NP Resp Care FINAL STUDY GUIDE
During mechanical ventilation using high-frequency oscillatory ventilation, functional residual capacity is adequately maintained when a chest radiograph reveals:
lung inflation of 9 posterior ribs above the level of the diaphragm
What risk factors increase the likelihood of an infant being born with persistent pulmonary hypertension? 3
male/ >41wG/ C-section prior to labor
which infant diagnosis are also associated with pulmonary hypertension? 3
meconium aspiration syndrome/ pulmonary hypoplasia/ hypoplastic left heart syndrome
what arterial blood gas result is evidence of a diagnosis of cyanide poisoning?
metabolic acidosis with adequate oxygenation
respiratory management for an infant with congenital diaphragmatic hernia should consist which of the following? 4
monitoring for hypercarbia/ avoidance of hypoxemia/ minimizing iatrogenic lung injury/ avoiding bag and mask ventilation to decrease abdominal distention
you have been providing PPV to a 26 week gestation infant for 1 minute. her heart rate via pulse oximeter is 55bpm. she is the limp and making no respiratory effort. she has no response. her color is pale blue. what is your next move besides continuing bag-mask ventilation?
Begin compression using two thumb technique with finger supporting back
what are clinical signs of necrotizing enterocolitis? 6
Bradypnea/ tachypnea/ increase WOB/ apnea/ ascites/ anasarca
In the prevention of pneumonia in a neonate, all the following are recommended except:
Bronchial hygiene therapy
According to current practice, What initial settings of CPAP, PIP, and inflation rate would be used for an infant who is placed on NIPPV?
CPAP 5cmh20/ PIP 15cmh20/ inflation rate 55/ i-time 0.3s
baby boy Rodger a 25wG at 1200g is breathing spontaneously and has a heart rate greater than 100bpm. after 1 minute his condition presence as follows; cyanosis and low spo2. what should the RRT consider at this time?
CPAP therapy
What treatments may improve lung fluid clearance in infant with transient tachypnea?3
CPAP/ oxygen/ frequent turning of the patient
what is the most commonly used treatment in the management of lung inhalation injuries?
CPT
Which of the following treatments should be used in the management of an infant who presents with a simple pneumothorax?
100% oxygen hood
What is the incubation period for an infant who is carrying the virus for bronchiolitis?
2-8 days
Which lecithin-sphingomyelin (L/S) ratio designates the correct lung maturity?
2:1; 2% chance to develop respiratory distress syndrome if delivered
What period of gestation does mature surfactant begin to appear?
35 weeks
what is the compression to ventilation ratio that a registered respiratory therapist should use during neonatal resuscitation?
3:1
What are initial nasal continuous positive airway pressures are recommended by the American Association of Respiratory Care Clinical Practice Guidelines for a neonate?
4-5cmh20
what is the half life of carboxyhemoglobin at room air?
5 hours
it's okay to leave patient bedside when surfactant has been delivered.
False
meconium stained amniotic fluid is common among infants who are less than 37 weeks gestation age.
False
most infants with transient tachypnea are born premature.
False
what is believed to be the cause of transient tachypnea of the newborn?
delayed clearance of fetal lung fluid
what are steps the healthcare team can Implement to minimize the risk of intraventricular hemorrhage?5
delayed cord clamping 30-120 seconds after delivery/ prenatal maternal steroids/ volume targeted pressure ventilation only/ monitor hemodynamic values/ maintaining neutral head position
A pregnant woman has been diagnosed with pregestational diabetes. Which of the following is not a(n) risk factor(s) that the therapist should be aware at the time of delivery involving the unborn baby?
diabetic ketoacidosis
in which type of drowning does laryngospam persist after a person loses consciousness?
dry drowning
potential benefits of gradual reduction of bowel vs. primary production include which of the following? 3
fewer days on the ventilator/ decrease incidence of barotrauma/ decrease risk for infection
During fetal development, what structure or opening allows circulation to bypass the lungs and enter the left atrium?
foramen ovale
What common disease process accompanies laryngomalacia?
gastroesophageal reflux
What substance speeds up lung growth and reduces the incidence of respiratory distress syndrome?
