1
Q
What is the FIO2 at blow-by at 5LPM?
A
- 1/2 inch away from the face 80%
- 1 inch away from the face 60%
- 2 inches away from the face 40%
2
Q
Why would you initiate positive pressure ventilation on a neonate?
A
- Apnea
- Gasping
- Hr <100
3
Q
When would you initiate chest compressions on a neonate?
A
- Hr< 60 with adequate ventilation
4
Q
What two methods are used to perform chest compressions on a neonate?
A
- By using two fingers
- By using both thumbs (preferred method)
5
Q
What are the indications for the administration of Narcan (naloxone)?
A
-Used if neonate has respiratory depression when delivered due to mother using narcotics.
6
Q
What are the indications for the administration of epinephrine?
A
- Used during resuscitation efforts with both positive-pressure ventilation and chest compressions. If the heart rate remains below 60bpm administer epi every 3-5 min.
7
Q
What is the rate of compression to breaths? What is it for cardiac babies?
A
- 3:1
- 15:2 for cardiac babies.
8
Q
What is the targeted preductal SpO2 after 10min?
A
- 85-95%
9
Q
What are the indications for phototherapy?
A
-Bili 5-9 mg/100
10
Q
If a newborns cry is lusty what does this indicate? If its shrill or high pitched?
A
- Lusty is normal
- Shrill or high pitched is abnormal
11
Q
What are the signs of respiratory distress?
A
- grunting
- retractions
- nasal flaring
- RR >60
12
Q
What are some conditions that cause a shift in apical pulse?
A
- pneumothorax
- atelectasis
13
Q
What condition causes cyanosis
A
- Hypoxemia
14
Q
What conditions cause yellowish hue to skin
A
- Jaundice
- Hyperbilirubinemia
15
Q
What abnormality is usually associated with an abnormal number of vessels in the cord?
A
- Urinary Tract infections
16
Q
What are the classifications of new borns weights?
A
- AGA
- SGA
- LGA
17
Q
What causes a murmur?
A
- PDA
- PFO
18
Q
What causes dark green staining?
A
- Meconium Aspiration
19
Q
What causes frothy secretions?
A
- TEF
20
Q
What causes pallor?
A
- Shock or anemia
21
Q
What causes retractions?
A
- Respiratory distress
22
Q
What causes abnormal facial features?
A
- Alcohol syndrome
23
Q
What causes scaphoid abdomen?
A
- Diaphragmatic hernia
24
Q
What causes distended abdomen?
A
- NEC
25
What are the factors assessed by the Dubowitz/ New Ballard score?
- Plantar creases
- Square window
- Scarf sign
- Heel to ear
26
What is the purpose of the Dubowitz/ Ballard score?
- Accurate gestational age
27
What are normal abdominal skin temperatures?
- 36- 36.5
28
What are clinical signs and treatments of hypoglycemia, hypocalcemia, and hypermagnesemia?
- Hypoglycemia = tremors, jitteriness, convulsions, apnea. Admin. Glucose and early feeding.
- Hypocalcemia = jittery, irritable, seizures, apnea.
- Hypomagnesemia = lethargy, hypotonia, and apnea.
29
What nebulizers are used for continuous nebulization?
- Heart
| - Hope
30
What are the characteristics of periodic breathing?
- Intermittent respiratory pauses for up to 10sec.
31
How do you assess fontanles?
- Needs to be firm but soft
| - Bulging means increased ICP
32
What is the proper use of UAC? High and Low.
- High= T8
| - Low= L3-4
33
What are the uses of the non-rebreathing mask.
- Administration of heliox
34
What is the effectiveness of HMEs on neonates?
- Less effective on cuffless tubes
35
What is the appropriate use of DPIs?
- Not for use until 6 years old
36
What is a good APGAR score vs. a good Silverman-Anderson score?
- 10 would be a perfect APGAR
| - 10 would be a poor Silverman-Anderson
37
What is the definition of tachypnea?
- RR >60
38
What is the score used to assess a newborn at 1 and 5 min?
- APGAR
39
What FIO2 is achieved with a simple mask?
- 60-80% if its tight on the face
| - 40% if its loose on the face
40
What artery is used to asses the pulse in labor/delivery room?
- Umbilical
41
What is a bulb syringe used for?
- Clear mouth and nose when needed
42
When is an incubator needed?
- Maintain NTE
| - Quiet and warm environment
43
What is an appropriate device for long term oxygen therapy?
- Nasal cannula
44
What are the FIO2s for a nasal cannula?
- .25L = 24-27%
- .5 L = 26-32%
- 1L = 30-35%
45
Use of an aerosol mist tent or croupette.
- Cool aerosol and FIO2 <50%
| - Must be tightly sealed to maintain FIO2
46
What are the advantages/ disadvantages of MDI and DPI?
- ?
