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60 Cards in this Set

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what are some antepartum risk factors that increases the potential that a newborn may require resuscitation?
multiple gestation, pregnant women <16y/o and >35y/o, post term, hypertension, preeclampsia, diabetes, polyhydramnios, premature rupture of the membrane, fetal malformation, decreased fetal movement, no prenatal care, drug use, fetal anemia, maternal infections, and abruptio placenta
birth at ____________ weeks causes delayed fetal transition?
??
what equipment for newborn resuscitation is NOT optional?
??
an infant born with a pink body and blue extremities, a pulse rate of 90 bpm, a strong cry, and active movement should be assigned an initial Apgar score of:
-Cries = 2
-Active Motion = 2
-Body Pink, Extremities Blue = 1
-pulse<100 bpm = 1
-Strong Cry = 2
TOTAL APGAR = 8
If you feel 13 pulsations in a 6-second time frame, the newborn's heart rate is approximately:
130 bpm.
Choanal atresia is defined as a :
narrowing or blockage of the nasal airway by menbranous or bony tissue; a congenital condition, meaning it presents at birth
the most common device to provide positive-pressure ventilation to a newborn in the prehospital setting is a :
self-inflating BVM
the correct positive-pressure ventilation rate for an apneic newborn is:
40-60 rpm
what size and type of laryngoscope blade is recommended for use in a full-term newborn?
Straight (miller) 1
after inserting an orogastric tube in a newborn, you should:
Attach a 10ml syringe and suction stomach contents. Then tape tube to newborn cheeks
if a newborn requires epinephrine and peripheral venous access is UNSUCCESSFUL, you should cannulate the ________________ vein
umbilical vein
signs of hypovelemia in the newborn include all of the following:
pallor, persistently low heart rate, weak pulses, no improvement in circulatory status despite adequate resuscitation efforts.
Naloxone (is/is not) recommended for use in newborns who are born to narcotic-addicted mothers and why?
is not
-not recommended as a First-line drug in resuscitation because may precipitate seizures and then death
-provide ventilatory support and rapid txp
in contrast to primary apnea, secondary apnea is usually ______________ _______________ to stimulation alone
no responsive
what are some situation that would most likely cause a newborn to experience a seizure?
hypoxia, infections (meningitis), hypoglycemia, epileptic syndromes, intercranial hemorrhage, hypocalcemia, encephalopathy, drug withdrawls, developmental defects
the single most common cause of seizures in both term and preterm infants is:
hypoxic ischemic encephalopathy secondary to perinatal asphyxia
______________ may not always be a presenting feature in newborns with an infection.
fever
-because a newborns temperature regulation system is not fully developed
the quickest way to prevent newborn hypothermia involves:
dry the baby, warm blankets, cap on head, or skin to skin with mom…. which one???
what disorders or conditions can be related to decreased glycogen stores in the newborn?
small for gestational age, prematurity, post-maturity
nearly _________% of all birth-related injuries are potentially avoidable with anticipation of ___________ risk factors
50%
-obstetric
after the baby's head emerges from the vagina, you should quickly assess for the presene of a nuchal cord and then perform what?
???
during your rapid assessment of a newborn's cardiopulmonary status, you note that its respiratoions 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?
????
you have been providing Bag-mask ventilation to a newborn with a sustained heart rate of 75 bpm, for approximately 5 minutes. the infants abdomen is m arkedly distended. although you are properly trained, your protocols do not allow you to intubate newborns. the MOST appropriate intervention would be to perform what?
???
Tetrology of Fallot is a combination of what four heart defects
-Ventricular Septal Defect
-Pulmonary Stenosis
-Right Ventricular Hypertrophy
-Over-riding Aorta
The risk of newborn complications is HIGHEST if the amniotic sac ruptured more than _______ hours before birth
12-24 ??????????????????
a newborn born between ________ and __________ weeks gestation is described as term
38-42 weeks
if a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based on:
??????
the MOST common etiology (cause) for bradycardia in a newborn is:
Hypoxia
common causes of respiratory distress in the newborn include:
PREMATURITY
-airway obstruction, aspiration, meconium, congenital diaphragmatic hernia, immature lungs
the most common reasons for ineffective bag-mask ventilations in the newborn are:
inadequate seal of the mask and incorrect head positioning
when suctioning the newborn's oropharynx to clear secretions prior to intubation, it is MOST important to:
pay close attention to not stimulating the vagus nerve. you need to watch the pulse rate, and avoid repeated or vigorous suctioning. bvm may be needed if the newborn develops bradycardia
chest compressions are indicated in the newborn if its heart rate remains less than _______________bpm despite effective positive-pressure ventilations for ________ seconds.