glucocorticoids
All of the following direct lung injuries can lead to acute respiratory distress syndrome except:
pulmonary edema
what are the clinical complications that coexist of congenital diaphragmatic hernia collectively known as CDH syndrome? 4
pulmonary hypoplasia/ pulmonary hypertension/ cardiac insufficiency /hypoxia
What viral pathogen accounts for 50% to 80% of all bronchiolitis cases?
respiratory syncytial virus
All the following are specific issues that put preterm babies at risk after delivery except:
strong capillaries within the brain which are at higher risk of rupture and bleeding
Polyhydramnios is associated with all of the following except
toxic habits
A 34 weeks gestation is born and breathing at 30 bpm. you began to provide assisted breaths using a t piece resuscitator. it is best to begin delivery of oxygen at room air.
true
An atrial septal defect that has a Qp/Qs ratio > 1.5:1 is indication for the need of an ASD closure.
true
During the first appearance of pulmonary surfactant in the Canalicular phase, type 1and 2 cells appear, but not enough surfactant is produced to sustain the opening of the alveoli.
true
Gestational Diabetes can delay the development of surfactant in the unborn.
true
Successful atrial septal defect closure has excellent long-term outcomes.
true
The alveoli will continue to proliferate until the age of 8-10 years of age.
true
a lower airway foreign body often is difficult to recognize and may manifest itself as a secondary pneumonia.
true
apnea of prematurity is a developmental disorder caused by a physiological immaturity of the neurological and chemical receptors system of the body.
true
because of their basal oxygen consumption, children will desaturate more rapidly than adults will.
true
capnography is the best mode of patient assessment ventilation, besides ABG.
true
infants are more susceptible than are adults to right mainstem intubation of the right lung.
true
invasive positive pressure ventilation is a system that helps recruit collapsed alveoli and maintain FRC and improve oxygenation.
true
more than 50% of congenital diaphragmatic hernia survivors will continue to be afflicted with gastrointestinal dysfunction.
true
persistent lung damage can cause pulmonary hypertension and lead to heart failure.
true
repair of the Omphalocele can be delayed for months to years depending on the size of the defect.
true
the best treatment of an upper airway foreign body obstruction and is coughing is to provide no medical care until object is removed or the child deteriorates.
true
the heated sensor for transcutaneous needs to be changed every 4 hours due to blistering.
true
the risk of cerebral palsy in patients with low grade intraventricular Hemorrhage is significantly higher for 24wG infants.
true
the single best way to prevent RDS is to prevent premature delivery.
true
What 4 risk factors are associated with necrotizing enterocolitis in infants?
umbilical catheters/ exchange transfusion/ polycythemia/ treatment for PDA with indomethacin
what are the three fundamental pathophysiologic group associated with PPHN?
under development of pulmonary vascular/ now development of pulmonary artery muscle layer/ Maladaptation due to adverse perinatal condition
transition to the extrauterine world consists of all of the following rapid, physiological events except:
Vasoconstriction of the pulmonary vascular and an increase in Pulmonary vascular resistance
What is the most common congenital cardiac defect?
Ventricular septal defect
When should Ribavirin be considered? I. Severe respiratory syncytial virus bronchiolitis II. Congenital immunodeficiency III. Inpatients admitted to hospital with bronchiolitis IV. Routine protocol as part of respiratory management of bronchiolitis V. Bone marrow transplant VI. Acute lung disease
I, II, V
How does pulmonary interstitial emphysema present? I. Hypoxemia II. Hypercapnia III. Hypertension IV. Episodes of apnea V. Cyst-like formations 4-10 mm in diameter VII. Mediastinal shift and atelectasis of contralateral lung VIII. Air bronchograms
I, II, V, VII
Treatment and management of choanal atresia include which of the following options? I. Choanal opening created via surgical repair II. Propping infant's nose open with nasal trumpet III. Intubation IV. Using a feeding nipple with a large opening
I, III, IV
What percentage of ventricular septal defects close in the first 2 years of life?
75%
if a newborn weighs 2.5 kg, where should the endotracheal tape be taped?
