NRP Megacode Scenario 6
By Lisa Wright, MHA, RRT-NPS | Medically reviewed by Andrew Wolf, EdD, RN on December 7, 2024
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Question 1 of 6
1. Question
Dr. Phillips’ patient just delivered her third child. The infant was born in a precipitous delivery. The resuscitation team determines that the infant is born at 39 weeks.The baby boy is flaccid and is not breathing or crying. You warm, dry, and stimulate the infant. You position his airway and suction his mouth and nose. He still is not breathing. You auscultate for a heart beat and note that the heart rate is 56 bpm.
You notice some acrocyanosis. The infant begins to have some gasping respirations.Another team member applies a pulse oximeter and a cardiac monitor while you begin positive pressure ventilation using a T-piece resuscitator.
You provide PPV at 40 to 60 breaths per minute with an oxygen concentration of 21%. After you provide PPV for 15 seconds, you instruct the team to do a quick assessment of the newborn.
1. The most significant finding of successful resuscitation of this infant is:
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Question 2 of 6
2. Question
The team member doing the assessment announces that the chest is rising, and the heart rate has increased to 80 bpm.As the resuscitation team leader, you go through the MR. SOPA interventions to improve ventilation and increase the heart rate. After an additional 15 seconds of PPV, the team reports that the infant’s heart rate is now 102 bpm. Immediately after resuscitation, the team transports the newborn to the neonatal intensive care unit (NICU).
2. After transfer to the NICU, the team may do all the following EXCEPT:
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Question 3 of 6
3. Question
The NICU team begins close monitoring for complications associated with resuscitation.Respiratory system disorders that might arise include pneumonia, pneumothorax, infection, aspiration, and pulmonary hypertension.
3. Possible interventions in the post resuscitation period may include all the following EXCEPT:
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Question 4 of 6
4. Question
The team notes a drop in blood pressure that does not respond to fluid resuscitation. The NICU nurse calls the neonatologist who considers administration of positive inotropes.4. If hypotension develops, the team may be required to administer positive inotropes. Inotropes:
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Question 5 of 6
5. Question
The team providing post resuscitation care monitors for neuromuscular problems including seizures and hypoxic ischemic encephalopathy (HIE).5. If HIE develops, the baby’s post resuscitation care may include all the following EXCEPT:
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Question 6 of 6
6. Question
The team understands that endocrine disorders usually present with a metabolic acidosis due to electrolyte imbalances following resuscitation.6. Electrolyte imbalances common during the post resuscitation period include:
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NRP Megacode Scenario 6 Video
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