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Nrp > Nrp Continued > Flashcards

Nrp Continued Flashcards

1
Q

At birth the blood vessels around the alveoli do what

A

Dilate and gas exchange across the lungs begins

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2
Q

At birth, the baby’s heart increases workload. Instead of shunting blood to the left heart, it now must move where?

A

Through the entire pulmonary vasculature and the formen ovale

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3
Q

After the circulatory system change of oxygenation in baby occurs the ductus arteriosus is___

A

Unoxygenated (the ductus arteriosus should close to create the vasculature the baby will have throughout life)

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4
Q

How long can it take after birth for the ductus arteriosus to fully close?

A

Hours to 2 days

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5
Q

When does complete dilation of the pulmonary blood vessels occur?

A

Several months after birth

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6
Q

Define Asphyxia

A

Lack of oxygen to the brain

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7
Q

When does Asphyxia (too much carbon dioxide , not enough oxygen) occur?

A

Before, during, or after birth

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8
Q

What happens if baby doesn’t take it’s first breath immediately after birth

A

prevents lung fluid from being absorbed

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9
Q

What causes Insufficient oxygen content in artieral blood?

A

When lung fluid is not absorbed (due to the baby not taking a breath immediately)

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10
Q

What is the impetus (momentum) for pulmonary vasodilation?

A

Increased oxygenation of arterial blood

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11
Q

How does lack of pulmonary vasodilation impair the neonate?

A

Impairs ability to oxygenate independently of the placenta

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12
Q

Define decompensation

A

the failure of an organ (especially the liver or heart)

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13
Q

What are signs of the need for resusitation (abnormal transition during birth)

A

-apnea
-tachypnea
-irregular breathing
-hypotension
-hypoxenia
-decreased muscle tone

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14
Q

Providers should ask what 3 questions at every delivery?

A

1) is neonate term? 37week+
2) neonate breathing/crying effectively?
3) neonate have adequate muscle tone? (Active with flexed extremities)

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15
Q

Is routine suctioning for neonates recommended?

A

No

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16
Q

What’s a clue to suction a neonate?

A

Meconium stained fluid or trouble clearing secretions

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17
Q

Tactile simulation should be limited to what 3 things?

A

Drying, rubbing back & soles of feet

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18
Q

What’s the proper position of airway support

A

Supine with neck slightly extended in the ‘sniffing’ position

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19
Q

What can help achieve proper degree of neck extension during airway support?

A

A small towel rolled under shoulders

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20
Q

What triggers vagal reflex?

A

Suctioning too deeply or vigorously

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21
Q

What causes bradycardia? And what is it?

A

A slowed heart rate under 60, (vagal reflex)

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22
Q

What kind of suctioning can cause the neonate to aspirate?

A

Suctioning nose before the mouth

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23
Q

Leaving a neonates skin wet can cause

A

Decrease body temp due to evaporation even under a radiant warmer.

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24
Q

What dual purpose does drying baby with towels do?

A

Simulate them to breathe, helps body temp from not being wet

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25
Q

Neonates less than 32 weeks should be warmed using special techniques

A

Drying can take place at same time as positioning/suctioning airway support

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26
Q

If baby is not breathing vigorously after suctioning, what’s your next step?

A

Gentle stimulation, tapping feet, rubbing back or chest

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27
Q

Harsh stimulation, deep rub or shaking are (never okay) (sometimes)

A

Never

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28
Q

What is the apgar score based on (5)

A

Color
Heart rate
Reflex irritability
Muscle tone
Respiration

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29
Q

When are apgar scores accessed?

A

1-5 min after birth

30
Q

Are initial introventions determined by apgar score?

A

No

31
Q

What is the apgar score useful for?

A

Index of response to resuscitation

32
Q

If the apgar score is less than 7 at 5 minutes, then what?