8.5 cm at the upper lip
what respiratory therapies are warranted for children with smoke inhalation injuries? I. expeditious intubation II. administration of racemic epinephrine III. antibiotic therapy IV. administering corticosteroid within 36-48H of insult to prevent further edema formation
I, II, IV
Pneumonia presents in which of the following ways? I. Respiratory rates greater than 60 breaths/minute II. Accessory muscle use and retractions III. Bulging sternum IV. Decreased heart sounds V. Abrupt duskiness VI. Hyperthermia VII. Abdominal distention
I, II, IV, VII
What are the clinical signs and symptoms of bronchiolitis? I. Cough II. Retractions III. Prolonged inspiratory time IV. High-grade fever V. Cyanosis VI. Otis drainage
I, II, V
What is -caffeine citrate? - inhaled nitric oxide? -inositol? -vitamin A? - thiazides?
- stimulant and Mild diuretic - pulmonary vasodilator -enhances the synthesis of surfactant phospholipids - retinol - diuretic of choice in ventilation
Which drugs can be used to stop contractions: 3
-Indomethacin -magnesium sulfate. -Terbutaline
Oligohydramnios is associated with? 4
-Renal agenesis -Congential abnormalities -Lung hypoplasia -AFI<5cm
What diagnostic tools are used to identify cardiac defects? I. Chest radiograph II. EKG III. Arterial blood gas testing IV. CT scan V. Echocardiogram VI. MRI
I, II, V
you have been providing PPV to a 26 week gestation infant for 30 seconds. her heart rate via pulse oximeter is 55bpm. she is the limp and making no respiratory effort. she has no response. her color is pale blue What is her apgar?
1
Septum secundum is defined as:
A muscular structure that grows downward from the upper portion of the embryologic atria
Which of the following conditions are associated with preeclampsia? I. Multiparity II. Chronic renal disease III. Proteinuria IV. Hypertension
All of the choices
Dead space ventilation in infants with respiratory distress syndrome is frequently caused by which of the following?
Alveolar hyperinflation
Which of the following is a life-threatening complication associated with bronchiolitis?
Apnea
A patient who presents with decreased femoral pulses, brachiofemoral delay, and continuous flow murmur suggest:
Coarctation of the aorta
Tracheoesophageal fistula should be suspected when an infant presents with which of the following symptoms?2
Excessive drooling/ feedings that give away to respiratory distress
what five errors can occur in ABG sampling?
Heparin dilution/ Air in sample/ venous admixture/ temperature/ metabolism
which of the following is not a problem with the typical case in meconium aspiration syndrome?
Hypovolemia
What are the clinical manifestations of pneumopericardium? I. Muffled or absent heart tones II. Decreased arterial blood pressure III. Tachycardia IV. Bradycardia and hypoxia V. Pulseless electrical activity
I ,II ,IV, V
which of the following are complications to NCPAP? I. decreased cardiac output II. increase work of breathing III. decrease pulmonary vascular resistance IV. increase cardiac output V. air leak syndrome VI. increase pulmonary vascular resistance
I ,II ,V, VI
What terms are synonymous with maintaining a higher PaCO2 to help deter lung injury in an infant? I. hypercarbia II. permissive hypercapnia III. gentle ventilation
I and II
what clinical evaluations need to be assessed by the RRT to determine whether the PIP has been set adequately in an infant who has respiratory distress syndrome? I. exhaled tidal volume is greater than 3 m l/kg and less than 6 or 7 ml/kg II. pH is 7.25- 7.35 with a paco2 a 45- 55mmhg III. pH of 7.45 with a paco2 60mmhg
I&II
What common diagnostic testing can be used to diagnose bronchiolitis? I. Chest radiograph II. CT scan III. MRI IV. Sputum culture V. Respiratory syncytial virus test
I&V
Registered respiratory therapists should use which of the following strategies to treat a severe upper respiratory obstruction associated with a double aortic arch? I. Intubate and place on mechanical ventilation II. Positive pressure ventilation III. Positive end-expiratory pressure IV. Bronchodilators V. Racemic epinephrine
I, II, III
Evidence-based clinical guidelines for treatment and management of acute bronchiolitis suggest which of the following? I. Mucous clearance is necessary. II. Frequent monitoring of respiratory status III. Ventilatory support as necessary IV. Oxygen support as necessary
I, II, III, IV
The goals of mechanical ventilation in the management of acute respiratory distress syndrome include which of the following? I. Reduce work of breathing. II. Increase alveolar recruitment. III. Minimize barotrauma. IV. Reduce metabolic demand. V. Reverse hypoxemia and hypercarbia.