47
Administration via oxyhood
- proper flowrates and temperature
| - 7-12 LPM at temp 32-34 C
48
What are airway clearance techniques?
- FET
- Huff cough
- Autogenic drainage
- breathing at 3 levels
- PEP therapy
- HFCWO
49
What is the treatment of hyperbilirubinemia?
- bili lights
50
What is the source of non shivering thermogenesis?
- Brown fat
51
What is the importance of infection control?
- IgG is only immunity that crosses the placenta . Protects only against gram positive organisms.
52
What is the diagnosis and management for NEC?
- distended abdomen
| - Managed with delayed feedings and surgery
53
To obtain correlation between Transcutaneous and arterial oxygen tensions, the infants skin surface must be heated to _________C
43-45C
54
Trancutaneous PO2 is measured with a modified Clark Electrode (True or False)
TRUE
55
The most common method of monitoring apnea is:
Impedance pneumography
56
The modified Allen's test can be used to verify collateral circulation when using the radial artery in a neonate (True or False)
TRUE
57
To avoid burning the skin, the transcutaneous monitoring site should be changed every
2-4 hours
58
Transilluminate if you are unable to feel a pulse in with of the following arteries?
RADIAL
59
Which of the following statements is false concerning capillary blood gases?
PO2 values correlate well if PaO2 is >60-70mmHg
60
A blood gas sample drawn from an umbilical artery catheter is pre-ductal. (True or False)
FALSE
61
Calcified heel nodules are a possible complication of obtaining a capillary blood sample. (True or False)
TRUE
62
What is the major advantage of heating a Transcutaneous CO2 electrode?
Increase response time
63
The CO2 transcutaneous sensor is of what type?
STOW
64
Which of the following factors relate to pulse oximeters?
1. A light source is passed through a perfused area to a photosensor
2. Readings are available within seconds of application
65
The blood in the left radial artery is
VARIABLE
66
Like transcutaneous monitors, pulse oximeters require a two-point calibration. (True or False)
FALSE
67
In the neonate, the initial application site for the TCPO2 electrode is:
Right Upper Chest
68
When should intubation be performed?
- The heart rate is less than 100.
- The infant is unresponsive to bag and mask ventilation.
- Transport of the unstable newborn is required.
69
Name the size tubes for neonates
```
<1000 grams = 2.5
1000 - 1500 grams = 3.0
1500 - 2500 grams = 3.5
Normal newborn = 3.5 - 4.0
6-12 months = 4.0 - 4.5
```
70
Explain intubation procedure for neonates
- Oxygenate with bag and mask and 100% oxygen. -Position infant in sniffing position.
- Use size "0" Miller blade.
- Appropriate insertion distance
71
What is the 7-8-9 rule?
- 7 cm mark at lip for 1 kg infant
- 8 cm mark at lip for 2 kg infant
- 9 cm mark for 3 kg infant
72
What are the catheter sizes for neonates?
- 2.5 tube = 5 fr catheter
- 3.0 tube = 6 fr catheter
- 3.5 tube = 8 fr catheter
- 4.0 tube = 8 fr catheter
73
What are the correct suction pressures for a neonate and a child?
- neonate= 60-80
| - child = 80-100
74
What factors decrease insensible water loss?
-Use of a heat shield, Increasing the relative humidity of the environment & Humidification of inspired gases.
75
Describe Apnea in a neonate
1. Apnea is often seen in premature newborns weighing less than 1,500 grams.
2. It may be accompanied by bradycardia, cyanosis, or both.
3. Central apnea occurs when respiratory effort ceases; there is no chest movement and no airflow. It is significant when it exceeds 20 seconds; it is also significant when it is less than 20 seconds if it is associated with bradycardia or color change.
4. Obstructive apnea is the lack of airflow despite continuation of respiratory effort; chest movement continues but there is no airflow.
5. Mixed apnea is a combination of central and obstructive apnea, with the central component usually followed by obstruction.
76
Apnea vs. Periodic breathing
-Periodic breathing is characterized by intermittent respiratory pauses for up to 10 seconds is a frequent finding in premature infants.
77
Name the 4 Mechanisms for losing heat and an example of each.
- Conduction– transfer of heat from newborn to a cooler surface in direct contact – example: placing infant on a cold scale to obtain weight.
- Convection– loss of heat to cooler surrounding air, air current or draft – example: resuscitation bag blowing cold air is left in the incubator.
- Evaporation– loss of heat when liquid evaporated from skin – example: infant is not dried immediately after delivery
- Radiation- transfer of heat to a cooler object not touching the infant – example: infant is in a single walled incubator without a heat shield.
78
What factors increase insensible water loss?
- Use of a radiant Warmer. Phototherapy
79
What is insensible water loss?
- The amount of fluid lost on a daily basis from the lungs, skin, and respiratory tract. Amount cannot be measured.
