Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatric/Neonatal Respiratory Care > Test 2- Ch.4 Techniques of Resusictaion and Stablization of the Neonate > Flashcards

Test 2- Ch.4 Techniques of Resusictaion and Stablization of the Neonate Flashcards

1
Q

The necessity to resuscitate a neonate is related to ___________, which can occur in utero during and after delivery

A

asphyxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define asphyxia

A

A combination of hypoxia, hypercapnia, and acidosis and may lead to irreversible damage to the brain and other vital organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some causes of fetal asphyxia

A
  • maternal hypoxia
  • insufficient placental blood flow
  • blockage of umbilical cord
  • fetal disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If hypoxia is not corrected, the ventilatory effort ceases and the fetus enters a period of apnea called _________ ____________. At this point the rate and blood pressure begins to drop

A

primary apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

With continued hypoxia, PaCO2 rises and the pH drops, leading to asphyxia. Continuation of the asphyxia leads to a second attempt by the fetus to ventilate

A

!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

During __________ ___________, there will be no attempt to breathe again unless ______________ ____________ ventilation is initiated

A

secondary apnea;
positive pressure ventilation (PPV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

____________ _______ _____________ is when blood flow continues to be shunted through the foramen ovale and the ductus arteriosus, completely bypassing the lungs as it did during the fetal circulation

A

Persistent fetal circulation (PFC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the preparations for resuscitation

A
  • Anticipation of a High-risk delivery
  • Prepare equipment
  • Have trained personnel who can perform resuscitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 questions that should be asked upon delivery of the neonate according to NRP?

A
  1. Is the neonate term?
  2. Is the neonate crying or breathing?
  3. Is there good muscle tone?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The first step in resuscitating the neonate us to provide some degree of

A

thermoregulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Radiant heat loss is defined as:

How is it minimized?

A

transfer of heat from one object to another without their coming in contact:

immediately placing the neonate under a radiant warmer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Conductive heat loss is the loss of…

How is it minimized?

A

heat through direct contact of one object with a cooler surface;

by placing the neonate on warmed blankets, towels, or heated mattresses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Evaporative heat loss is the loss of heat through

How is it minimized?

A

evaporation of liquids from a surface;

Thoroughly drying the neonate with a warmed towel ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Convective heat loss is the loss of heat due to the

How is it minimized?

A

movement of air past the skin and carrying away heat loss

By preventing cold drafts over the bed and keeping movement minimized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who are at higher risk for heat loss?

A

Low-birth-weight and preterm neonayes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the next step in the resuscitation ?

A

Opening up the airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Once the neonate is sniffers position, what is the order of suctioning?

A

1st. The mouth
2nd. The nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A vigorous neonate is defined as one with (3)

A
  • strong respiratory effort
  • good muscle tone
  • a heart rate greater than 100 bpm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Respirations should produce good chest rise that is regular in depth and pattern and is unlabored and free of grunting, flaring, or retracting

A

!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If the neonate presents with any gasping, apnea, or a heart rate less than 100 bpm what should be done?

A

PPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If the neonate presents with an HR greater than 100 bpm and labored breathing, grunting, flaring, or retractions What should you ensure?

A

the airway is clear and consider initiate CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can the HR be assessed?

A

Grasping the base of the umbilical stump between the middle finger and the thumb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The heart rate is measured for

A

six seconds and is multiplied by 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

If the HR is below 100 bpm…

If the HR is above 100 bpm…

A

below, PPV is initiated

above, then the neonates respiratory effort and color are evaluated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define acrocyanosis

A

blueness of the hands and feet, for up to several hours after delivery

26
Q

It may take up to ____ minutes for a neonate to obtain oxygenation saturation of > ___%

A

10 ;
85 %

27
Q

Where should the pulse ox be placed? And why?

A

Right hand, wrist, or forearm;
This will allow the assesment of preductal oxygen

28
Q

Because of the risk of oxygen toxicity what is recommended

A

oxygen blender, which allows the provider the ability to use a range of oxygen between 21% and 100%, during the course of the resuscitation

29
Q

How can chest compressions be administered?

