Pharmacology and Med Administration Flashcard 2
Rationale
B. Rationale: The recommended concentration of epinephrine for use in neonatal resuscitation is 1:10,000 or 0.1 mg/mL at a dose of 0.02 mg/kg.
Question
What is the recommended concentration of epinephrine for use in neonatal resuscitation?
a. 1 mg/mL
b. 0.1 mg/mL
c. 0.01 mg/mL
d. 0.001 mg/mL
Answer
b. 0.1 mg/mL
Rationale
B. Rationale: Newborns requiring neonatal resuscitation are prone to hypoglycemia resulting from anaerobic metabolism. The body quickly utilizes glucose during anaerobic metabolism. If hypoglycemia persists, clinicians treat these patients with intravenous dextrose.
Question
What is the treatment for hypoglycemia in newborns?
a. Insulin
b. Intravenous dextrose
c. Breastmilk
d. Intravenous fluid resuscitation
Answer
b. Intravenous dextrose
Rationale
B. Rationale: The infusion rate of 5 to 10 minutes is recommended. Fast drip is not recommended, particularly in preterm babies, because rapid administration of volume expanders has a risk of intraventricular hemorrhage.
Question
When giving volume expanders for neonatal resuscitation, what is the recommended infusion rate?
a. Fast drip
b. 5 to 10 minutes
c. 1 hour
d. 2 hours
Answer
b. 5 to 10 minutes
Rationale
B. Rationale: The recommended site for intravenous catheterization is the umbilical vein. Umbilical catheterization is also recommended rather than peripheral venous catheterization because of its larger access route and success rates. Also, the peripheral vessels are likely to collapse in arrest and cause extravasation of epinephrine, significantly delaying the absorption of the drug.
Question
Which is the preferred route of catheterization to establish access for medications when resuscitating a newly born in need of epinephrine and volume expansion?
a. Saphenous vein
b. Umbilical vein
c. Antecubital vein
d. Tibial intraosseous access
Answer
b. Umbilical vein
Rationale
A. Rationale: Endogenous administration of surfactant is necessary to lower the surface tension of the alveoli in the preterm infant. The goal of surfactant administration is to improve gas exchange between the pulmonary vasculature and the alveoli.
Question
Which of the following interventions is necessary to lower surface tension in the alveoli so that gas exchange in the preterm lung is efficient?
a. Surfactant
b. Corticosteroid
c. Beta-agonists
d. Oxygen
Answer
a. Surfactant
Rationale
C. Rationale: The neonatal resuscitation program recommends giving volume expander at a dose of 10 mL/kg. If the newborn does not respond, another dose of 10 mL/kg can be administered.
Question
You are the team leader for the resuscitation of a newly born with significant blood loss. You order volume expander to be given as part of your treatment regimen. The nurse in charge is asking how much to give the patient. What is the dose of volume expander for this neonate?
a. 200 mL of volume expander
b. 20 mL/kg of volume expander
c. 10 mL/kg of volume expander
d. 500 mL of volume expander
Answer
c. 10 mL/kg of volume expander
Rationale
D. Rationale: The packed RBCs must be typed appropriately and cross-matched to the mother to ensure that any circulating maternal antibodies in the newborn’s bloodstream will not be affected. Otherwise, when no cross-matched blood is available, the provider may choose non-cross-matched type O, Rh-negative packed RBCs.
Question
You have requested packed RBCs for volume expansion in a high-risk newly born needing neonatal resuscitation due to cord disruption during labor. How will you ensure that the newly born will not have any untoward reaction to the donated blood?
a. Use packed RBCs that are properly typed and cross-matched to the newly born.
b. Use blood type O and Rh-positive packed RBCs.
c. Avoid using packed RBCs; you can only use crystalloid solutions as volume expanders.
d. Use packed RBCs that are correctly typed and cross-matched to the mother.
Answer
d. Use packed RBCs that are correctly typed and cross-matched to the mother.