PRNC 03

Question 1

In relation to intubation, what would be indicative of a too small of an ETT tube

Answer 1

decreased minute ventilation, increased resistance and WOB

Question 2

What happens if you place too large of an ETT tube in an infant?

Answer 2

can cause laryngeal and mucosal damage which will be evident post-extubation

Question 3

What can you do in order to prevent tracheal stenosis

Answer 3

Use ETT with cuffs

Question 4

What are some complications that with intubation?

Answer 4

Palatal grooving and incisal enamel hypoplasia

Question 5

What is one of the most important aspects in the care for a neonate

Answer 5

Thermoregulation

Question 6

What is the term for describing how the infant regulates temperature when they get cold?

Answer 6

Non-shivering thermogenesis

Question 7

Internal Thermal Gradient

Answer 7

This is the temperature difference between the environment and the skin

Question 8

What are the four main environmental factors effecting thermal regulation

Answer 8

radiation
conduction
convection
evaporation

Question 9

heating the bed, turning on the warmer, and hat help combat which of the 4 environmental factors

Answer 9

Radiation

Question 10

how do you prevent conduction?

Answer 10

preheating the bed and everything else you use on the baby (stethescope, wipes, ect.)

Question 11

How to prevent convection heat loss

Answer 11

Dont want air/breeze passing over the baby, place in isolet

Question 12

At what point does cold stress begin to occur?

Answer 12

<36

Question 13

What are the four behavioral cues that a baby is over stimulated

Answer 13

Facial grimacing, gaze aversion, hiccups, and irritability

Question 14

What are the physiologic cues that a baby is overstimulated

Answer 14

Cyanosis and hypoxemia

Question 15

Three things to keep in mind regarding the infant’s fragile skin

Answer 15

Use mild soap/cotton balls for cleaning
Coban or velcro use
Use citrus oils to help remove adhesives

Question 16

Why is increased WBC count not a reliable result to diagnose infection/sepsis

Answer 16

WBC are increased in infants as is

**Instead assess for a presence of the C-Reactive Protein

Question 17

What is the number one serious complication with hyperbilirubinemia?

Answer 17

Kernicterus aka bilirubing encephalopathy (braing damage)

Question 18

Normal glucose levels

Answer 18

50-110

Question 19

at what point is it classified as hypoglycemia

Answer 19

<50 mg/dl

**Detrimental to brain development

Question 20

What is the usual treatment for hypoglycemia

Answer 20

D5W 10% infusion

Also want to get them oral feedings as soon as possible

Question 21

When would it be appropriate to place an LMA?

Answer 21

If you are unable to intubate or ventilate

Question 22

What are the sizes of LMAs you would use

Answer 22

sizes 1-2

**Use size 1 for PRETERM up to 5kg

Question 23

ratio of breaths to compression

Answer 23

30:90 a min

Question 24

What are two main limitations to LMA

Answer 24

they will have a leak because they cannot handle high pressures, also should not be used on a preterm baby