Dr. Operation
With this diagnosis the intestines have twisted on themselves which has caused a partial or complete obstruction. This baby needs to immediately go to the OR.
What is malrotation?
Late preterm gestation
What is 34-36 6/7 weeks
This ductus did not close after birth, so the baby now has bounding pulses, a murmur, widened pulse pressures, and poor weight gain.
What is a Patent Ductus Arteriosus (PDA)?
The baby requires assistance breathing and is intubated. This is the only setting on the ventilator that a nurse may change independently.
What is the oxygen?
Everyone in the room went to eat lunch and you are alone watching the room of 5 patients. The full term baby working on feeds suddenly alarms with a HR of 90 and O2 sat of 51. You get to his bed and his O2 sat is now in the 40s and still falling. Do you find your phone and call an RT to help or give the baby PPV and pull the code button?
What is give the baby PPV and pull the code button?
With this diagnosis, the ganglion cells are absent in the colon resulting in a decreased ability to move stool out of the body. This baby will need rectal irrigations and a pull-through procedure.
What is Hirschprung's Disease?
You receive in report from the day shift nurse on a new admission that the mom tested positive for opioids and cannabis. This should be started within 24 hours of birth.
What is NAS/Finnegan's Scoring?
In report, you are told that your patient has a known heart defect limiting the amount of oxygen he should receive. When you do your safety checks, you should find your resuscitation bag attached here.
What is the blender and not the wall?
This is administered by the RT through the ETT to a premature baby. The baby may have desaturations with the administration, but you should try not to suction the baby for at least one hour after this administration.
What is surfactant?
Your patient has a PIV with D12.5W infusing and a new order for D15W. Your line is due to be changed 2 days from now. Your patient also got a PICC today and it is in good placement. It is 5pm and you are getting ready to change your fluids for the day. Do you change just the bag since the line isn't due yet or do you get an order for heparinized fluids and hang a new line to the PICC?
What is get an order for heparinized fluids and hang a new line to the PICC?
Testing for this diagnosis is often done after your patient presents with frothy bubbles from the mouth, coughing with feeds, and an NG tube that can only be placed as deep as 11 cm.
What is Tracheo-Esophageal Fistula (TEF)?
A 4 day old baby with seizures is now hooked up to a continuous EEG machine. You notice in your last two assessments that his temperature is falling and is now 35.9 C. You obtain a trans thermal mattress because you know that you cannot do this because it will cause a burn
What is turn on the radiant warmer?
Upon admission 4 extremity BPs are ordered and are as follows: R arm 60/40 (50) L arm 55/36 (43) L leg 30/10 (20) R leg 35/14 (24) These findings are a red flag for this heart defect.
What is a Coarctation of the Aorta?
This diagnosis is the result of pulmonary hypoplasia due to the herniation of abdominal contents in the chest. Right sided ones are usually worse that left sided ones.
What is Congenital Diaphragmatic Hernia (CDH)?
Your patient spikes a fever and a septic workup is ordered (labs, cultures, tylenol, and antibiotics). All your supplies and medications come to the bedside at the same time. This should be done before anything else?
What is obtain blood cultures?
Your patient is a former 24 weeker and is now adjusted to 27 weeks. He is having more As and Bs than last week, his belly is firm to the touch, and you notice there is blood in his diaper. Your patient should get an xray for further investigation of this disease.
What is Necrotizing Enterocolitis (NEC)?
A 41 week gestation baby is born with a tight nuchal cord. Cord blood gas: 6.98/45/-18 and the baby began seizing at 3 hrs of life. You should anticipate getting this equipment at the bedside.
What is total body cooling equipment?
A rare condition caused by a combination of four defects present at birth
What is Tetralogy of Fallot (TOF)?
Treatment for this diagnosis may be nothing, a needle aspiration, or chest tube placement.
What is a pneumothorax?
You pack up your patient to take them to the CT scanner. Your baby is on 7 Lpm High Flow Nasal Cannula, NPO, PIV with maintenance fluids. Other than yourself what additional staff are needed for transport to CT.
What is an RT?
With this diagnosis, umbilical lines are contraindicated and there's a defect in the abdominal wall that forms an opening that the bowel pushes through.
What is Gastroschisis
A baby with hydrocephalus has an external ventricular drain (EVD) and mom wants to hold the baby. You have an order for mom to hold. You must do this before moving the baby to mom's arms.
What is clamp the EVD?
TOF has these 4 defects
Pulmonary Stenosis
VSD
Over ridding Aorta
Right Ventricular Hypertrophy
ph 7.22 Co2 57 O2 30 HCO3 20
What is Respiratory Acidosis
You walk into your patient's B pod room after report and immediately smell TPN. You notice a puddle on the floor by the bed and blood in the bed. The tubing connected to the PICC is cracked. This is the FIRST thing that you do.
What is clamp the PICC line?