Chapter 5
Classify what is meant by an extreme apneic event:
a) Apnea duration 30 seconds or longer or a heart rate less than 50 to 60 bpm for 10 seconds or more
b) Apnea duration of 20 to 29 seconds or a heart rate less than 50 to 80 bpm for 5 to 15 seconds
c) Cessation of breathing for more than 20 seconds or cessation of breathing for longer than 10 seconds, heart rate less than 100 bpm
d) Bradycardia of heart rate less than two-thirds of baseline and saturation SPO2 less than 80%
c) Cessation of breathing for more than 20 seconds or cessation of breathing for longer than 10 seconds, heart rate less than 100 bpm
What is an unacceptable oxygenation index that would suggest the need for extracorporeal membrane oxygenation?
40 and above
Maintaining a neutral head position on a 24 week infant will help prevent:
a. ROP
b. CDH
c. IVH
D. PDA
c. IVH
The Hz is set at 12 in one of your patient's rooms. How many breaths is this patient getting per minute?
12 x 60 = 720 breaths per minute
A decrease in incidence of bronchopulmonary dysplasia has been seen in all of the following modalities of care EXCEPT:
A. Pulse oximetry limits
B. Institution of high FiO2
C. Institution of nasal continuous positive airway pressure
D. Avoidance of intubation
B. Institution of high FiO2
What is the most common underlying diagnosis of persistent pulmonary hypertension of the newborn?
a) Meconium aspiration syndrome
b) Pneumonia
c) Sepsis
d) Congenital diaphragmatic hernia
a) Meconium aspiration syndrome
A patient has developed a feeding intolerance. The patient has had an increased amount of gastric aspirates and blood in the stool as well as a distended abdomen. What is the most likely diagnosis?
NEC
How much surfactant should an infant receive per kg if they've had surfactant one time before?
1.25 ml/kg
Which of the following effects should be anticipated with the use of diuretics in chronic lung disease?
a) An increase in pulmonary compliance
b) An increase in oxygen requirements
c) A decrease in metabolic alkalosis
d) An ineffectual use of pharmaceuticals
a) An increase in pulmonary compliance
In cases of persistent pulmonary hypertension of a newborn, what mode of ventilation maintains the same mean airway pressure and improves oxygenation and ventilation the fastest?
a) Controlled mandatory ventilation
b) Extracorporeal membrane oxygenation
c) High-frequency oscillatory ventilation
d) High-frequency jet ventilation
c) High-frequency oscillatory ventilation
When managing a mechanically ventilator patient with intraventricular hemorrhage, what values should a registered respiratory therapist be most concerned with? (SELECT ALL THAT APPLY)
I. PaCO2
II. PaO2
III. pH
IV. HCO3
I. PaCO2
III. pH
If an infant weight 10 lbs, where should the ET tube be at the lip?
10 / 2.2 = 4.5 kg
6 + 4.5 = 10.5 at the lip
What is a major predictor of neurodevelopment outcomes?
a) Respiratory distress syndrome
b) Chronic lung disease
c) Extremely low birth weight
d) Bronchopulmonary dysplasia
d) Bronchopulmonary dysplasia
Which of the following statements about respiratory distress syndrome are true?
a) Higher incidences occur in males than in females.
b) Higher incidences occur in black fetuses than in white fetuses.
c) Males and females are affected equally.
d) Higher incidences occur in later gestational periods and at lower birth weights.
a) Higher incidences occur in males than in females.
Which of the following can be used in the management of an infant with necrotizing enterocolitis? Select all that apply:
I. Decompression of bowel
II. Replacement of blood products
III.IV antibiotics
IV. Total parenteral nutrition
V.IV prostaglandin inhibitor
I. Decompression of the bowel
II. Replacement of blood products
III. IV antibiotics
IV. Total parenteral nutrition (TPN)
A full-term newborn with PPHN is receiving high-frequency ventilation. The following data are available:
FIO2 1.0
Frequency 15 Hz
Amplitude 46 cm H2O
Paw 25 cm H2O
pH 7.34
PaCO2 52 mm Hg
PaO2 55 mm Hg
HCO3- 24 mEq/L
BE +1 mEq/L
SaO2 (calc) 85%
What is the oxygen index?
Paw (FiO2 / PaO2)
25 (100 / 55) = 45.45
What is the physiological difference between “old bronchopulmonary dysplasia (BPD)” and “new BPD”?
SELECT ALL THAT APPLY
I. Old BPD was a direct result of injury to the lung as a result of oxygen and mechanical ventilation.
II. New BPD is considered a developmental delay or arrest of lung tissue.
III. There is no difference between the two terms; it is just a revision of terminology.
I and II
I. Old BPD was a direct result of injury to the lung as a result of oxygen and mechanical ventilation.
II. New BPD is considered a developmental delay or arrest of lung tissue.
A post-term infant is receiving PC ventilation. The following values are noted:
Paw 20
FIO2 1.0
PaO2 60 torr
PaCO2 65 torr
Which of the following should the respiratory therapist recommend?
a) Initiate ECMO.
b) Continue present therapy.
c) Change to HFOV.
d) Administer prostaglandin (Alprostadil).
c) Change to HFOV.
What laboratory tests are essential to diagnose the presence of necrotizing enterocolitis? Select all that apply:
I. Complete blood count
II. Basic metabolic panel
III. C-reactive protein
IV. Electrolyte panel
V. Clotting function
VI. Abdominal radiograph
VII. Blood cultures
I. CBC
III. CRP
IV. Electrolyte Panel
V. Clotting Function
VI. Abdominal Radiograph
A CBG sample is drawn from an intubated 28-week gestational age infant following the administration of surfactant. The following values are noted:
FiO2 .35
PIP 25
PEEP 3
I-time 0.5
f 35
pH 7.35
PCO2 45
PO2 30
HCO3- 24
BE 0
SpO2 90%
Based on this information, what should the respiratory therapist recommend?
a) Maintain current settings
b) Increase Fio2
c) Increase PEEP
d) Decrease PIP
a) Maintain current settings