Neonatal Assessment Flashcard 3
Rationale
B. Rationale: The rapid assessment is essential in all newly born cases. If the answer to the following questions is “yes,” we are then confident that the newly born is healthy. The questions that need answering are the following: (1) term gestation?, (2) good tone?, and (3) breathing or crying.
Question
Which of the following questions should the team ask to complete the rapid assessment?
a. Any malformations?
b. Good tone?
c. Significant blood loss?
d. All of the above
Answer
b. Good tone?
Rationale
B. Rationale: The Ballard Maturity Score is used to assess the physical traits of a newly born. If neuromuscular maturity is being assessed, it considers posture, wrist flexibility, arm recoil, popliteal angle, scarf sign, and heal to ear. If physical maturity is being assessed, it takes into consideration the skin texture, presence of lanugo, appearance of the plantar surface, breast, eyes, ears, and genitals.
Question
Which one of the following can be used to assess the maturational age of a newly born?
a. Head circumference
b. Ballard score
c. Fetal weight
d. Apgar scoring
Answer
b. Ballard score
Rationale
A. Rationale: A CO2 detector connects to the ET tube and can be used to determine that the tube is in place. It will change color from purple to yellow if CO2 expired from the patient’s lungs has entered the device.
Question
Which one of the following instruments can be used to assess whether the endotracheal tube is correctly in place?
a. CO2 detector
b. Laryngoscope
c. An ultrasound
d. A bronchoscope
Answer
a. CO2 detector
Rationale
B. Rationale: Waveform capnography uses a carbon dioxide sensor that detects the end-tidal CO2 pressure after each exhalation. It is vital to gauge the quality of CPR and the detection of spontaneous respiration in intubated patients.
Question
Which one of the following instruments can monitor the exhaled carbon dioxide of an intubated patient?
a. Pulse oximeter
b. Waveform capnography
c. Electrocardiogram
d. Flowmeter
Answer
b. Waveform capnography
Rationale
C. Rationale: The four prebirth questions guide the clinician in answering the possible perinatal risk factors. These include: (1) What is the expected gestational age? (2) Is the amniotic fluid clear? (3) Umbilical cord management plan? (4) Are there any additional risk factors?
Question
Which one of the following is NOT part of the four prebirth questions?
a. What is the expected gestational age?
b. Is the amniotic fluid clear?
c. What is the sex of the baby?
d. What is the umblical cord management plan?
Answer
c. What is the sex of the baby?
Rationale
B. Rationale: Each method of assessing the heart rate has its advantages and disadvantages. However, NRP guidelines prefer the use of an ECG monitor to determine the heart rate once an alternative airway is needed. An ECG monitor shortens interruptions in chest compressions, but slow electrical activity may be recorded without the heart pumping blood. During resuscitation, auscultation can be difficult. If the newly born’s perfusion is extremely poor, the pulse oximeter will be inaccurate.
Question
Which one of the following is the preferred method to assess the newly born’s heart rate once an alternative airway is needed?
a. Palpating the carotid pulse
b. An ECG monitor
c. A pulse oximeter
d. Auscultation for the heartbeat
Answer
b. An ECG monitor
Rationale
B. Rationale: Bradycardia is a sign of abnormal transitioning during the birthing process. Others include irregular respirations, apnea or tachypnea, tachycardia, decreased muscle tone, low oxygen saturation, and hypotension.
Question
You are part of the birthing team attending a high-risk delivery. In these situations, it is important to monitor for abnormal transitioning in the newly born. Which one of the following is a sign of an abnormal transition?
a. Hypertension
b. Bradycardia
c. APGAR scores of 8 and 9
d. Incessant crying
Answer
b. Bradycardia