CRT RRT NBRC PAPER ACTUAL QUESTIONS AND
ANSWERS SURE A+
✔✔Chest ECG electrodes - ✔✔-V1 = 4th intercostal space on right side of sternum
-V2 = 4th intercostal space on left side of sternum
-V3 = between V2 and V4 on left side
-V4 = 5th intercostal space, left mid-clavicular line
-V5 = between V4 and V6 on left side
-V6 = 5th intercostal space, left mid-axillary line
✔✔Estimating heart rate on ECG - ✔✔-two R waves between 3-5 large boxes = normal
-two R waves closer and 3 large boxes = tachycardia
-two R waves wider than 5 large boxes = bradycardia
✔✔Sinus Bradycardia - ✔✔Rate less than 60
Treat with Oxygen/Atropine
✔✔Multifocal PVC - ✔✔
✔✔Premature Ventricular Contraction (PVCs) - ✔✔
✔✔Ventricular Tachycardia (V-Tach) - ✔✔
✔✔Ventricular Fibrillation (V-Fib) - ✔✔
✔✔Asystole - ✔✔
✔✔1st Degree AV Block - ✔✔
✔✔2nd Degree AV Block - ✔✔
,✔✔3rd Degree AV Block - ✔✔
✔✔Ischemia - ✔✔-reduced blood flow to tissue
-indicated by a depressed or inverted T-WAVE
✔✔Injury - ✔✔-indicated by an elevated ST segment
✔✔Infarction - ✔✔-diagnosed by significant Q waves
✔✔APGAR Score - ✔✔-1 minute will determine neonatal survival
-5 minute predicts future neurological outcome
-0-3 resuscitate
-4-6 Stimuiate (stimulate, warm, O2)
-7-10 Monitor (Routine care)
✔✔Transillumination - ✔✔-Normally a small lighted halo around point of contact
-a pneumothorax or pneumomediastinum will cause the entire hemithorax to light up
(LARGE HALO)
✔✔Dubowitz Method - ✔✔-assessment of gestation age
- >40 = post term (meconium)
- <40 = pre term (IRDS)
✔✔New Ballard Score (NBS) - ✔✔-modification of dubowitz
-score of 40 = 40 weeks
✔✔Pre and post ductal blood gas - ✔✔-R to L shunt across ductus arteriousus, PaO2
from pre-ductal(right arm) often exceeds PaO2 from post-ductal(umbilical or legs)
-pre ductal is 15 torr higher than post ductal = PDA w/ R to L shunt
-echocardiogram recommended
✔✔Capnography - ✔✔-PaCO2 = 40 torr/PetCO2 = 30 torr
-increase in PECO = decreased ventilation (vent failure)
-decrease in PECO = increase in ventilation (PE, hypovolemia)
-low petco2 after intubation = esophagus
-during CPR, PETCO would increase
✔✔Transcuataneous Monitoring - ✔✔PO2 and PCO2 measurement
-heat to 43-45 °C
-correlates well with arterial values as long as perfusion is adequate
✔✔Pressure Transducer - ✔✔-if transducer is above the catheter, readings are LOWER
-if transducer is below the catheter, readings are HIGHER
, ✔✔Hemodynamics - ✔✔
✔✔Swan-Ganz Catheter - ✔✔-When the balloon is inflated, the catheter will WEDGE
and the back pressure from the pulmonary capillary will be measured
-measuring PAP = balloon deflated
-double spike (dicrotic notch) is normal for PAP
-Pressure Dampening = obstructed catheter (blood clot, bubble, kink)
-if a blood clot occurs: ASPIRATE-FLUSH-ROTATE catheter
✔✔Oropharyngeal Airway - ✔✔-UNCONSCIOUS PATIENT
-supports base of tongue
-Bite block
-facilitate oral suctioning
-should be left unsecured
-gagging: remove-suction-oxygen
✔✔Nasopharygeal Airway - ✔✔-CONSCIOUS PATIENT
-supports base of tongue
-facilitate deep tracheal suctioning
-decrease trauma during NT suctioning
-increased airway resistance (USE LARGEST SIZE)
-inserted anatomically shaped with lubricant
✔✔NARCAN - ✔✔-Narcan - Narcotic overdose
-Atropine - Bradycardia
-Valium/Versed - Sedation
-Epinephrine -Asystole
-Lidocaine - PVC
- X2 normal IV dose + 10 mL saline
✔✔Cuff Pressures - ✔✔-20 mmHg / 25 CM H20
- >5 - lymphatic - edema
- >10 - vein - edema
- >20 - artery - necrosis
-Low pressure, high volume, high compliance, floppy cuff is preferred
✔✔Cricoid Pressure - ✔✔-Sellick maneuver
-indicated if larynx is in an anterior location
✔✔Assessment of Tube Position - ✔✔- Inspect for bilateral chest expansion
- Ausculate for bilateral breath sounds
