Neonatology Flashcards
You are caring for a newly born infant delivered approximately 8 minutes ago. The infant had a one minute APGAR score of 6, which improved to 7 at 5 minutes. Despite drying, warming, suctioning and stimulating the infant, he continues to have central cyanosis. His heart rate is 132, and his respirations are 50. which of the following is the best action in this situation?
A. Administer 0.01 mg/kg of epinephrine subcutaneously
B. Assist ventilations with a bag-vavle-mask device
C. Administer “blow- by” oxygen
D. Begin chest compressions
C. Administer “blow-by” oxygen
You have been dispatched with the neonatal resuscitation team to an outlying hospital to stabilize and then transport a 30-week-gestation newborn to a neonatal intensive care unit. Which of the following methods should you use to maintain this newborn’s body temperature?
A. Wrap thenewborn in receiving blankets, covering the body and head but leaving the face exposed, and place 104 degree F hot water bottles next to him.
B. Activate 2 or 3 chemical hot packs, place them against the newborn’s body, and secure them by wrapping him in a receiving blanket.
C. Wrap the newborn in a receiving blanket, covering the body and head but leaving the face exposed, and hold him securely against your body for warmth.
D. Dress the newborn lightly in a T-shirt and diaper and cover loosely with a light blanket
A. Wrap the newborn in receiving blankets, covering the body and head but leaving the face exposed, and place 104 degree F hot water bottles next to him.
Which of the following is NOT an option for prehospital vascular access in the newborn?
A. Femoral vein cannulation
B. Cannulation of a peripheral vein in an extremity
C. Intraosseous needle placed in the proximal tibia
D. Scalp vein cannulation
A. Femoral vein cannulation
Which of the following is the correct dosage of epinephrine in neonatal resuscitation?
A. 0.01 to 0.03 mg/kg
B. 0.1 to 0.3 mg/kg
C. 0.01 to 0.03 mL/kg of a 1:10,000 solution
D. 1 to 3 mg/kg of a 1;1,000 solution
A
0.01 to 0.03 mg/kg
You have just assisted in the delivery of an approximately 4 kg newborn whose mother is a rather petite primapara. Upon assessment, you note that there is no spontaneous movement of the infant’s right arm, although he otherwise exhibits vigorous movement and has a 1-minute APGAR score of 9. Which of the following should you suspect?
A. Fractured clavicle
B. Caput succedaneum
C. Spinal cord damage
D. Neonatal abstinence syndrome
A
Fractured clavicle
The most common cause of bradycardia in the newborn is _______ and should be treated with _________.
A. Hypoxia; aggressive suctioning, intubation, ventilation
B. Increased vagal tone; atropine
C. Hypoxia; basic resuscitation procedures such as tactile stimulation, oxygen, and ventilation
D. Maternal narcotic use; naloxone
C
Hypoxia; basic resuscitation procedures such as tactile stimulation, oxygen, and ventilations
Which of the following parameters is the most important indicator of neonatal distress?
A. Increased heart rate
B. Increased respiratory rate
C. Decreased respiratory rate
D. Decreased heart rate
D
Decreased heart rate
You are assessing a 1-minutes APGAR score on a patient who has peripheral cyanosis and a heart rate of 98, who cried spontaneously after delivery, is actively moving his extremities, and has a strong cry. What is the APGAR score for this patient?
A. 7
B. 9
C. 8
D. 10
C
8
Which of the following is appropriate for suctioning thick meconium from the airway of a full-term infant?
A. Bulb syringe
B. 2.5 mm endotracheal tube
C. 3.5 mm endotracheal tube
D. 30 cc syringe
C
3.5 mm endotracheal tube
Which of the following describes the appropriate administration of intravenous fluids in a newborn?
A. Normal saline, 10mL/kg, slow IV push
B. 5% dextrose in 0.45% saline solution, 30 mL/kg
C. 10% dextrose in water, 20 mL/kg, slow IV push
D. Normal saline or lactated Ringer’s solution 40mL/kg using a pressure infuser
A
Normal saline, 10 mL/kg, slow IV push
At 90 seconds after birth, bases on the following findings, which newborn does NOT require resuscitative efforts beyond routine care?
A. HR 98, RR 27, peripheral cyanosis, APGAR 6
B. HR 75, RR 25, central cyanosis, APGAR 5
C. HR 158, RR 40, central cyanosis, APGAR 6
D. HR 100, RR 30, peripheral cyanosis, APGAR 8
D
HR 100, RR 30 , peripheral cyanosis, APGAR 8
Which of the following sets of vital signs is normal for a newborn?
A. HR 190, RR 35
B. HR 180, RR 30
C. HR 125, RR 65
D. HR 175, RR 60
D
HR 175, RR 60
Which of the following is the correct dosage for sodium bicarbonate in newborn resuscitation?
A. 0.5 mL/gm
B. 0.5 mL/kg
C. 0.5 mEq/kg
D. 0.5 mg/gm
C
0.5 mEq/kg
Which of the following is likely to occur due to prolonged and/or deep suctioning of the newborn’s airway?
A. Hypoxia, tachycardia
B. Vagal stimulation, tachycardia
C. Hypoxia, vagal stimulation, bradycardia
D. Hypoxia, vagal stimulation, ventricular fibrillation
C
Hypoxia, vagal stimulation, bradycardia
Which of the following statements concerning suctioning the airway of the newborn is true?
A. The presence of thin, watery meconium staining requires aggressive suctioning with an endotracheal tube in place.
B. Using a bulb syringe, first the nose, then the mouth, should be suctioned.
C. Newborns should not be suctioned unless there is meconium present.
D. Using a bulb syringe, first the mouth, then the nose, should be suctioned
D
Using a bulb syringe, first the mouth, then the nose, should be suctioned
