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PARA 240 > NERPS > Flashcards

NERPS Flashcards

1
Q

What % of newborns require SOME breathing assistance?

A

10%

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2
Q

What percent of new borns require extensive resuscitative efforts?

A

1%

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3
Q

Birth Asphyxia rates

A

23% of neonatal deaths each year world wide

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4
Q

What 3 questions need to be asked initially for good neonatal functioning

A

Term gestation?

Breathing or crying?

Good tone?

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5
Q

The most important and effective action in neonatal resuscitation?

A

Ventilating the babies lungs

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6
Q

Before birth the babies lungs are filled with

A

Fluid and expanded

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7
Q

If the baby does not begin breathing in response to stimulation they are assumed to be in ________and ___________ should be provided

A

Secondary Apnea

Positive pressure Ventilation PPV

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8
Q

If the baby is in secondary apnea then the pulse will subsequently _________ and the blood pressure will _________

A

Fall
And
Fall

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9
Q

We can know that the baby’s adequate ventilation is restored when

A

The pulse improves rapidly

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10
Q

Premature babies and some risks associated.

A

Any baby born before 37 completed weeks of gestation

  • lungs deficient in surfactant
  • immature brain development
  • weak muscles (spontaneous breathing more difficult)
  • thin skin
  • high likelihood of infection
  • fragile blood vessels in brain
  • small blood volume (Hypovolemia)
  • immature tissues
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11
Q

Targeted pre-ductal spo2 levels after birth

A 
1 min= 60-65
2min= 65-70
3min= 70-75
4min= 75-80
5min= 80-85
10min= 85-95
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12
Q

Pre ductal spo2 @ 1min

A

60-65

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13
Q

Pre ductal spo2 @ 2 min

A

65-70

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14
Q

Pre ductal spo2 @ 3 min

A

70-75

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15
Q

Pre ductal spo2 @ 4min

A

75-80

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16
Q

Pre ductal spo2 @ 5min

A

80-85

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17
Q

Pre ductal spo2 @ 10min

A

85-95

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18
Q

When deciding which babies are “vigorous” what 3 characteristics are needed?

A

Good Breathing

Good Muscle Tone

HR above 100

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19
Q

What size of catheter is needed to clear the oropharynx before inserting a ET tube?

A

12-14 French

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20
Q

The newborn is covered in meconium, is breathing well, has normal muscle tone, has a heart rate of 120, and is pink. What is the correct action for suctioning?

A

Suction the mouth and nose with a bulb syringe or suction catheter.

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21
Q

A new born is still not breathing after a few seconds of stimulation. What is the next action?

A

Administer PPV

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22
Q

You have stimulated a new born and suctioned their mouth. It is now 30 seconds after birth, and she is still apneic and pale. Her heart rate is 80. Your next action is

A

Provide PPV

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23
Q

MR SOPA

A

Mask seal

Reposition Airway

Suction Mouth and nose

Open Mouth

Pressure Increase

Airway Adjunct (alternative)

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24
Q

Full term in weeks

A

End of 27-40

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25
Q

APGAR

A

Appearance

Pulse

Grimace

Activity

Respirations

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26
Q

Fluid replacement amount in neonates

A

10ml/kg over 5-10 mins

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27
Q

Measuring OG tubes in neonates

A

Measure the distance from the nose to the earlobe and then from the earlobe to a point halfway between the xiphoid process and the umbilicus

28
Q

Size of OG tube

A

8F

29
Q

How far should a OG tube be inserted (cm)

A

22

30
Q

Assisted ventilation may be discontinued when:

A

Heart rate is above 100bpm

Sustained spontaneous breathing is present

31
Q

Hold resuscitation device so you can see the newborns_________

A

Chest and abdomen

32
Q

A baby is born apneic and cynotic. You clear the airway and stimulate. Thirty seconds after birth the baby has not improved, the next step is to

A

Begin PPV

33
Q

Self inflating bags require the attachment of _________________ to deliver a high concentration of oxygen.

