Respiratory
Gastrointestinal
Cardiac
Thermoregulaton
Neurological
100

How long should you count respirations for in the NICU?

60 secs

100

What is the difference between an Omphalocele and gastroschisis?

Omphalocele: Herniation of intestine/other viscera into the umbilicus

Gastroschisis: Evisceration of intestinal loops with no sac covering

100

What is the Normal Heart Rate Range for Infants?

90-180

100

What are the 4 modes of heat loss?

Conduction, convection, radiation, and evaporation.

100

What is the name of the pain scale we use and what is it looking to score?

N-PASS

Crying, behavior, facial expressions, tone, vital signs

200

• A day old full term infant admitted for R/O sepsis develops respiratory distress.  An ABG drawn via the right radial artery reveals the following result:

•pH = 7.15,  pCO2 = 36, PO2 = 60, HCO3 = 12

This blood gas is:

  a. Normal

  b. Compensated

  c. Uncompensated

  d. Partial Compensated

The blood gas reveals:

  a. Respiratory Acidosis

  b. Respiratory Alkalosis

  c. Metabolic Acidosis

  d. Metabolic Alkalosis

What intervention should be anticipated by the bedside RN?

Partially Compensated metabolic acidosis

Anticipate holding feeds, possibly administering fluids... Na Acetate

200

What is a nursing consideration for an infant with Esophageal Atresia with a TE Fistula?

Avoid bag and mask ventilation and nasal CPAP to prevent over-distension of the stomach, place a replogle with suction as ordered, and consider/anticipate the need for intubation.

200

What is the only heart rhythm NICU RN's need to recognize?

Normal Sinus 

200

Where should you place the skin temperature probe on an infant in and isolette? on a radiant warmer?

Under the axilla, over the liver

200

If you are admitting a baby who has potential HIE with an arterial blood gas suggesting the need for whole body cooling, what would you do first?

set the radiant warmer to 35 degrees C

300

What is the correct order to set up a needle aspiration? 

tubing, stopcock, 30cc syringe (minimum)

300

What is the primary risk factor for NEC?

Prematurity

300

How should you administer adenosine and for what rhythm can it be used for?

fast push followed by a fast flush

SVT that has not responded to vagal maneuvers.

300

Why is it important to recognize temperature instability in an infant and how can the RN recognize temperature instability?

Can be an early sign of sepsis

Monitoring axillary temperatures, ISC- skin and air temperatures

300

What other body system should be a focus when considering the neurological system of an infant

Integumentary system/skin

400

What type of ventilation is commonly used for Meconium aspiration syndrome, persistent pulmonary hypertension, or Pulmonary Interstitial Emphysema 

High Frequency Jet Ventilation 

400

How often should you flush a replogle, where should you flush and with what?

PRN or once a shift, flush using a tree and the main port of the replogle, and with NS or sterile water.

400

Name a congenital cyanotic heart defect and at least 3 nursing considerations.

Coarctation of the aorta, Aortic stenosis, Hypoplastic left heart, Tetralogy of Fallot, Transposition of the great vessels.

monitor vitals (EKG, BPs, Pulse ox., etc.)

monitor Is & Os (weigh diapers)

Listen to heart sounds and lung sounds

monitor for cyanosis

administer medications as ordered with careful consideration to their effects. 



400

What is the appropriate NTE for a 5 day old 2000 g infant?

31.0-33.2 with a starting temperature of 32.1

400

Name three common signs of an infant with NAS.

Tremors, Restlessness, Hyperactive reflexes, Regurgitation, Increased muscle tone, High pitched cry, Sneezing, Frantic sucking of fists, Inability to sleep, Stretching, Nasal stuffiness, Respiratory distress, Vomiting, Frequent yawning, Sweating, Excoriation of knees, toes and nose, Mottling, Diarrhea, Fever, Pallor, Lacrimation and Generalized convulsion

500

•Complete & accurate respiratory assessment is essential

•Bubbling in water seal chamber is normal when air is escaping – monitor the level in the chamber to monitor the severity of the leak

•Order to water seal - turn off WALL Suction

Observe the following:

•Chest tube dressing with Vaseline gauze – needs to be an occlusive dressing -

•Ensure tubing is patent without

–tubing kinks

–dependent loops

–Clots

•Tubing is securely pinned to the bed – prevent tension on the tube.

•Chest drainage system, which should be upright and below level of tube insertion

•Hang chest drain system on the RW or incubator

500

How should you place an NG/OG tube and how do you check for placement?

Prep site of NG/OG, measure from orifice to tragus to zyphoid and add, insert tube and secure with 3M tape without tension on the skin. Check placement with Rightspot: attach rightspot to 5-10cc enteral syringe, connect to NG/OG, insert .5 to 1 cc of air and then pull back until gastric contents touch's paper, watch for color change (good placement = pH of 5 or less), disconnect the rightspot and discard in the biohazard, then document.

500

What happens in the initial period to infant circulation once the infant takes its first breath and the umbilical cord is cut?

Pressure decreases in the pulmonary arteries allowing blood to circulate to the lungs which leads to the eventual closure of the ductus arteriosus and the foreman ovale.

500

What are the detrimental effects of cold stress on an infant?

hypoxemia, hypoxia, hypoglycemia, acidosis

500

What is a myelocele and what are the nursing considerations?

Myelocele - Most severe form of myelomeningocele – flattened, plate-like mass of nervous tissue with no overlying membrane. 

RNs should consider keeping the infant prone and covering the defect with sterile moist gauze until brought to OR for revision