CH 43 Flashcards
(44 cards)
If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon:
appearance, skin color, and muscle tone.
respiratory effort, pulse rate, and color.
respirations, appearance, and muscle tone.
pulse rate, activity, and appearance.
respiratory effort, pulse rate, and color.
After performing the initial steps of resuscitation, you assess a newborn and note that their respirations are poor and their pulse rate is 50 beats/min. You should:
immediately begin positive-pressure ventilations and chest compressions and then reassess the newborn’s pulse rate in 30 seconds.
perform tactile stimulation for 30 seconds, reassess the infant’s respirations and pulse rate, and begin positive-pressure ventilations if there is no improvement.
begin chest compressions, insert an endotracheal tube, and administer 0.1 to 0.3 mL/kg of epinephrine 1:10,000 down the endotracheal tube.
begin chest compressions if the heart rate remains below 60 beats/min after 30 seconds of effective positive-pressure ventilation.
begin chest compressions if the heart rate remains below 60 beats/min after 30 seconds of effective positive-pressure ventilation.
You and your partner are caring for a 5-pound distressed newborn. After providing 30 seconds of effective bag-mask ventilations, the newborn’s heart rate remains below 60 beats/min. You should:
start a peripheral IV line and give 4 mEq of sodium bicarbonate.
try tactile stimulation as you continue bag-mask ventilations.
continue bag-mask ventilations and initiate chest compressions.
cannulate the umbilical vein and give 0.5 mL of epinephrine.
continue bag-mask ventilations and initiate chest compressions.
The quickest way to prevent newborn hypothermia involves:
thoroughly drying the newborn after birth.
applying a hot water bottle to the groin area.
administering warmed, humidified oxygen.
administering warmed IV fluids.
thoroughly drying the newborn after birth.
Which of the following events is a critical part of fetal transition?
Diversion of blood flow to the fetus’s lungs
Fetal lung expansion within 5 minutes after birth
An acute increase in intrapulmonary pressure
Blood flow diversion across the ductus arteriosus
Diversion of blood flow to the fetus’s lungs
Choanal atresia is defined as a:
condition in which the occipital skull is abnormally large.
bony or membranous obstruction of the back of the nose.
condition in which high-flow oxygen causes blindness.
small chin that causes a posteriorly positioned tongue.
bony or membranous obstruction of the back of the nose.
Your assessment of a depressed 7-pound newborn reveals tachypnea, pallor, weak peripheral pulses, a heart rate of 120 beats/min, and a blood glucose level of 58 mg/dL. Which of the following interventions will most likely cause improvement in this newborn’s condition?
Normal saline
Naloxone
Epinephrine
Dextrose
Normal saline
Which of the following is a sign of a diaphragmatic hernia?
Presence of a tracheoesophageal fistula
Metabolic acidosis
Bilaterally absent breath sounds
Scaphoid or concave abdomen
Scaphoid or concave abdomen
You are transporting a newborn who requires ongoing ventilatory support and chest compressions for severe bradycardia. Your estimated time of arrival at the hospital is 45 minutes. Air medical transport was unavailable due to severe weather. A peripheral IV line has been established in the antecubital vein, and you are in the process of attempting intubation. Approximately 10 seconds into your intubation attempt, the newborn’s heart rate suddenly drops more. You should:
administer 0.1 to 0.3 mL/kg of epinephrine via rapid IV push.
abort the intubation attempt and continue ventilations.
continue the intubation attempt and administer atropine.
ensure that chest compressions are of adequate rate and depth.
abort the intubation attempt and continue ventilations.
A delay in clamping the umbilical cord and keeping the baby below the level of the placenta can result in fetal:
polycythemia.
hypovolemia.
exsanguination.
anemia.
polycythemia.
Which of the following disorders or conditions is related to decreased glycogen stores in the newborn?
Large for gestational age
Hypoxia or hypothermia
Maternal diabetes mellitus
Small for gestational age
Small for gestational age
Which of the following factors is associated with the highest risk of newborn hypoglycemia?
Neonatal polycythemia
Morbid obesity in the mother
5-minute Apgar score of less than 7
The larger of discordant twins
Morbid obesity in the mother
During your rapid assessment of a newborn’s cardiopulmonary status, you note that the newborn’s respirations are adequate, you feel 8 pulsations in a 6-second time frame, and the newborn is centrally pink but peripherally cyanotic. The most appropriate next action should be to:
provide 30 seconds of tactile stimulation.
assess the newborn’s blood glucose level.
give free-flow oxygen by mask at 5 L/min.
administer positive-pressure ventilations.
administer positive-pressure ventilations.
The single most common cause of seizures in both term and preterm infants is:
hypoxic–ischemic encephalopathy.
a severe derangement in electrolytes.
intracranial hemorrhaging.
congenital or developmental defects.
hypoxic–ischemic encephalopathy.
If you feel 13 pulsations in a 6-second time frame, the newborn’s heart rate is approximately:
30 beats/min.
130 beats/min.
90 beats/min.
60 beats/min.
130 beats/min.
The most common reasons for ineffective bag-mask ventilations in the newborn are:
hyperflexion of the newborn’s head and thick mucous plugs.
pneumothorax and a face mask that is too large for the infant.
inadequate mask-to-face seal and incorrect head position.
equipment malfunction and a ventilation rate that is too rapid.
inadequate mask-to-face seal and incorrect head position.
Respiratory distress in a premature infant is most often the result of:
pneumonia at birth.
a pneumothorax.
intracranial hemorrhage.
surfactant deficiency.
surfactant deficiency.
Which of the following statements regarding fever in the newborn is correct?
Because of their active immune systems, newborns commonly experience fever.
Fever in newborns is defined as a rectal temperature greater than 99.0 degrees Fahrenheit.
The ability of the newborn to dissipate heat through sweating is prominent.
Fever may not always be a presenting feature in newborns with an infection.
Fever may not always be a presenting feature in newborns with an infection.
What is the combined Apgar score for a newborn with a heart rate of 80 beats/min and slow, irregular breathing?
5
2
4
3
2
Naloxone is contraindicated for use in newborns:
unless the umbilical vein has been cannulated.
with shallow breathing and persistent bradycardia.
who weigh less than 5.5 pounds.
who are born to narcotic-addicted mothers.
who are born to narcotic-addicted mothers.
Which of the following is a sign hypovolemia in the newborn?
Persistent acrocyanosis
Persistent pallor
Strong pulses
High pulse rate
Persistent pallor
You have just delivered a baby boy who was born 4 weeks premature. There is no evidence of meconium in the amniotic fluid. After drying, warming, suctioning, positioning, and stimulating the infant, he remains acrocyanotic and is not crying. You should:
determine the newborn’s Apgar score.
begin assisting his ventilations at once.
open his airway and assess respirations.
resuction his mouth for up to 10 seconds.
open his airway and assess respirations.
If hypovolemia is suspected or confirmed, you should administer how many milliliters of normal saline to a 6-pound newborn over a period of 5 to 10 minutes?
18 mL
55 mL
33 mL
27 mL
27 ml
A newborn is at greatest risk for meconium aspiration if they:
are born at more than 42 weeks’ gestation.
are large for their gestational age.
require positive-pressure ventilations.
have respiratory depression at the time of birth.
are born at more than 42 weeks’ gestation.