A

The apgar assessment should be repeated every 5 minutes for up to 20 minutes

33
Q

If neonate is gasping within first 60sec after birth then immediately provide

A

Ppv

34
Q

While ppv is initiated, check ______

A

Heart rate

35
Q

If neonate is breathing adequately, but HR is >100bpm the first intervention is

A

PPV (NOT chest compressions)

36
Q

What’s the most importation intervention in neonatal resuscitation?

A

Ventilation

37
Q

In addition to providing PPV, providers should also use what?

A

Oximeter & ECG (Electrocardiogram)

38
Q

Where to put pulse oximeter on neonate?

A

Right wrist

39
Q

Define auscultation

A

listening to the sounds of the body during a physical examination

40
Q

Define palpation

A

using one’s hands to check the body

41
Q

What could cause the pulse oximeter not to provide an accurate heart rate?

A

Poor tissue perfusion (passage of blood), peripheral circulation

42
Q

Peripheral circulation

A

the part of the circulatory system that consists of the veins and arteries not in the chest or abdomen (i.e. in the arms, hands, legs and feet).

43
Q

If the heart rate is at least 100 bpm and baby is not gasping or apneic, what should baby be examined for?

A

Cyanosis

44
Q

During the transition period when is cyanosis normal?

A

When it’s only present in hands and feet

45
Q

Define Acrocyanosis

A

Blueness in hands and feet

46
Q

Define central cyanosis

A

Blueness in perioral area (lips, tounge, gums) or chest abdomen and back

47
Q

Diagnosing cyanosis in some babies could be difficult under what conditions?

A

Dark skin tone
Ambient lighting
Radiant warmers

48
Q

What is the underlying cause of cyanosis?

A

Poorly oxygenated blood

49
Q

True or false: pulse oximetry does not give a more accurate assessment of poorly oxygenated blood

A

False

50
Q

True or false: you can rely solely on skin coloration to diagnosis cyanosis

A

False, use pulse oximetry too

51
Q

When is use of pulse oximetry indicated (advised)?

A

To diagnosis cyanosis
Resuscitation
PPV
With supplemental oxygen

52
Q

Where is the preductal blood oxygenation measured at on infant?

A

Right arm

53
Q

Why is the blood in the arteries on the left arm and legs less well oxygenated in a newborn?

A

Because some of the blood is shunted across the heart and ductus, bypassing the lungs. (Until the ductus arteriosus closes)

54
Q

How long is the normal transition of blood oxygenation in neonate?

A

10-15 min

55
Q

A normal pulse oximetry reading 2 mins after birth may range from ___ to ___

A

65% to 80%

56
Q

What can be used as a guide to diagnosis hypoxemia?

A

The table of “normal” preductal percent blood oxygenation levels. (The percentage of oxygen in blood)

57
Q

High concentrations of _____ are toxic to neonatal lung tissue

A

Oxygen

58
Q

Oxygen concentrations that exceed concentration of oxygen in room air must be used with cation. What’s room air percentage of oxygen?

A

21%

59
Q

Rule of thumb for free flow oxygen is

A

10L /min @ 30% oxygen concentration

60
Q

What’s CPAP?

A

a therapy that helps newborns breathe by delivering a constant stream of air through a mask or prongs in the nose

61
Q

CPAP can be administered to babies who are

A

Persistently cyanotic or who have labored breathing or both

62
Q

“Normal” oxygen saturation 1 min after birth is

A

60-65%

63
Q

Normal oxygen saturation 2 min after birth

A

65%-70%

64
Q

Normal oxygen saturation 3 min after birth

A

70%-75%

65
Q

Normal oxygen saturation 4 min after birth

A

75%-80%

66
Q

Normal oxygen saturation 5 min after birth

A

80%-85%

67
Q

Normal oxygen saturation 10 min after birth

A

85%-95%

68
Q

Hypotension

A

Low blood pressure

69
Q

Hypoxia

A

lack of oxygen in the body

70
Q

Apnea

A

a pause in breathing that lasts 20 seconds or longer, or a shorter pause that’s accompanied by other signs

71
Q

Tachypnea

A

Rapid and Shallow breathing

Nrp (8 decks)

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