I, II, III, IV, V
What are the signs of respiratory distress in a near drowning patient? I. pink frothy sputum II. serosanguieous fluid in the lung III. coughing IV. rales V. atelectasis VI. paradoxial breathing VII. asymmetric breath sounds
I, II, III, IV, V, VII
Which of the following are considered inexpensive methods at the bedside to identify choanal atresia? I. Tissue test II. Mirror test III. Nasal endoscopy IV. Deep tracheal suctioning V. MRI scan VI. CT scan
I, II, III, and IV
What are the reasons to avoid excess of oxygen delivery to premature infants? I. increase the risk of brain injury as a result of instability of blood vessels in germinal Matrix. II. increased risk of brain injury as a result of over stabilisation of blood vessels in germinal Matrix. III. increased retinal damage IV. permanent structural damage to type 1 cells in alveoli V. temporary structural damage to type 1 cells in alveoli VI. temporary structural damage to type 2 cells in alveoli
I, III, IV
Symptoms evident into childhood in a patient with an atrial septal defect presents with which of the following initial symptoms? I. Exercise-induced dyspnea II. Ventricular tachycardia III. Atrial fibrillation IV. Exercise-induced fatigue V. Atrial flutter
I, III, IV, V
Which of the following are organisms that lead to pneumonia in the infant? I. Group B streptococci II. Staphylococcus aureus III. Cytomegalovirus IV. Chlamydia trachomatis V. Listeria monocytogenes
I, III, IV, V
Which of the following are symptoms of aortic stenosis? I. Tachypnea II. Normal feedings III. Failure to thrive IV. SyncopeV. Vigor VI. Gradual exercise intolerance
I, III, IV, VI
What does a registered respiratory therapist need to be vigilant in assessing once a patient is given prostaglandin therapy? I. Apneas of greater than 20 seconds II. Tachypnea III. Bradycardia IV. Desaturations V. Peripheral edema VI. Hypotension
I, III, IV, and V
Pneumonia is often classified into which of the following four categories? I. Aspiration pneumonia II. Severe acute respiratory syndrome III. Hospital-acquired pneumonia IV. Bronchiolitis obliterans organizing pneumonia V. Immunocompromised pneumonia VI. Community-acquired pneumonia
I, III, V, VI
Which of the following diagnostic tests are used to confirm a diagnosis of double aortic arch? I. MRI II. CT scan III. CT angiography IV. Barium swallow
I, III, and IV
which of the following options illustrates risk factors for transient tachypnea? I. C-section delivery II. maternal long labor intervals III. prolonged labor IV. female gender
I,II,III
strategies to manage persistent pulmonary hypertension of the newborn consists of which of the following? I. oxygen therapy for treatment of hypoxia II. glucose if cause in hypoglycemia III. surfactant for RDS IV. pain medication if the causes pain
I,II,III,IV
How does a patient present with meconium aspiration syndrome? I. Gasping respirations II. retractions III. High umbilical pH IV. tachypnea V. grunting
I,II,IV,V
Patients with which of the following genetic syndromes have an increased prevalence of coarctation of the aorta? I. Trisomy 13 II. Turner syndrome III. DiGeorge syndrome IV. Down syndrome
II and III
A patient with atrioventricular septal defect would present with which of the following characteristics? I. Rapid weight gain II. Diaphoresis while feeding III. Noneventful feeding episodes IV. Fatigue
II and IV
Postoperative surgical risks for coarctation of the aorta include which of the following? I. Persistent hypotension II. Vocal cord paralysis III. Chylothorax IV. Upper extremity paralysis V. Post coarctectomy syndrome
II, III, and IV
What are some clinical symptoms of a moderate-to-large ventricular septal defect, specifically nonrestrictive left-to-right shunting? I. Tachycardia II. Tachypnea III. Accessory muscle use IV. Failure to thrive V. Diaphoresis VI. Cyanosis VII. Poor feeding
II, IV, V, and VII
A registered respiratory therapist should include which of the following treatments in the care and management of a postoperative patient with an atrial septal defect? I. Albuterol II. Hyperventilation III. Chest physiotherapy IV. Noninvasive ventilation V. Supplemental oxygen
IV and V
Treatment for ventricular septal defect should consist of all of the following except:
IV fluids
all of the following revealed positive response to surfactant replacement therapy:2
Improved sao2, decreased WOB
what facilitates the changes in a neonate that allow the neonate to move from fetal circulation to adult circulation? 3
a decrease in pulmonary vascular resistance in a significant increase in systemic vascular resistance/ a newborn first breath/ clamping of umbilical cord
all the following symptoms support diagnosis of respiratory distress syndrome except:2
L/S ratio 1:2, shake test positive
Which of the following is both the most common laryngeal anomaly and the most common congenital cause of stridor?
