![]() Which of the following is an appropriate action? Administer CPAP at 5 cm H2O pressure with 21% oxygen. The baby's heart rate is 120 bpm and the oxygen saturation is 90% without respiratory support. The baby is 5 minutes old and breathing spontaneously. You are in the delivery room caring for a preterm newborn at 27 weeks gestation. In most cases, who are the usual and appropriate surrogate decision makers for a newborn? The newborn's parents When a newborn has a high risk of mortality and there is a significant burden of morbidity among survivors, what should be included in the discussion with the parents concerning options for resuscitation? The option of providing comfort care can be considered. What is your next intervention? Start PPV. The baby does not breathe spontaneously and remains apneic after stimulation. A woman in labor received opioid medication for pain relief 1 hour before delivery. What are the most appropriate steps as you begin your resuscitation? Intubate the trachea and insert an orogastric tube into the stomach. What is the most likely cause of this distress? Left-sided pneumothorax You attend the birth of a baby with prenatally diagnosed severe congenital diaphragmatic hernia. ![]() The baby has decreased breath sounds on the left side and transillumination reveals a bright glow. Subsequently, the baby's heart rate and oxygen saturation suddenly worsen. Which of the following is a common cause of asymmetric breath sounds in an intubated baby? Endotracheal tube inserted into the right mainstem bronchus During resuscitation, a baby initially responds to PPV with a rapidly increasing heart rate. A baby's heart rate does not increase after intubation and the breath sounds are louder on the right side than on the left side of the chest. What immediate decision needs to be made regarding post-resuscitation care? Identify who will continue to monitor the baby in the mother's room. The team plans for the baby to room-in with their mother. The baby is now 15 minutes old, breathing comfortably in room air, and bonding with their mother. A term baby was vigorous at birth but receives CPAP for 3 minutes after birth for grunting respirations. Which of the following is the most appropriate intervention for this newborn? Admit the newborn to a center with capability to perform therapeutic hypothermia. The cord blood gas demonstrates a severe metabolic acidosis, and the physical examination is consistent with hypoxic-ischemic encephalopathy (HIE). The baby was limp and bradycardic at birth and was intubated at 6 minutes after birth for persistent apnea. Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, a hat, and a skin temperature sensor A term newborn was born via emergency cesarean section in the setting of fetal bradycardia. Choose the appropriate step(s) to prepare for the birth of a newborn <32 weeks gestation. What is the most appropriate next step? Begin PPV by mask. The initial steps of care, including gentle stimulation, have been completed and the baby is nearly 1-minute old. As you prepare your equipment, what concentration of oxygen will you use initially if PPV is required? 21% to 30% A baby is born at 26 weeks gestation. At what rate should this be administered? Over 5 to 10 minutes How soon after administration of intravenous epinephrine should you pause compressions and reassess the baby's heart rate? 60 seconds You are called to the birth of a newborn at 30 weeks gestation. You administer 10 mL/kg of normal saline (based on the newborn's estimated weight). ![]() There is a history of acute blood loss around the time of delivery. Your team is caring for a term newborn whose heart rate is 50 bpm after receiving effective ventilation, chest compressions, and intravenous epinephrine administration. According to the Textbook of Neonatal Resuscitation, 8th edition, what volume of normal saline flush should you administer? 3 mL According to the Textbook of Neonatal Resuscitation, 8th edition, what is the suggested initial dose for IV epinephrine (0.1 mg/1 mL=1 mg/10 mL)? 0.02 mg/kg (equal to 0.2 mL/kg) When is the administration of a volume expander indicated during newborn resuscitation? The baby's heart rate is not increasing and there are signs of shock or a history of acute blood loss. You have administered epinephrine intravenously. ![]() Your team is resuscitating a newborn whose heart rate remains less than 60 bpm despite effective PPV and 60 seconds of chest compressions. What is the recommended depth of chest compressions? One-third of the anterior-posterior diameter of the chest During chest compressions, which of the following is correct? To coordinate compressions and ventilations, the compressor calls out one-and-two-and-three-and-breathe-and. ![]()
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