Nelson - Routine DR and Initial Care

Question 1

T/F In resource-poor countries, gentle wiping of the face, nose, and mouth with a soft cloth may be equally effective as a bulb syringe

Answer 1

T

Question 2

Delayed clamping of the umbilical cord (___sec) has value in reducing the incidence of anaemia in infancy

Answer 2

~30sec

Question 3

T/F Apgar score was designed to predict neurologic outcome

Answer 3

F

Question 4

T/F Apgar score is normal in most patients in whom cerebral palsy subsequently develops

Answer 4

T

Question 5

T/F Incidence of CP is low in infants with AS 0-3 @ 5min but higher in infants with AS 7-10

Answer 5

T

Question 6

T/F Low AS and umbilical artery blood pH predict neonatal death

Answer 6

T

Question 7

T/F An AS of 0-3 @ 5min is a better predictor of neonatal death than an umbilical artery pH ≤ 7

Answer 7

T

Question 8

BSA of a newborn is approximately ___ times that of an adult, and heat loss depends on BSA

Answer 8

3

Question 9

The estimated rate of heat loss in a newborn is approximately ___ times that of an adult

Answer 9

4

Question 10

Under the usual DR conditions (20-25C) an infant’s skin temp falls approx ___C/min

Answer 10

0.3

Question 11

Under the usual DR conditions (20-25C) an infant’s deep body temp falls approx ___C/min

Answer 11

0.1

Question 12

T/F Falsely Low AS: Mg SO4

Answer 12

T

Question 13

T/F Falsely Low AS: Precipituous delivery

Answer 13

T

Question 14

Factos that result in falsely negative AS or normal AS

Answer 14

1) Maternal acidosis 2) High fetal catecholamine levels 3) Some full-term infants

Question 15

T/F Regardless of the etiology, a low AS identifies an infant needing immediate resuscitation

Answer 15

T

Question 16

Cumulative heat loss immediately after birth

Answer 16

2-3C or ~200kcal/kg

Question 17

Mechanism of heat loss after birth: To the cooler surrounding air

Answer 17

Convection

Question 18

Mechanism of heat loss after birth: To the colder materials touching the infant

Answer 18

Conduction

Question 19

Mechanism of heat loss after birth: To other nearby cooler objects

Answer 19

Heat radiation

Question 20

Mechanism of heat loss after birth: From skin and lungs

Answer 20

Evaporation

Question 21

The optimal method of maintaining temp in the stable newborn

Answer 21

Skin-to-skin contact with the mother

Question 22

T/F Once temp is stabilised, skin and UC of a healthy infant should be cleansed with

Answer 22

Warm water or a mild nonmedicated soap solution and rinsed with water

Question 23

To reduce colonisation with S. aureus and other pathogenic bacteria, the UC may be treated daily with bactericidal or antimicrobial agents such as

Answer 23

1) Chlorhexidine 2) Triple dye 3) Bacitracin

Question 24

T/F One application of triple dye followed by 2x daily alcohol swabbing (until the cord falls off) reduces colonisation, exudates, and foul door of the umbilicus in comparison with dry care (soap and water when soiled

Answer 24

T

Question 25

T/F Topical ointments should not be applied to preterm infants in NICU because this treatment increased risk of bacterial sepsis

Answer 25

T

Question 26

Routine or repeated total-body exposure to hexachlorophene may be toxic to which body system

Answer 26

Neurologic

Question 27

Hand-to-elbow washing for ___mins in the initial wash and ___ sec in the subsequent washes is essential for staff and visitors entering the nursery

Answer 27

2, 15-30

Question 28

T/F The eyes of ALL infants, including those born by CS, must be protected against gonococcal ophthalmia neonatorum by application of a 1-cm ribbon erythromycin (0.5%) or tetracycline (1.0%) sterile ophthalmic ointments in each conjunctival sac.

Answer 28

T

Question 29

An acceptable alternative to erythromycin and tetracycline eye ointments is ___ but it leads to a transient chemical conjunctivitis in 10-20% of cases

Answer 29

1% silver nitrate

Question 30

___ should be given to all infants shortly after birth to prevent HDN

Answer 30

IM injection of 0.5-1mg water-soluble vitamin K1 (phytonadione)

Question 31

T/F Oral Vitamin K is as effective as parenteral dosage in preventing HDN

Answer 31

F

Question 32

Hepatitis B immunization before discharge from the nursery is recommended for newborns with weight ___kg IRRESPECTIVE of maternal hepatitis status

Answer 32

2