60
30 seconds
epinephrine is indicated during newborn resuscitation if:
if ventilations and chest compressions do not improve the bradycardia
if hypovelemia is suspected or confirmed, you should administer________________ ml of normal saline to a 6-pound newborn over a period of _______________
6lbs= 2.72kg
2.72kg x 10ml
=27.2ml of saline bolus

over 5-10 minutes
a shift of heart tones and severe respiratory distress despite positive-pressure ventilations usually is indicative of:
Pneumothorax
mortality and morbidity are high among infants who are delivered at 24 weeks gestation, usually because of:
-respiratory issues related to the need for long-term ventilation and oxygen treatment
-neurologic issues, relating to recurrent hypoxia and bleeding into the brain.
a subtle seizure in the newborn is characterized by:
a seizure characterized by eye deviation, blinking, sucking, pedaling movement of the legs, and apnea
which anti-convulsant medication would most likely be administered to a newborn with seizures in the prehospital setting
phenobarbitol or dilantin may interfere with respiratory or cardiac functions. ATIVAN is most appropriatie
when fever is suspected in the newborn, you should:
examine the newborn for the presence of rashes, sespecially petechiae or pinpoint pink or red lesions.
what factors are associated with the HIGHEST risk of newborn hypoglycemia?
newborn of a diabetic mother, large for gestational age, hypoxia, hypothermia, sepsis
what dose and concentration of glucose would be most appropriate for a 6-pound hypoglycemic newborn?
d10w
-2ml/kg formula
3.8kg x 2 = 7.6ml total given
Caput Succedaneum is defined as:
swelling of the soft tissue of the newborns scalp as it presses against the dilating cervix. this is common and dissapears in first day or two
during your assessment of a 30 y/o 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:
provide ventilatory support and rapid transport
after performing the initial steps of resuscitation, you assess a newborn and note that its respirations are poor and its pulse rate is 50bpm. you should:
begin CPR (compressions)
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 60bpm. you should :
begin CPR (compressions)/ ventilations
-reassess
-IV Epi if still not above 60bpm after that
an untreated Patent Ductus Arteriosus may cause subsequent development of:
Congestive Heart Failure
what congenital defect may result in an undersized or absent right ventricle?
Tricuspid Atresia
What events are critical parts of fetal transition?
??????
according to the APGAR Score, a newborn with a heart rate of 80 bpm and slow, irregular breathing should receive a combined score of __________
2 ?
a newborn with central cyanosis, adequate respirations, and a heart rate of 120 bpm should initaially be treated with:
provide supplement free-flow oxygen. if there is no other warming device available, keep newborn on mothers chest and continue to manage airway
compared to subsequent breaths, the first few positive-pressure breaths delivered to a distressed newborn may necessitate what special modification of the BVM?
??????
signs of a Diaphragmatic Hernia include?
may present with little or no S/S, or… severe hypoxia, increased work of breathing (depending on size of the hernia), and can lead to pulmonary hypoplasia / hypertension. heart sounds shift to the other side
the recommended iv dose and concentration of epinephrine for the newborn is:
0.01-0.03mg/kg of 1: 10,000
a newborn is at GREATEST risk for meconium aspiration if he or she is born at more than _____________ weeks gestation
42 ???????????
most common in post-term newborns and those who are small for their gestation age
what type of seizure is MOST common in premature infants
Tonic Seizures
severely hypothermic newborns may present with Sclerema, which is defined as:
hardening of the skin associated with reddening and edema - may be seen on the back, limbs, or all over the body.
in addition to an IV Dextrose bolus, the MOST important treatment for newborn hypoglycemia is:
always maintain normal body temperature
-hypothermia places additional demand on glucose.
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:
??????
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 110bpm. you should:
employ standard interventions (abc's and warming the patient)
Total Anomalous Pulmonary Venous Return is a rare congenital defect in which:
the 4 pulmonary veins do not connect to the Left Atrium. instead, the pulmonary veins connect to the Right Atrium, resulting in diminished oxygen and increased load on the right ventricle.