NRP - NEONATAL RESUSCITATION PROGRAM Final Exam Questions and Answers Latest Verified Answers.

NRP - NEONATAL RESUSCITATION PROGRAM Final Exam Questions and Answers Latest Verified Answers. NRP recommends that resuscitation of the baby 32 weeks and greater is initiated with 21% oxygen. If baby doesn’t have spontaneous respirations and a heart rate of 100bpm or higher within 1 minute of birth, begin PPV HR should be at least 100bpm—auscultation along the left side of the chest is the most accurate to determine HR -Palpation at the umbilical cord base may be felt but is less accurate and may underestimate the true HR -Using a stethoscope, estimate the HR by counting the number of beats in 6 seconds and multiply by 10 ie. 6 seconds x 12 beats= 120bpm If HR cannot be determined, connect ECG and/or Pulse Ox—pulse ox may not function is HR is too low or baby has low perfusion so ECG would be preferred method After The Initial Steps Listed Above, What To Do If The Baby Is Not Breathing Or HR Is Low: Start PPV if baby is not breathing (apnea) OR if the baby has gasping respirations Start PPV if the baby appears to be breathing, but the HR is below 100bpm Call for help if alone at the warmers If the baby has not responded to the initial steps within the first minute of life, it is NOT appropriate to continue to provide only tactile stimulation What Do You Do If The Baby Is Breathing And The Heart Rate Is At Least 100bpm, But The Baby Appears Persistently Cyanotic? **Apply a pulse oximeter** Indications to apply a pulse oximeter: When resuscitation is anticipated To confirm your perception of persistent central cyanosis When supplemental oxygen is administered When positive-pressure ventilation is required Acrocyanosis is normal-blue hands and feet Normal Pulse Ox is 60% INTRA-UTERINE so normal transition may take several minutes to increase their blood oxygen saturation to more than 90% Oxygen saturation levels are slightly lower in cesarean births than vaginal births HR on pulse oximeter should be the same as the HR on the cardiac monitor (ECG) Central Cyanosis-low oxygen saturation causing the baby’s lip, tongue, and torso to appear blue *Healthy babies may have central cyanosis for several minutes after birth Place the pulse oximeter on the RIGHT HAND OR WRIST **This is because the left arm and both legs may have lower oxygen saturation because they may receive blood from the aorta after it has mixed with poorly oxygenated venous blood shunted from the right side of the heart through the ductus arteriosus TARGET SPO2 AFTER BIRTH 1 minute- 60-65% 2 minute- 65-70% 3 minute- 70-75% 4 minute-75-80% 5 minute-80-85% 10 minute-85-95% **A healthy newborn breathing room air may take more than 10 minutes to achieve oxygen saturation greater than 90% Supplemental O2 is indicated when the oximeter remains below the target range for baby’s age FREE FLOWING oxygen is when the oxygen is held close to the baby’s mouth and nose-CANNOT GIVE IF BABY IS NOT BREATHING!! *For free flowing oxygen delivery, adjust the flow meter to 10L/min *Start free flow oxygen supplementation with the blender to set to 30% oxygen. Using the blender, adjust the oxygen concentration as needed to achieve oxygen saturation target. **Goal is to prevent hypoxia without using excess oxygen to cause hyperoxia To prevent heat loss, oxygen given to newborns for a prolonged period should be heated and humidified If the baby has labored breathing or persistently low oxygen saturation, apply CPAP **This should only be considered in the delivery room is the baby is breathing and the HR is at least 100bpm **Cannot be given using a self inflating bag Meconium-stained fluid and a NON-VIGOROUS newborn If baby is born through meconium stained amniotic fluid, bring baby to the radiant warmer Perform initial steps of newborn care Use a bulb syringe to clear secretions- M to N If baby is not breathing or HR is less than 100bpm after initial steps are completed, proceed with PPV **Do not intubate for tracheal suction-there is insufficient evidence to continue recommending this practice PIP- peak inspiratory pressure- highest pressure administered with each breath PEEP- positive end-expiratory pressure- the gas pressure maintained in the lungs between breaths when the baby is receiving assisted breaths CPAP- continuous positive airway pressure- gas pressure maintained in the lungs between breathes when the baby is breathing spontaneouslyWe offer online tutoring and solutions to all assignments for all modules. Contact: