NRP 8th Edition Questions and Answers Complete Solution
What is the single most important and effective step in neonatal resuscitation? ✔Ans✔ Ventilation of the newborn's lungs
Abnormal Transition Findings ✔Ans✔
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NRP 8th Edition Questions and Answers Complete Solution
What is the single most important and effective step in neonatal resuscitation? ✔Ans✔ Ventilation of the newborn's lungs
Abnormal Transition Findings ✔Ans✔ -Irregular Breathing, absent breathing, or rapid breathing
-Slow or fast heart rate
-Decreased Muscle Tone
-Pale Skin or Blue Skin
-Low oxygen saturation
-Low blood pressure
NRP algorithm- First Step ✔Ans✔ Antenatal Counselling
Team Debriefing
Equipment Check
After the birth of the baby, what do you ask? ✔Ans✔ 1. Term Gestation?
2. Good Tone?
3. Breathing or crying?
FIVE INITIAL STEPS:
If you answer NO to any of the three questions (term, tone, breathing) what do you do? ✔Ans✔ Warm
Dry
Stimulate
Position airway
Suction if needed
Apnea or gasping? HR <100bpm= NO with laboured breathing/cyanosis ✔Ans✔ Position airway, suction if needed
Pulse oximeter
Oxygen if needed
Consider CPAP
Apnea or gasping? HR <100bpm= YES ✔Ans✔ PPV
Pulse Oximeter
Consider Cardiac Monitor
HR STILL less than 100bpm= YES ✔Ans✔ Ensure adequate ventilation
Consider ETT or laryngeal mask
Cardiac Monitor
HR <60 bpm? ✔Ans✔ ETT or laryngeal mask
Chest compressions
Coordinate PPV-100% oxygen
UVC
HR STILL <60 bpm? ✔Ans✔ IV Epinephrine every 3-5 minutes
If still less than 60, consider hypovolemia or pneumothorax
Rapid Evaluation ✔Ans✔ Determine if the newborn can remain with the mother or should be moved to the radiant warmer for further evaluation
REVIEW: Three questions you ask during rapid evaluation? ✔Ans✔ 1. Term?
2. Good Muscle Tone?
3. Breathing/crying?
If the answer is NO to any of these, baby should be brought to radiant warmer.
Airway ✔Ans✔ Perform the initial steps to establish an open Airway and support spontaneous respiration
Breathing ✔Ans✔ PPV is provided to assist Breathing for babies with apnea or bradycardia
Circulation ✔Ans✔ If severe bradycardia persists despite assisted ventilation, Circulation is supported by performing chest compressions coordinated with PPV
Drug ✔Ans✔ If severe bradycardia persists despite assisted ventilation and coordinated chest compressions, the Drug Epinephrine is administered as coordinated PPV and chest compressions continue
What are the 4 pre-birth questions to ask the provider before every delivery? ✔Ans✔ 1. Expected Gestational Age
2. Is the amniotic fluid clear?
3. Are there any additional Risk Factors?
4. What is our umbilical cord management plan?
Equipment Check- Warm ✔Ans✔ -Preheated radiant warmer
-Towels/Blankets
-Temp Sensor/sensor cover
-Hat
-Plastic Wrap (<32 weeks)
-Thermal Mattress (<32 weeks)
Equipment Check- Clear the airway ✔Ans✔ -Bulb Syringe
-10F or 12F Suction catheter attached to wall suction set at 80-100mm Hg
-Tracheal Aspirator
Equipment Check- Auscultate ✔Ans✔ -Stethoscope
Equipment Check- Ventilate ✔Ans✔ -Sets flowmeter to 10 L/min
-Sets oxygen blender to 21% (21-30 if less than 35 weeks gestation)
-Checks presence/function of PPV devices, including pressure settings and pressure pop-off valves
-Sets T-Piece resuscitator at peak inflation pressure
(PIP=20-25cm H20 for term, 20cm H20 for preterm) (PEEP= 5 cm H20)
-Term and preterm sized masks
-Laryngeal mask (size 1) and 5ml syringe
-5F or 6F orogastric tube if insertion port present on laryngeal mask
-8F orogastric tube and 20ml syringe
-Cardiac Monitor and leads
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