- Capnography or CO2 detectors
ANSWERS SURE A+
✔✔Chest ECG electrodes - ✔✔-V1 = 4th intercostal space on right side of sternum
-V2 = 4th intercostal space on left side of sternum
-V3 = between V2 and V4 on left side
-V4 = 5th intercostal space, left mid-clavicular line
-V5 = between V4 and V6 on left side
-V6 = 5th intercostal space, left mid-axillary line
✔✔Estimating heart rate on ECG - ✔✔-two R waves between 3-5 large boxes = normal
-two R waves closer and 3 large boxes = tachycardia
-two R waves wider than 5 large boxes = bradycardia
✔✔Sinus Bradycardia - ✔✔Rate less than 60
Treat with Oxygen/Atropine
✔✔Multifocal PVC - ✔✔
✔✔Premature Ventricular Contraction (PVCs) - ✔✔
✔✔Ventricular Tachycardia (V-Tach) - ✔✔
✔✔Ventricular Fibrillation (V-Fib) - ✔✔
✔✔Asystole - ✔✔
✔✔1st Degree AV Block - ✔✔
✔✔2nd Degree AV Block - ✔✔
,✔✔3rd Degree AV Block - ✔✔
✔✔Ischemia - ✔✔-reduced blood flow to tissue
-indicated by a depressed or inverted T-WAVE
✔✔Injury - ✔✔-indicated by an elevated ST segment
✔✔Infarction - ✔✔-diagnosed by significant Q waves
✔✔APGAR Score - ✔✔-1 minute will determine neonatal survival
-5 minute predicts future neurological outcome
-0-3 resuscitate
-4-6 Stimuiate (stimulate, warm, O2)
-7-10 Monitor (Routine care)
✔✔Transillumination - ✔✔-Normally a small lighted halo around point of contact
-a pneumothorax or pneumomediastinum will cause the entire hemithorax to light up
(LARGE HALO)
✔✔Dubowitz Method - ✔✔-assessment of gestation age
- >40 = post term (meconium)
- <40 = pre term (IRDS)
✔✔New Ballard Score (NBS) - ✔✔-modification of dubowitz
-score of 40 = 40 weeks
✔✔Pre and post ductal blood gas - ✔✔-R to L shunt across ductus arteriousus, PaO2
from pre-ductal(right arm) often exceeds PaO2 from post-ductal(umbilical or legs)
-pre ductal is 15 torr higher than post ductal = PDA w/ R to L shunt
-echocardiogram recommended
✔✔Capnography - ✔✔-PaCO2 = 40 torr/PetCO2 = 30 torr
-increase in PECO = decreased ventilation (vent failure)
-decrease in PECO = increase in ventilation (PE, hypovolemia)
-low petco2 after intubation = esophagus
-during CPR, PETCO would increase
✔✔Transcuataneous Monitoring - ✔✔PO2 and PCO2 measurement
-heat to 43-45 °C
-correlates well with arterial values as long as perfusion is adequate
✔✔Pressure Transducer - ✔✔-if transducer is above the catheter, readings are LOWER
-if transducer is below the catheter, readings are HIGHER
, ✔✔Hemodynamics - ✔✔
✔✔Swan-Ganz Catheter - ✔✔-When the balloon is inflated, the catheter will WEDGE
and the back pressure from the pulmonary capillary will be measured
-measuring PAP = balloon deflated
-double spike (dicrotic notch) is normal for PAP
-Pressure Dampening = obstructed catheter (blood clot, bubble, kink)
-if a blood clot occurs: ASPIRATE-FLUSH-ROTATE catheter
✔✔Oropharyngeal Airway - ✔✔-UNCONSCIOUS PATIENT
-supports base of tongue
-Bite block
-facilitate oral suctioning
-should be left unsecured
-gagging: remove-suction-oxygen
✔✔Nasopharygeal Airway - ✔✔-CONSCIOUS PATIENT
-supports base of tongue
-facilitate deep tracheal suctioning
-decrease trauma during NT suctioning
-increased airway resistance (USE LARGEST SIZE)
-inserted anatomically shaped with lubricant
✔✔NARCAN - ✔✔-Narcan - Narcotic overdose
-Atropine - Bradycardia
-Valium/Versed - Sedation
-Epinephrine -Asystole
-Lidocaine - PVC
- X2 normal IV dose + 10 mL saline
✔✔Cuff Pressures - ✔✔-20 mmHg / 25 CM H20
- >5 - lymphatic - edema
- >10 - vein - edema
- >20 - artery - necrosis
-Low pressure, high volume, high compliance, floppy cuff is preferred
✔✔Cricoid Pressure - ✔✔-Sellick maneuver
-indicated if larynx is in an anterior location
✔✔Assessment of Tube Position - ✔✔- Inspect for bilateral chest expansion
- Ausculate for bilateral breath sounds
- Capnography or CO2 detectors