Laryngomalacia
A pregnant woman at 30 weeks of gestation with premature rupture of membranes has been admitted to the hospital with preterm labor. The physician has ordered betamethasone be given to the mother one week in advance of her delivery. What is the advantage of giving Betamethasone in early pregnancy?
Matures the development of the lungs in the unborn infant
What are some of the contributing factors for neonatal atelectasis? 4
Meconium aspiration syndrome / Low lung compliance due to RDS / Lung compression from lung masses or diaphragmatic hernia / Surfactant deficiency
what is the best way to deliver oxygen to an infant who has a weak inspiratory effort that helps reduce expiratory WOB venting excess gas away from the patient?
NCPAP
what are complications associated with congenital diaphragmatic hernia? 4
PDA/ patent foramen ovale/ malrotation/ pulmonary hypoplasia
Gentle ventilation consists of maintaining which of the following parameters? 5
PIP to maintain paco2 45-60mmhg/ ventilation pressure less than 25cmh20/ PEEP 4-6cmh20/ i-time 0.3-0.4s/ normoxemia
Findings that suggest a patient has acute respiratory distress syndrome include a PaO2/FiO2 of:
Pa02/ Fi02 less than 200
which of the following cases does not indicate the need for NCPAP but intubation & ventilation?
Pac02 greater than 60mmhg and pH less than 7.25
Mechanical ventilation strategies to manage acute respiratory distress syndrome should include all of the following except:
Plateau pressures > than 40cmh20
baby Carter presents with gasping breaths, his heart rate is greater than 100 beats per minute and the presence of secondary apnea is seen. Initially what is the best approach when managing this newborn?
Positive pressure ventilation via resuscitation bag and mask
What initial intervention for Robin sequence will alleviate 70% of an infant's airway obstruction?
Prone position
Foramen ovale connects the:
RA to LA
A recently home-delivered baby is brought in to the Emergency Department by the paramedics. The physician asks the respiratory therapist to help evaluate the newborn's condition. Normal vital signs for a term newborn include all of the following EXCEPT:
RR 20bpm
Which of the following are the clinical symptoms used to measure the severity of bronchiolitis? 7
RR/ Hypoxemia- sao2/ accessory muscle use/ WOB/ breath sounds/ mental status/ feedings
What is considered the most common subglottic abnormality seen by registered respiratory therapists?
Subglottic stenosis
Treatment of the infant with persistent pulmonary hypertension may include all the following except
Theophylline
Atrioventricular septal defect is especially common in children with what syndrome?
Trisomy 21
normally meconium is not passed by the infant until after birth.
True
What are some of the causes for a pneumomediastinum? 3
airway obstruction/ infections/ obstructive lung disease
what does the acronym apgar stand for?
appearance, pulse, grimace, activity, respirations
Which of the following are considered risk factors for a pneumothorax? 3
aspiration of meconium/ RDS/ mechanical ventilation
what radiographic finding is common in infants with transient tachypnea?
bilateral perihilar infiltrates
what is the primary means of diagnosing direct lung injury?
bronchoscopy
Which of the following drugs is considered the safest and most effective in treating apnea in premature infants?
caffeine citrate
The best definition for extreme apneic events are those with;
cessation of breathing for 30 seconds or a HR less than 50 to 60 bpm for 10 seconds or more
anatomical and physical differences between children and adults include which of the following? 4
children have smaller cricoid than adults/ epiglottis, tongue, lymphoid tissues is larger in an infant compared to adult
What are the signs and symptoms of pneumonia? 6
chills/ lethargy/ loss of appetite/ increase WOB/ cough with thick sputum/ fever >38.5C
which of the following are options to treat a patient who presents with patent ductus arteriosus with pulmonary edema on CXR? 4
consider HFOV/ increase PEEP by 1-2cmh20/ administer exogenous surfactant/ judicious administration of oxygen
an upper airway foreign body obstruction is manifested by: 5
coughing/ different phonation/ wheezing or stridor/ retractions/ drooling
What is the smallest portion of a child's Airway?
