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NRP 7th edition part 1
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NRP 7th edition part 1 NRP 7th edition part 1 NRP 7th edition part 1
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NRP 7th edition part 1A baby is born at term with a bilateral cleft lip and palate and a very small mandible. She requires
positive-pressure ventilation because she is not breathing. You are unable to achieve a seal with bag and
mask. Which intervention is indicated? - ANS Insert a laryngeal mask
You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute.
What is the most important action you can take? - ANS Provide positive-pressure ventilation
What size (internal diameter) endotracheal tube should be used to intubate a newborn with an
estimated gestational age of 26 weeks (estimated birth weight of 800 g)? - ANS 2.5 mm
Your team attends an emergency cesarean delivery of a term baby because of chorioamnionitis,
meconium-stained amniotic fluid, and fetal heart rate decelerations. At delivery, the newborn is term as
expected, with very poor tone and he is not breathing (apneic). You quickly perform initial steps, but the
newborn is still not breathing. What is the most appropriate next step of resuscitation? - ANS Start
positive-pressure ventilation and check heart rate response after 15 seconds
During the resuscitation of a newborn, you auscultate the apical pulse and count 10 beats over a 6
second period. What heart rate do you report to your team? - ANS 100 beats per minute
You are part of a team preparing for the birth of a baby who has meconium-stained fluid and a category
III fetal heart rate tracing. A person skilled in endotracheal intubation should be - ANS Present at the
birth.
You are at a delivery of a baby born through meconium-stained amniotic fluid, and the baby is not
vigorous. What steps should be taken immediately after birth? - ANS The baby should be brought to
the radiant warmer for initial steps of newborn care.
What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after
initial steps? - ANS Administration of positive-pressure ventilation that inflates the lungs
, A newborn of 34 weeks' gestation is not breathing (apneic) at birth, does not respond to initial steps and
requires positive-pressure ventilation. What concentration of oxygen should be used as you begin
positive-pressure ventilation? - ANS 21 - 30% oxygen
You have started positive-pressure ventilation for a newborn because her heart rate is low
(bradycardia). What is the most important indicator of successful positive-pressure ventilation? - ANS A
rising heart rate
A baby requires positive-pressure ventilation because she is not breathing (apneic), but she soon
establishes spontaneous respirations and a heart rate over 100 beats per minute. Her oxygen saturation
is lower than the target level when in room air, so you provide free-flow oxygen. Which of the following
devices cannot reliably deliver free-flow oxygen? - ANS Mask of self-inflating bag
Which statement best describes normal transitional physiology at the time of birth? - ANS Babies may
take as long as 10 minutes after birth to increase their oxygen saturation to greater than 90%.
A baby is born at 34 weeks' gestation. After the initial steps of resuscitation, the baby is not breathing
(apneic). What are the next steps? - ANS Initiative positive-pressure ventilation, place a pulse oximeter
sensor on the right hand or wrist, evaluate heart rate.
A full-term baby is born by emergency cesarean delivery because of fetal bradycardia (Category III fetal
heart rate tracing). The baby is limp and not breathing after initial steps. What is the next step in the
resuscitation process? - ANS Initiate positive-pressure ventilation and check for increasing heart rate
What is the appropriate technique to stimulate a baby to breathe? - ANS Gently rub the baby's back or
extremities
You are called to attend to a newborn at birth. At the time the baby is delivered, which 3 questions
should you ask to evaluate whether the baby can stay with his mother or be moved to the radiant
warmer for further assessment? - ANS Is the baby term? Does the baby have good muscle tone? Is the
baby breathing or crying?
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