔✔What are the antibiotics we would use for sepsis management - ✔✔-start with
broad-spectrum coverage prior to culture results available
-then change for organism coverage
✔✔What else do we need to do for the management of sepsis - ✔✔-support
hemodynamic status
-support respiratory status
-consider viral or fungal infection
, They get very shock like symptoms
✔✔What is hypoxic-ischemic encephalopathy - ✔✔Perinatal asphyxia (APP-ACOG):
-profound umbilical artery acidosis <7
-5 minute APGAR score <3
-neurologic sequela of sometype: seizures, hypotonia, coma
-multiple organ dysfunction
✔✔What are the risk factors for hypoxic-ischemic encephalopathy - ✔✔-cord
compression- no blood flow
-placental abruption
-difficult delivery: failure to progress, shoulder distocia, need forceps
✔✔What is the management for hypoxic-ichemic encephalopathy (HIE) - ✔✔-
therapeutic hypothermia - has to be started within 6 hours
-seizure management
-maintain normal electrolytes and glucose
-monitor intake and output closely due to potential renal impairment
-MRI- day 7
-educate and support family- many times this happens when they expected a healthy
baby so they need a lot of support - look like healthy term newborns
✔✔What are the types of intracranial hemorrhages - ✔✔-subdural
-subarachnoid
-cerebellar
-intraventricular- most common
✔✔What is an intraventricular hemorrhage - ✔✔-germinal matrix hemorrhage (collection
of blood vessels in preterm baby)- interloops overtime
-higher risk with prematurity - term babies dont have this- lose around 32-34 weeks
-grade 1-4- 1 is least bad and 4 is bad
-90% of hemorrhage occurs in the first 72 hours of life
✔✔What are fetal anomalies - ✔✔an abnormality of structure, function or metabolism
whether genetically determined or a result of environmental interference during
embryonic or fetal life
✔✔What are some fetal anomalies - ✔✔-Trisomies (13, 18, 21)
-cleft lip and palate
-VATER association
✔✔What does neuromotor maturation follow - ✔✔follows a predictable sequence as
premature infant progresses to 40 weeks of age
✔✔What is the actual timing of neuromotor maturation - ✔✔actual timing is individual