cricoid ring
which of the following can be used in the management of an infant with necrotizing enterocolitis? 3
decompression of bowel/ replacement of blood products/ IV antibiotics
What structure vasoconstricts after the umbilical cord is clamped?
ductus venosus
Which of the following tests can definitively verify the presence of recurrent respiratory papillomatosis?
endoscopy
which of the following can a registered respiratory therapist employee to the most effectively assess the quality of lung inflation and a patient with necrotizing enterocolitis?
evaluate pressure volume loops
Aerosol- dose medication is calculated based on body size.
false
Antibiotic regiments should be given as routine therapy for viral bronchiolitis.
false
Higher surface tension improves lung compliance.
false
The administration of surfactant to infants less than 28 weeks of gestation has not significantly decreased infant mortality rates associated with pneumothorax.
false
a neonate should not be suctioned prior to the installation of surfactant.
false
bradycardia always occurs with an apnea episode and associated saturation problems.
false
bronchopulmonary dysplasia and asthma are similar in their pathologies.
false
caffeine citrate should not be used routinely in treatment of apnea of prematurity.
false
capillary sampling is reliable for P02 values.
false
during cardiopulmonary resuscitation, a newborns heart rate should be assessed every 5 seconds to determine effectiveness of compressions.
false
in recent studies, sufficient evidence has been given to support the routine use of inhaled nitric oxide as a rescue therapy for treatment of respiratory distress syndrome.
false
surfactant progress has been made in developing therapies to slow the progression of necrotizing enterocolitis.
false
to avoid increase wob , infants automatically compensate by decreasing their RR to decrease their minute ventilation.
false
transcutaneous monitoring is reliable during code blue situation.
false
which statement below best describes surfactant?
helps reduce surface tension within lung on exhalation
Complications for arterial blood gas sampling include? 3
hematoma, scarring, vessel trauma
Cesarean Delivery is indicated for which of the following Maternal Infections?
herpes simplex
Which of the following statements about respiratory distress syndrome are true?
higher incidence occur in males than females
What organism causes the viral disease recurrent respiratory papillomatosis?
human papillomavirus HPV
high dosages of dexamethasone given to an infant within the first week after birth can increase the risk of all the following except:
hypoglycemia
which of the following factors May stimulate pulmonary vascular spasm in cause persistent pulmonary hypertension of the newborn? 4
hypoxemia/ acidosis/ hypotension/ pain and agitation
which of the following statements are true regarding disadvantages of self-inflating bags? 3
inability to know if a good seal is being obtained/ a reservoir attachment needed to achieve 100% fio2/ inability to provide 100% fio2 free-flowing dependably
the capillary gas sampling techniques errors include? 3
inadequate warming of site/ excessive squeezing our Milking/ exposure of blood to air during sampling
what may cause the collapse of the extrathoracic trachea in a neonate due to the cricoid development?
increase negative pressure from increased work of breathing
the best way to reduce paco2 in neonates is by; 3
increasing pip/ increasing vt/ increasing inspiratory time
which of the following factors contribute to surfactant dysfunction in patients with congenital diaphragmatic hernia? 2
lung hypoplasia/ Change in surfactant composition as a direct result in ventilatory induced injury
what is the leading cause of death among burn patients?
inhalation injury
what is the course of action when a newborn presents with secondary apnea?
initiate positive pressure ventilation
a decrease in incidence of bronchopulmonary dysplasia has been seen in all the following modalities of Care except:
institution of high fi02
which of the following should be done early in treatment of the non vigorous infant with meconium aspiration syndrome?
intubate and suction
All of the following statements about fetal heart rate FHR monitoring are true except:
it improves neonatal outcomes
Recurrent respiratory papillomatosis is the most common benign neoplasm of which airway structure?
larynx
what week of gestation and birth weight combination are considered to be premature And extremely unlikely for survival?
less than 23 wG; less than 500g birth weight
all the following are associated with IVH in a neonate except?
neutral head positioning
what is a mechanical ventilation strategy that can be used to decrease the risk of developing bronchopulmonary dysplasia?
