Chapter 8 Resuscitation and Stabilization

Question 1

What are some factors that make preterms more vulnerable? (5)

Answer 1

1. rapid heat loss from thin skin
2. less fat stores, larger BSA
3. immature organ systems
4. small blood volumes
5. vulnerability to hypoglycemia
   (p. 214)

Question 2

What temperature should the room be set to for preemies?

Answer 2

74-77 or 23-25
(p. 214)

Question 3

What interventions should be used to warm a preemie less than 32 weeks?

Answer 3

Plastic wrap and a thermal mattress
(p. 214)

Question 4

How should babies be positioned?

Answer 4

Avoid positioning their head above their legs to avoid neural injury
(p. 214)

Question 5

At what gestational age should surfactant be considered?

Answer 5

WHEN LESS THAN 30 WEEKS “would benefit from”
(p. 218)
another page says < 26 weeks “some experts recomend prophylactic surfactant for extremely premature infants)
(p. 218)

Question 6

What is the target body temp for a preemie?

Answer 6

36.5.-37.5 axillary
(p. 218)

Question 7

Why should high FiO2 be avoided in preemies?

Answer 7

They are more susceptible to oxygen injury , may damage retina
(p. 223)

Question 8

What can you do to reduce the chances of neurologic injury in the preterm? (6)

Answer 8

1. avoid obstruction of venous drainage
2. avoid rapid changes in CO2
3. avoid rapid changes in blood volume
4. avoid placing legs higher than head
5. avoid high PPV/CPAP pressure
6. avoid rapid fluid bolus
   (p. 223)

Question 9

What should you monitor during the initial stabilization period?

Three parameters

Answer 9

monitor temp
monitor blood glucose
monitor for apnea/bradycardia

Question 10

You have turned on the radiant warmer in anticipation of the birth of a baby at 27 weeks gestation. List 4 additional steps that will help maintain this baby’s temperature?

Answer 10

1. room temp to 74-77 degrees
2. prepare thermal mattress
3. prepare plastic wrap or bag
4. pre warm transport incubator if baby will be moved after birth
   p. 230

Question 11

What does the AAP consider a term baby?
What about the book?

Answer 11

38-42 weeks
preterm is birth prior to 37 weeks p. 217

Question 12

What does the AAP consider a late preterm baby

Answer 12

34-36 weeks

Question 13

A baby is born at 26 weeks gestation. The initial steps of care, including gentle stimulation, have been completed and the baby is nearly one minute old. The baby is not breathing and the HR is 80 bpm. How should you intervene?

Answer 13

PPV p. 229

Question 14

A baby is delivered at 30 weeks gestation. At 5 minutes of age, the baby is breathing , has a heart rate of 140 bpm, and is receiving CPAP with 30% oxygen. A pulse oximeter on the right hand is reading 95% and is increasing. How should you respond?

Answer 14

decrease the FiO2
p. 229

Question 15

Which device can provide CPAP, self-inflating bag or t- piece?

Answer 15

T-peice p.229

Question 16

You are preparing of a 34 week GA. You set the PPV device so that the peal pressure is____ and the PEEP is _____?

Answer 16

20-25 cm H20
5 cm H2O

p. 230

Question 17

Initial resuscitation of a preterm baby less than 35 weeks should begin with what FiO2?

Answer 17

21-30%

p. 230