A
  • thumb technique
  • two-finger technique
30
Q

The sternum is compressed ______ of the anterior-posterior diameter at a rate of ____ bpm

A

1/3;
90

31
Q

When is intubation indicated during a resuscitation? (5)

A
  1. When thick meconium is present in a non-vigorous infant
  2. If bag and mask ventilation is difficult or ineffective
  3. If prolonged PPV is required due to lung disease
  4. If chest compressions have been necessary
  5. In extreme prematurity and need for surfactant adminstration
32
Q

______________ is the only drug used during resuscitation

A

Epinephrine

33
Q

What are the indications for Epi during resuscitation? (2)

A
  1. HR remains below 60 bpm despite 30 seconds of effective PPV and 30 seconds of chest compressions
  2. the HR is zero
34
Q

Placement of a UVC and administration of epi and/or volume expanders is indicated when previous resuscitative efforts have not resulted in improvement of the infant

A

!

34
Q

Volume expanders used in neonatal resuscitation include

A
  • normal saline
  • Ringer’s lactate
  • O- Rh-neg PRBC
34
Q

The use of volume expanders is indicated in those infants showing signs of hypovolemic shock due to

A

acute blood loss

34
Q

APGAR examines 5 areas. What are they?

A
  • Respiratory effort
  • HR
  • Muscle tone
  • Reflex irritability
  • Color
34
Q

O Rh-negative packed red blood cells may be considered in extreme considered in extreme cases of documented

A

fetal anemia

35
Q

Normal glucose for term
Normal glucose for premie

A

greater than or equal to 35;
greater than or equal to 25

35
Q

Each area on the APGAR score is assessed at __ minute after delivery with a 2nd evaluation performed at __ minutes, up until __ minutes

A

1 minute;
5 minutes;
20 minutes

35
Q

Each area is given a score of

A

0, 1, or 2

35
Q

Neonatal Hypoglycemia is defined as a plasma glucose level less than

A

30 mg/dL

35
Q

What is a treatment for hypoglycemia in neonates?

A
  • A glucose infusion of 10% dextrose and water (D10W) over 1 to 3 minutes
36
Q

An umbilical arterial catheter (UAC) is indicated for use in a seriously ill neonate who may require (2)

A
  • Frequent blood gas sampling
  • Continuous arterial blood pressure monitoring
37
Q

What is the most common complication of a UAC? (2)

A
  • Thrombus formation on the catheter tip
  • hypertension and necrotizing enterocolitis
38
Q

What does the S.T.A.B.L.E mnemonic stands for?

A
  • Sugar
  • Temperature
  • Airway
  • Blood pressure
  • Lab work
  • Emotional support
39
Q

When do you initiate chest compressions?

A

Persistent HR <60 bpm (despite tactile stimulation and 30 seconds of adequate PPV)

40
Q

When performing chest compressions the sternum is compressed

A

1/3 of the chest diameter at 100-120/ min allowing the chest to fully recoil after each compression

41
Q

It can take up to 10 minutes to reach sats of 85%

A

important

42
Q

If the HR is > 60 bpm but <100 bpm continue PPV an monitor sats. Evaluate chest rise. If HR does not increase after 30 seconds of PPV reposition the infant, check your seal and continue PPV for an addition 30 seconds.

A

!!!

43
Q

If HR remains <100 then consider

A

intubation

44
Q

Targeted preductal SPO2 after birth:
1 minute

A

60-65%

45
Q

Targeted preductal SPO2 after birth:
2 minutes

A

65-70%

46
Q

Targeted preductal SPO2 after birth:
3 minutes

A

70-75%

47
Q

Targeted preductal SPO2 after birth:
4 minutes

A

75-80 %

48
Q

Targeted preductal SPO2 after birth:
5 minutes

A

80-85%

49
Q

Targeted preductal SPO2 after birth:
10 minutes

A

85-95%

50
Q

APGAR is assessed every 5 minutes up to 20 minutes until a score of _____ is achieved

A

greater than or equal to 7

51
Q

Primary apnea the neonate will

A

react to stimulation

52
Q

Secondary apnea the neonate does not

A

react to stimulation and requires PPV

53
Q

What is the suction level for neonates

A

-80 to -100 mmHg

Pediatric/Neonatal Respiratory Care (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions