Neonatal Care Chapter 42

The recommended IV dose and concentration of epinephrine for the newborn is:

. 0.1 to 0.3 mL/kg, 1:10,000

The recommended IV dose and concentration of epinephrine for the newborn is:

0.1 to 0.3 mL/kg, 1:10,000.

How much naloxone should you give to a 6.5-pound newborn with respiratory depression secondary to maternal narcotic administration?

0.3 mg

If you feel 13 pulsations in a 6-second time frame, the newborn's heart rate is approximately:

130 beats/min.

According to the Apgar score, a newborn with a heart rate of 80 beats/min and slow, irregular breathing should receive a combined score of:

2.

If hypovolemia is suspected or confirmed, you should administer ____ mL of normal saline to a 6-pound newborn over a period of ____.

27, 5 to 10 minutes

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

32 mL of normal saline

In which of the following situations would a newborn MOST likely experience a seizure?

33 weeks' gestation

A newborn born between ___ and ___ weeks of gestation is described as term

38, 42

A newborn born between ___ and ___ weeks of gestation is described as term.

38, 42

Newborn hypoglycemia is defined as a blood glucose level lower than:

45 mg/dL.

What dose and concentration of glucose would be MOST appropriate for a 6-pound hypoglycemic newborn?

5.5 mL of 10% dextrose (D10)

Chest compressions are indicated in the newborn if its heart rate remains less than ____ beats/min despite effective positive-pressure ventilations for ____ seconds.

60, 30

An infant born with a pink body and blue extremities, a pulse rate of 90 beats/min, a strong cry, and active movement should be assigned an initial Apgar score of:

8

Which of the following events is a critical part of fetal transition?

Diversion of blood flow to the fetus's lungs

During delivery of post tem baby, you note presence of particulate meconium in amniotic fluid. Post deliver assessment of newborn reveals RR: 60, BP (Systolic) 60HR: , and baby is NOT limp. The most likely form of treatment would be:

Ensure the infant is warm and dry, closely monitor and transport.(Intubation not indicated under these circumstances) * babies muscle tone would have to be limp

Which of the following statements regarding fever in the newborn is correct?

Fever may not always be a presenting feature in newborns with an infection.

Which of the following statements regarding the Apgar score is correct

If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation

Which of the following statements regarding the Apgar score is correct?

If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation.

You have been providing mag mask ventilation to a new born with a sustained HR o75 bpm/ 5 minutes. Infants abdomen is markedly distended. Intubation is against protocols. The MOST appropriate intervention involves:

Inserting Orogastric tube

Which of the following anticonvulsant medications would most likely be administered to a newborn with seizures in the prehospital setting?

Lorazepam

Which of the following factors is associated with the HIGHEST risk of newborn hypoglycemia

Morbid obesity in the mother

Which of the following factors is associated with the HIGHEST risk of newborn hypoglycemia?

Morbid obesity in the mother

What size and type of laryngoscope blade is recommended for use in a full-term newborn?

No. 1, straight correct

During transport of a newborn, timely intervention of acute deterioration is most effectively achieved by:

Ongoing observation and frequent reassessment

An oropharyngeal airway would MOST likely be indicated for a newborn with:

Pierre Robin sequence.

Delaying clamping of the umbilical cord may cause?

Polycythemia

Which of the following is NOT an antepartum risk factor that increases the potential that a newborn may require resuscitation

Prolapsed cord

Reddish hardening of the skin, usually within the first week of life/Premature infants. Very rare form of panniculitis.

Sclerema

Which of the following disorders or conditions is related to decreased glycogen stores in the newborn?

Small for gestational age

A shift of heart tones and severe respiratory distress despite positive-pressure ventilations is indicative of:

a pneumothorax

A shift of heart tones and severe respiratory distress despite positive-pressure ventilations is indicative of:

a pneumothorax.

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 in the vicinity. 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:

abort the intubation attempt and continue ventilations.

During your rapid assessment of a newborn's cardiopulmonary status, you note that its 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:

administer positive-pressure ventilations.

After performing the initial steps of resuscitation, you assess a newborn and note that its respirations are poor and its pulse rate is 50 beats/min. You should:

begin chest compressions if the heart rate remains below 60 beats/min after 30 seconds of effective positive-pressure ventilation.

Signs of a diaphragmatic hernia include all of the following, EXCEPT:

bilaterally absent breath sounds.

Causes of delayed fetal transition include all of the following, EXCEPT:

birth at 41 weeks.

Choanal atresia is defined as a

bony or membranous obstruction of the back of the nose

Choanal atresia is defined as a:

bony or membranous obstruction of the back of the nose.

If a newborn requires epinephrine and peripheral venous access is unsuccessful, you should

cannulate the umbilical vein

If a newborn requires epinephrine and peripheral venous access is unsuccessful, you should:

cannulate the umbilical vein

When performing chest compressions on a newborn, you should:

compress the chest one third the anteroposterior depth of the chest.

An untreated patent ductus arteriosus may cause subsequent development of:

congestive heart failure.

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:

continue bag-mask ventilations and initiate chest compressions.

When an atrial septal defect is present:

deoxygenated blood is able to shift from one atrium to the other and mix with oxygen-rich blood.

During the delivery of a post-term baby, you note the presence of particulate meconium in the amniotic fluid. Your post-delivery assessment of the newborn reveals that it is active, has a strong cry, and has a heart rate of 110 beats/min. You should:

ensure that the infant is warm and dry, administer free-flow oxygen if needed, and provide continuous monitoring.

A subtle seizure in the newborn is characterized by

eye deviation

During your assessment of a 30-year-old woman in active labor, she admits to being a chronic heroin abuser and states that she last "shot up" about 6 hours ago. After the baby delivers, you will MOST likely need to:

give positive-pressure ventilations.

Severely hypothermic newborns may present with sclerema, which is defined as:

hardening of the skin associated with reddening and edema.

The single MOST common cause of seizures in both term and preterm infants is:

hypoxic ischemic encephalopathy.

The MOST common reasons for ineffective bag-mask ventilations in the newborn are

inadequate mask-to-face seal and incorrect head position

A newborn is at GREATEST risk for meconium aspiration if he or she:

is born at more than 42 weeks' gestation

A newborn is at GREATEST risk for meconium aspiration if he or she:

is born at more than 42 weeks' gestation.

In contrast to primary apnea, secondary apnea:

is usually unresponsive to stimulation alone.

After inserting an orogastric tube in a newborn, you should:

leave the tube open to allow air to vent.

Compared to subsequent breaths, the first few positive-pressure breaths delivered to a distressed newborn:

may necessitate manual disabling of the pop-off valve

Compared to subsequent breaths, the first few positive-pressure breaths delivered to a distressed newborn:

may necessitate manual disabling of the pop-off valve.

Common causes of respiratory distress in the newborn include:

mucous obstruction of the nose.

The primary source of heat production in the newborn is:

nonshivering thermogenesis.

When fever is suspected in the newborn, you should:

observe for the presence of a rash.

During transport of a newborn, timely intervention of acute deterioration is MOST effectively achieved by

ongoing observation and frequent reassessment

You have just delivered a little girl 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, she remains acrocyanotic and is not crying. You should:

open her airway and assess respirations.

Signs of hypovolemia in the newborn include all of the following, EXCEPT:

persistent acrocyanosis

A delay in clamping the umbilical cord and keeping the baby below the level of the placenta can result in fetal

polycythemia

The initial steps of newborn resuscitation include:

proper positioning.

In addition to an IV dextrose bolus, the MOST important treatment for newborn hypoglycemia is:

proper thermal management.

A newborn with a pulse rate of 80 beats/min:

requires immediate positive-pressure ventilation.

Mortality and morbidity are high among infants who are delivered at 24 weeks' gestation, usually because of:

respiratory and neurologic problems.

If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon:

respiratory effort, pulse rate, and color.

Tetralogy of Fallot is a combination of four heart defects, including:

right ventricular hypertrophy.

The risk of newborn complications is HIGHEST if the amniotic sac:

ruptured more than 18 hours before birth.

The MOST common device used to provide positive-pressure ventilation to a newborn in the prehospital setting is a:

self-inflating bag-mask device.

The MOST common etiology for bradycardia in a newborn is

severe hypoxia

The MOST common etiology for bradycardia in a newborn is:

severe hypoxia.

You are assisting in the delivery of a baby. After the baby's head emerges from the vagina, you should quickly assess for the presence of a nuchal cord and then

suction its mouth and nose.

Respiratory distress in a premature infant is MOST often the result of:

surfactant deficiency.

Caput succedaneum is defined as:

temporary swelling of the soft tissue of the baby's scalp secondary to pressure from the dilating cervix.

Because stimulation of the parasympathetic nervous system and bradycardia can occur during intubation of a child, you should closely monitor??

the childs cardiac rhythm and HR

Total anomalous pulmonary venous return is a rare congenital defect in which:

the four pulmonary veins connect to the right atrium.

Epinephrine is indicated during newborn resuscitation if:

the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions

The quickest way to prevent newborn hypothermia involves:

thoroughly drying the newborn after birth.

Naloxone is NOT recommended for use in newborns:

who are born to narcotic-addicted mothers.