A

Oxygen reservoir

34
Q

Principle safety features of FLOW INFLATING bags

A

Pop off valve

Pressure gauge

35
Q

Principle safety features of SELF INFLATING BAGS

A

Pressure gauge

36
Q

Principle safety features of T PIECE RESUCITATOR

A

Maximum pressure relief control

Pressure gauge

37
Q

PPV rates for ventilation neo nates

A

40-60 breaths per minute

38
Q

Begin PPV with an initial inspiratory pressure of ___________

A

20 cm of water

39
Q

Assess PPV BY ____________ and ____________ then listening for _________________. If these signs are unacceptable then look for ________________

A

HR and SPo2

Lung sounds

Chest rise

40
Q

After 30 second of PPV what do you do if the babies HR is below 60

A

Begin chest compressions and consider intubation

41
Q

After 30 seconds of PPV you babies HR is greater than 60 but less than 100 but steadily improving. What do you do?

A

Adjust oxygen, gradually decrease pressure as rate improves, insert OG and continue monitoring

42
Q

After 30 seconds of PPV the babies HR is above 60 but less than 100 and not improving. What should be done?

A

Do MR SOPA and consider intubation

43
Q

The preferred chest compression technique is

A

The thumb technique

44
Q

The correct depth of compressions is

A

One third of the anterior-posterior diameter of the chest

45
Q

Compression area of neo nate chest

A

Lower third of the sternum between the xyphoid process and a line drawn between the nipples

46
Q

Ratio for compressions to breaths

A

3:1

47
Q

The rate of ventilations without chest compressions is

A

40-60

48
Q

There should be how many “events” during chest compressions?

A

120

49
Q

The three compressions and one breath should take

A

2 seconds

50
Q

Size of ET tube for babies below 1000g or below 28 weeks

A

2.5

51
Q

ET tube size for baby between 1000-2000g or 28-34 weeks

A

3.0

52
Q

ET tube size for baby 2000-3000g or 34-38 weeks

A

3.5

53
Q

ET tube size for baby above 3000g or above 38 weeks

A

3.5-4.0

54
Q

The neonatal intubation procedure should take more than

A

30 seconds

55
Q

Neonate intubation steps

A
  • Stabilize head in sniffing position
  • slide laryngoscope on right to left.
  • lift blade
  • look for landmarks
  • Insert tube
  • if chords closed wait for them to open
  • brace tube against hard palate
56
Q

Useful situations for LMA

A

Facial or upper airway malformations render ventilation by mask ineffective

Iff PPV not working and ET intubation not possible.

57
Q

Fewer than what percent of babies need Epi to stimulate their hearts

A

1%

58
Q

Effective ventilation and coordinated chest compressions have been preformed for 45-60 seconds, the trachea has been intubated, and the baby’s heart rate is below 60 beats per minute. You should now ______________ while continuing chest compressions and ________________

A

Give epinephrine

Ventilation

59
Q

What is the potential problem with administering Epi through an endotracheal tube?

A

Epi is not reliably absorbed in the lungs. A higher dose (0.5-1ml/kg) should be considered.

60
Q

The recomended dose of epi for new borns is _________ to __________ml/kg IV or __________ to __________ml/kg ET

A
  1. 1-0.3 ml/kg IV

0. 5-1.0 ml/kg ET

61
Q

If the neo nate appears to be in shock there is evidence of blood loss. And resuscitation is not resulting in improvement, you should consider giving _____________ via _____________

A

10ml/kg of volume expanders via umbilical vein

62
Q

Therapeutic hypothermia in neonates

A

33.5-34.5 c

63
Q

Choanal Atresia can be ruled out by what procedure?

A

Passing a NPA through the nares to assess for obstruction of the skull

64
Q

Babies with robin syndrome who have upper airway obstruction may be helped by placing a ___________ and positioning them ______________. Endotracheal of such babies is usually _______

A

Nasopharyngeal tube

Prone on their abdomen

Difficult

65
Q

You should suspect a congenital diaphragmatic hernia if ___________. Such babies should not be resuscitated with _____________.

A

Flat appearing scaphoid abdomen present

PPV by mask

PARA 240 (6 decks)

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