Assessment and resuscitation of newborn

Question 1

List Maternal risk factors

Answer 1

Gestational diabetes
Pre-eclampsia
Previous pregnancy complications
Advanced maternal age
Drug or alcohol use
Smoking
Placental previa
Placental abruption
Amniotic fluid volume disorders

Question 2

What are the effects of Gestational Diabetes

Answer 2

Makes Baby very large
Poses delivery risks in birth canal
Babies may have hypoglycemia lead to resp issues

Question 3

What is Pre-eclampsia

Answer 3

Hi blood pressure in mom (causes seizures) for mom
Eclampsia causes baby to be small for gestational age, baby born premature to save mom

Question 4

What are effects of previous pregnancy complications

Answer 4

Incompetent cervix, leads to high risk pregnancy

Question 5

What age is considered advance maternal age/ geriatric pregnancy

Answer 5

35

Question 6

What effect does alcohol have during pregnancy / on the fetus

Answer 6

Nervous system abnormalities
Small for gestational age
Placental abruption

Question 7

what is placental abruption

Answer 7

Placenta becomes detached from uterine wall

Question 8

What affect does placental abruption have on the baby

Answer 8

Baby isnt getting O2 + Nutrients
Hypovolemic
fetal asphyxia

Question 9

What effect does smoking have on the baby

Answer 9

Prematurity
Small for gestational age
Baby at higher risk for SID

Question 10

How does Oligohydraminos effect the infant

Answer 10

Can cause umbilical cord compression on babies head

Question 11

What is polyhydramnios

Answer 11

Premature rupture of the membranes

Question 12

What is the Fern Test

Answer 12

A test done to see if mom is leaking amniotic fluid

Question 13

What is cord prolapse

Answer 13

Cord comes out of the vagina before baby

Question 14

What is Amniocentesis

Answer 14

A test done to test chromosomal abnormalities

Question 15

what does an ultrasound do ?

Answer 15

Measure fetal growth
View position of fetus and placenta
Assess amniotic fluid amount
Identify potential anomalies

Question 16

Is variability good or bad in fetal HR?

Answer 16

Good, there should be variability in HR

Question 17

What do Decelerations mean in fetal HR

Answer 17

A drop greater than 45 indicates something is going on

Question 18

During resuscitation what % FiO2 do you use on a infant over 35 weeks

Answer 18

21%

Question 19

During resuscitation what % Fio2 do you use for an infant under 35 weeks

Answer 19

30%

Question 20

What is an indication of delivery room CPAP

Answer 20

Newborns who are spontaneously breathing with signs of resp distress ( Accessory muscle use or grunting)

Question 21

What are indications for PPV resuscitation

Answer 21

Apnea
Gasping after stimulation
HR <100

Question 22

Indications for neonatal intubation

Answer 22

Bag mask ventilation is ineffective
Chest compressions are required
Prolonged positive pressure ventilation

Question 23

What are routes of administration for a baby

Answer 23

Umbilical venous line
Intravenous
Instraosseous

Question 24

How often do you repeat giving epi?

Answer 24

every 3-5 min

Question 25

If baby has bloodloss/fetal asphyxia what do you need?

Answer 25

You need a volume expander and epi while doing chest compressions

Question 26

*preterm babies may breathe faster than term abies

Question 27

What is a term babies BP

Answer 27

60/40

Question 28

That is a preterm babies BP

Answer 28

50/30

Question 29

what is a key sat for newborns

Answer 29

>90

Question 30

What is a NewBorns babies HR

Answer 30

110-160

Question 31

What is Pectus Excavatum

Answer 31

Sternum curves inward can be severe (funnel chest)

Question 32

What is pectus carunatum

Answer 32

Bird chest, Chest curves outward

Question 33

What does nasal flaring/grunting indicate ?

Answer 33

Baby is trying to breath with difficulty Nasal flaring: baby trying to open nose more Grunting: trying to create more pressure

Question 34

What do retractions and grunting indicate

Answer 34

Trachea sinking in

Question 35

What are types of retractions

Answer 35

Suprasternal Substernal Subcostal Intercostal

Question 36

Suprasternal Retractions

Answer 36

Tracheal tugging Jugular notch at area close to trachea

Question 37

Substernal Retractions

Answer 37

Beneath ribs at level of abdomen

Question 38

Subcostal Retractions

Answer 38

Just below rib cage (belly breathing)

Question 39

Intercostal retractions

Answer 39

(Inbetween ribs) Presentation: rib will sink in

Question 40

What us Acrocyanosis?

Answer 40

Cyanosis of hands and feet, fine can take up to 24 hours to go away. Baby has to reverse circulation

Question 41

What is Circumoral Cyanosis

Answer 41

Cyanosis around nose/mouth/mucous membranes More central (close to heart) will provide O2 and CPAP

Question 42

what us the silverman anderson score?

Answer 42

score helps assess severity of resp distress

Question 43

What are ABG sites in a Newborn

Answer 43

Radial Artery Umbilical Artery

Question 44

What is a capillary stick site

Answer 44

heel stick

Question 44

What are noninvasive ways to monitor POC and PCO2?

Answer 44

Pulse oximetry and transcutaneous monitoring

Question 45

What value do we not use from a capillary stick

Answer 45

PO2

Question 46

What may appear enlarged on an xray after birth?

Answer 46

The heart

Question 47

Where should the ETT be on a newborn?

Answer 47

at the level of T3, or between the clavicles and carina

Question 48

What is thymus

Answer 48

Extra part in the mediastinum (goes away with age)

Question 49

Where is the Umbilical Venous line on a cxr

Answer 49

Tip should be near IVC at the level of the diaphragm

Question 50

Where is the Umbilical Arterial Line

Answer 50

At the level of T6-T9

Question 51

How many ribs should you see on a CXR?

Answer 51

8-10

Question 52

What is the definition of a maternal risk factor

Answer 52

Any condition that interferes with placental blood flow or the transfer of oxygen or the fetus