A team has been summoned to the delivery room to perform neonatal resuscitation. Because no perinatal history is available, which of the following information would be useful for the resuscitation team to know in preparation for this event?
I. Number of babies expected
II. Age of the mother
III Gestational age of the infant
IV. Presence or absence of meconium
A. I and IV only
B. II and III only
C I, III, and IV only
D. I, II, III, and IV
C I, III, and IV only
What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate?
I. Dry the infant’s skin.
II. Wrap the infant in prewarmed blankets.
III. Remove wet linens from around the infant.
IV. Measure the neonate’s body temperature.
B. I, II, and III only
While stabilizing a preterm neonate before resuscitation, the therapist notices the infant display laryngeal spasm, bradycardia, and a delayed onset of spontaneous breathing. What could have caused these events to occur?
B. Performing aggressive pharyngeal suctioning
As the head of a neonate contaminated with meconium emerges at birth, the heart rate monitor indicates 120 beats/minute, and the physician notices that the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide airway care?
A. Intubate the infant immediately.
B. Perform pharyngeal and tracheal suctioning immediately. C. Perform tracheal suctioning only at this time.
D. Do not perform tracheal suctioning on this infant at this time.
D. Do not perform tracheal suctioning on this infant at this time.
A preterm neonate with a heart rate of 55 beats/minute is receiving positive-pressure ventilation immediately after delivery. What should the therapist do at this time?
D. Apply cardiac compressions and maintain positive-pressure ventilation.
A term infant is born displaying acrocyanosis. What should the therapist do at this time?
C. Do nothing, as this condition is often transient.
The therapist has completed a 1-minute Apgar score. The following evaluations were obtained: the infant is pale.
The heart rate is 90 beats/minute.
The respiratory effort is irregular.
Some muscle tone is noted.
No response to nasal suctioning is found.
On the basis of these findings, what Apgar score should be assigned to this neonate?
B. 3
The therapist, working with a neonate, observes that the newborn has adequate ventilatory efforts and a heart rate of 120 beats/minute. However, at the same time, the infant demonstrates cyanosis of the lips and mucous membranes. What should the therapist do at this time?
A. Direct 100% oxygen at a flow of 8 L/minute about one-half inch above the infant’s nose and mouth.
A respiratory therapy supervisor is observing a staff member perform bag—mask ventilation on an infant who is being resuscitated. The supervisor notices that the therapist places his fingers on the anterior margin of the infant’s mandible, and lifts the infant’s face into the mask. What should the supervisor do at this time?
C. Take no action because the therapist is correctly performing valve—mask ventilation.
While performing positive-pressure mechanical ventilation on a neonate, the therapist notices that the infant’s thorax is not displaying bilateral expansion during each inspiration. Auscultation of the chest reveals diminished bilateral breath sounds. The infant’s heart rate is 85 beats/minute and observation demonstrates central cyanosis. Which of the following events may have caused this clinical situation?
I. Pneumothorax
II. Poorly positioned or leaking mask
III. Inappropriately sized endotracheal tube
IV. Airway obstruction
B. I, II and IV only
What appears to be the reason for the infrequent need to administer chest compressions and cardiopulmonary resuscitative drugs to neonates in the delivery rooms?
A. The delivery of adequate ventilation is the primary factor in effective resuscitation of a neonate.
What ratio of chest compressions and positive-pressure breaths must the therapist administer to a newborn during cardiopulmonary resuscitation?
C. Three compressions for every one breath
The therapist has been performing cardiopulmonary resuscitation on a neonate for about 90 seconds, applying ventilation with 100% oxygen and chest compressions. The infant has maintained a spontaneous heat rate of 40 beats/minute. What should the therapist recommend at this time?
A. Administering epinephrine
Which of the following medications is used to reverse respiratory depression induced by opioid overdose?
B. Naloxone
Which of the following actions constitutes appropriate stimulation of a neonate?
I. Gently slapping the infant’s buttocks
II. Gently shaking the infant’s upper torso
III. Flicking the bottoms of the infant’s feet
IV. Drying with a towel
