NRP-Part 2 (Advanced) Exam
Questions & Answers12
Gastroschisis: Definition - ANSWERS-An abdominal wall defect where the baby's bowel
protrudes through an opening the the abdominal wall
-Usually on the right side of umbilical cord
Gastroschisis: Management - ANSWERS--Avoid prolonged face-mask ventilation
-Intubate or insert laryngeal mask if required
-Emergency UVC may be inserted if needed (leave as much cord length as possible
Omphalocele: Definition - ANSWERS-Abdominal wall defect that includes the umbilical cord;
baby's bowel is often inside a large sac that may contain other abdominal organs
Omphalocele: Management - ANSWERS--Respiratory support including CPAP or mechanical
ventilation
-Emergency UVC can't be inserted IO can be used
Management of Omphalocele OR Gastroschisis: - ANSWERS-1. Clamp and cut umbilical cord
(leave as much length as possible)
2. Place baby in sterile, clear plastic bowel bag
3. Position bag on right side
4. Place cardiac monitor leads and upper arms/chest
5. Insert 8F or 10F OG tube or Replogle tube (preferred)
6. Monitor temp
7. Monitor fluid administration
, Intubation is recommended when: - ANSWERS-Baby's HR is <10 and not increasing after PPV
Intubation is recommended BEFORE: - ANSWERS-Starting chest compressions
The baby has to weight more than what for a laryngeal mask to be used: - ANSWERS-2kg
Advantages when using Intubation: 3 things - ANSWERS-1. May improve ventilation efficacy and
prevent need for chest compressions
2. If compressions are needed, it may improve coordination with compressions
3. Allows compressor to give compressions from the head of the bed, so there's space for
someone else to insert and umbilical catheter
Additional Indications for Endotracheal Intubation: - ANSWERS-1. Direct tracheal suction
2. Surfactant administration
3. Stabilization of a newborn with a suspected diaphragmatic hernia
Picking the ETT considerations: 2 things - ANSWERS--Tube that's too small increases resistance
to air flow and may become obstructed
-Tube that is too large could cause trauma to airway
Tube size: <28 weeks - ANSWERS-2.5mm
Tube size: 28-34 weeks - ANSWERS-3.0mm
Tube size: >34 weeks - ANSWERS-3.5mm
Questions & Answers12
Gastroschisis: Definition - ANSWERS-An abdominal wall defect where the baby's bowel
protrudes through an opening the the abdominal wall
-Usually on the right side of umbilical cord
Gastroschisis: Management - ANSWERS--Avoid prolonged face-mask ventilation
-Intubate or insert laryngeal mask if required
-Emergency UVC may be inserted if needed (leave as much cord length as possible
Omphalocele: Definition - ANSWERS-Abdominal wall defect that includes the umbilical cord;
baby's bowel is often inside a large sac that may contain other abdominal organs
Omphalocele: Management - ANSWERS--Respiratory support including CPAP or mechanical
ventilation
-Emergency UVC can't be inserted IO can be used
Management of Omphalocele OR Gastroschisis: - ANSWERS-1. Clamp and cut umbilical cord
(leave as much length as possible)
2. Place baby in sterile, clear plastic bowel bag
3. Position bag on right side
4. Place cardiac monitor leads and upper arms/chest
5. Insert 8F or 10F OG tube or Replogle tube (preferred)
6. Monitor temp
7. Monitor fluid administration
, Intubation is recommended when: - ANSWERS-Baby's HR is <10 and not increasing after PPV
Intubation is recommended BEFORE: - ANSWERS-Starting chest compressions
The baby has to weight more than what for a laryngeal mask to be used: - ANSWERS-2kg
Advantages when using Intubation: 3 things - ANSWERS-1. May improve ventilation efficacy and
prevent need for chest compressions
2. If compressions are needed, it may improve coordination with compressions
3. Allows compressor to give compressions from the head of the bed, so there's space for
someone else to insert and umbilical catheter
Additional Indications for Endotracheal Intubation: - ANSWERS-1. Direct tracheal suction
2. Surfactant administration
3. Stabilization of a newborn with a suspected diaphragmatic hernia
Picking the ETT considerations: 2 things - ANSWERS--Tube that's too small increases resistance
to air flow and may become obstructed
-Tube that is too large could cause trauma to airway
Tube size: <28 weeks - ANSWERS-2.5mm
Tube size: 28-34 weeks - ANSWERS-3.0mm
Tube size: >34 weeks - ANSWERS-3.5mm
