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A premature newborn is born apneic and requires ongoing respiratory support and chest compressions. You and 3 colleagues provide care immediately following birth. What behavioral skills are critical to ensure successful and optimal care during resuscitation?

teamwork, leadership, communication.

The steps of intubation should ideally be completed within which duration?

30 seconds

A 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?

insert a laryngeal mask

You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care?

warm position head clear secretions dry stimulate

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?

term? muscle tone? breathing or crying?

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?

rising heart rate

Which statement describes recommended practice when using a pulse oximeter in the delivery room?

place pulse oximeter on right hand and use minute by minute specific O2 SAT TARGET

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?

100 BPM

Which statement best describes normal transitional physiology at the time of birth?

Babies may take as long as 10 minutes after birth to increase their oxygen saturation to greater than 90%.

What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps?


What is the preferred technique for removing secretions from the mouth and nose of a newborn who requires resuscitation?

Suction the mouth before the nose.

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?

initiate ppv& check for rising heart rate

What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?

Determine the color of the baby’s chest and abdomen, and monitor for central cyanosis

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?

Initiate positive-pressure ventilation and check for increasing heart rate

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?

21 – 30% oxygen

Your hospital is planning Neonatal Resuscitation Program® training and trying to decide who should be included.
For every delivery, what is the minimum requirement for care of the newborn at birth?

Someone capable of initiating neonatal resuscitation should be present at every delivery whose only responsibility is management of the newborn.

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)?

2.5 mm

What is the appropriate technique to stimulate a baby to breathe?

Gently rub the baby’s back or extremities

Four pre-birth questions should be asked to assess perinatal risk and determine who should be present at the birth. Which is one of the questions?

What is the gestational age?

Effective team functioning is critical in ensuring the best performance. Which of these characteristics is critical in team leaders?

They should be able to maintain situational awareness

A full-term newborn has a heart rate less than 60 beats per minute despite 30 seconds of positive-pressure ventilation that moves the chest. Your team plans to intubate. Which of the following is a true statement regarding the procedure?

The baby should be positioned on a flat surface with the neck slightly extended

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?

Initiative positive-pressure ventilation, place a pulse oximeter sensor on the right hand or wrist, evaluate heart rate.

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

present at the birth.

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