Initial Steps of Resuscitation Flashcard

C. Rationale: Acrocyanosis can be found in a healthy newly born patient. It is a finding limited to both the hands and feet and is not an indication of poor oxygen saturation. If there is congenital heart disease causing a right-to-left shunt, there will be central cyanosis (lips and buccal mucosa), which is more evident if the patient is crying.

C. Rationale: The patient is in respiratory failure, which is the most common reason to perform neonatal resuscitation in the newly born. Tactile stimulation is the first intervention to elicit spontaneous breathing from the newly born in respiratory failure. If respiratory failure has just occurred, tactile stimulation will typically be enough to elicit this favorable response. However, if respiratory failure has persisted, then it may be necessary to provide positive pressure ventilation or high-quality CPR.

A. Rationale: The newly born must always be kept at normal temperature, especially in cases where the initial steps of resuscitation are necessary. Hence, a radiant warmer is the recommended place to perform the initial steps of neonatal resuscitation.

A. Rationale: Clamping the umbilical cord between 30 and 60 seconds after delivery is the recommended time for delay.

A. Rationale: The bulb syringe is the most common and effective device for use in the newborn to remove oral and nasal secretions. NRP recommends suctioning only when needed.

D. Rationale: Delayed cord clamping is a recommended procedure to improve neonatal care outcomes. The benefits include (1) reduced intraventricular hemorrhage, (2) higher blood pressure and blood volume, (3) less need for transfusion after birth, and (4) less necrotizing enterocolitis. These benefits arise from fewer interruptions in circulation from the mother to the placenta and the umbilical cord, continuing placental gas exchange between mother and infant.

D. Rationale: Routine care is provided at normal deliveries where the newborn exhibits vigorous motor activity, good respiratory effort, and good muscle tone. It involves drying with a warm towel and placing the baby in skin-to-skin contact with the mother.

A. Rationale: NRP guidelines recommend the following terminology: newly born—a baby at the time of birth, and newborn and neonate—an infant during the initial hospitalization day following a live birth.

D. Rationale: Adjust the gas mixture to 30% initially when giving free-flow oxygen supplementation. This is adjusted higher or lower, depending on the preductal oxygen saturation. The goal is to limit the administration of excessive oxygen that may cause hyperoxia and prevent hypoxia.