Neonatal Resuscitation Program (NRP) practice Questions & Answers(RATED A+)

Questions to ask prior to birth -ANSWER 1. what is expected Gestational age, (preterm <38 wks, term 38-41 wks or post-term >41 wks) 2. what is amniotic fluid color (only clear good), 3. what's number of babies expected (twins mebbe more), 4. are any additional risk factors (GDM, miscarriages, preeclampsia, etc.) When to clamp umbilical cord -ANSWER 30-60 seconds after birth for VIGOROUS newborn Things to look for after birth -ANSWER 1. Is the baby term, (if no, bring baby to warmer) 2. does the baby have good muscle tone, (flaccid/extended extremities are bad) 3. is the baby breathing or crying? (if no crying, observe chest for breathing efforts. if vigorous crying, return to mom) 5 initial steps of care -ANSWER 1. Warm, 2. position airway, 3. clear secretions if needed, 4. dry, 5. stimulate Flow rate for free-flow O2 administration -ANSWER 10lpm O2 level for free-flow O2 administration -ANSWER 30% Suction setting for newborn -ANSWER 80-100mmHg Antepartum risk factors -ANSWER gestation <36wks or >41wks, pre-eclampsia and eclampsia, maternal HTN, poly and oligohydramnios, fetal hydrops, macrosomia and IGR, fetal malformations or anomalies, no prenatal care. Inpartum -ANSWER Emergency c-section, vacuum assisted delivery, breech or abnormal presentation, category II or III, maternal anesthesia, mag, or narcs, prolapse cord, shoulder dystocia, meconium staining, bleeding, placental abruption, chorioamnionitis Abnormal transition signs and symptoms -ANSWER Apnea, tachypnea, bradycardia, tachycardia, decreased muscle tone, low SpO2, hypotension Preductal SpO2 at 1 min -ANSWER 60-65% Preductal SpO2 at 2 min -ANSWER 65-70% Preductal SpO2 at 3 min -ANSWER 70-75% Preductal SpO2 at 4 min -ANSWER 75-80% Preductal SpO2 at 5 min -ANSWER 80-85% Preductal SpO2 at 10 min -ANSWER 85-95% Where to put pulse oximeter on newborn -ANSWER Right hand or wrist (preductal) Requirements for CPAP on newborn -ANSWER HR >100bpm and spontaneous respirations Best way to determine HR -ANSWER Listen with stethoscope on left side chest for 6 seconds, multiply by 10 If suctioning, do you suction the mouth or nose first? -ANSWER Mouth Indications for PPV -ANSWER Apnea, gasping, HR<100bpm, SpO2 low despite free-flow O2 or CPAP Preparation for PPV -ANSWER Clear secretions, position yourself at baby's head, position baby's head and neck When to clamp umbilical cord -ANSWER 30-60 seconds after birth for VIGOROUS newborn