no clear strategy but minimizing oxygen and volumes to the lung will reduce lung injury
delivery room management of congenital diaphragmatic hernia consists of which of the following? 3
no mask ventilation/ NG tube placement/ 1.0 Fio2 application
Which one of the following is an advantage for using capnography?
noninvasive
All of the following are symptoms of severe laryngomalacia except:
normal feedings
what characteristic of chest wall in neonate make it susceptible to signs and symptoms of respiratory distress and reducing FRC?
overly compliant chest wall
when managing mechanically ventilated patient with intraventricular hemorrhage, what value should a registered respiratory therapist be most concerned with? 2
paco2/ pH
The treatment indicator for infants with transient tachypnea requiring High fio2 would be to:
place on CPAP
which of the following procedures should a delivery room resuscitation team perform for a newborn with gastroschisis? 3
place the exposed bowel in a bowel bag/ insert a NG tube/ administer IV broad-spectrum antibiotics
the risk factors for bronchopulmonary dysplasia consists of all the following except:
placenta abruptio
In newborn, what interalveolar connections are responsible for the lack of collateral air circulation leading them to decompensate more rapidly?
pores of kohn
what actions are usually enough to stimulate a newborn to breathe? 3
positioning, drying, and suctioning
Patency of the tracheostomy tube should be verified by which of the following procedures?3
positive end-tidal CO2/ measuring exhaled tidal volume/ passing the suction catheter
the focus of therapy for BPD is ( Click all that apply) 4;
prevention of development/ minimal oxygen use/ permissive hypercapnia/exogenous surfactant
a newborn presents at delivery with meconium stained amniotic fluid and is handed to the resuscitation team. she is crying, has central cyanosis, and is moving spontaneously. the following is the most appropriate first action for the team to take to resuscitate?
provide warmth, clear airway, dry and ongoing evaluation
During fetal circulation, the ______atrium is at higher pressure than the ______ atrium.
right/left
At the end of which phase does mature surfactant begin to appear, so that the neonate is at minimal risk of pulmonary complications?
saccular phase
what is one of the most noticeable physical findings in a newborn who presents with congenital diaphragmatic hernia?
scaphoid abdomen
a sinusoidal heart rate is indicated of: 3
severe fetal hypoxia/ acidosis/ or anemia
clinical manifestations of possible pediatric lung injury include: 5
singed nares/ soot in mouth/ facial or neck burns/ increased WOB or retractions/ cyanosis
Which of the following are factors associated with an increased risk of contracting pneumonia? 5
smoking/ exposure to chemicals/ ethnicity/ crowded living/ surgery
which is the best position for keeping the airway open in both children and adults?
sniffing
the leading cause of RDS in neonates is;
surfactant deficiency
what methods of treatment are used to correct patent ductus arteriosus?4
surgical ligation/ decrease fluid intake/ indomethacin/ treating hypoxemia
you are caring for a mechanically ventilated neonate at risk of developing intraventricular hemorrhage. choose the best practice guidelines for this patient. 5
synchronized mode of ventilation/ adjust PIP to maintain pH 7.25-7.35, pco2 45-55mmhg and tidal volume within normal limits/ RR 30-60bpm/ i-time 0.3-0.4s/ PEEP 4-7cmh20
which of the following clinical findings are usually seen in meconium aspiration syndrome?4
tachypnea and grunting/ irregular pulmonary densities on the chest film/ gasping respirations/ retractions
what is the first action a clinician needs to perform for a patient experiencing apnea?
tactile stimulation
PPHN should be suspected when:2
the infant has rapidly changing fi02 w/o changes in fi02 apnea is present
what chest compression methods are recommended by the neonatal resuscitation program, and gives a better Peak systolic pressure when performing CPR on newborns?
thumb encircling hand technique ( two thumbs with fingers encircling the chest and supporting the back)
what neonatal ventilation value is most closely determined by Peak inspiratory pressure?
tidal volume
all the following are examples of antioxidant enzymes that have been suggested to decrease lung injury except:
vitamin K
During which gestational phase in weeks have the airways begun to branch to approximately four generations?
week 7
withholding and discontinuing resuscitation efforts may be appropriate and all the following circumstances except:
when gestational age is less than 28 weeks
