A
Starting at the placenta, which of the following represents the correct sequence of fetal blood flow?
a. umbilical vein, ductus venosus, foramen ovale, ductus arteriosus, umbilical artery
b. umbilical vein, foramen ovale, ductus arteriosus, ductus venosus, umbilical artery
c. umbilical artery, ductus venosus, pulmonary artery, foramen ovale, umbilical vein
d. umbilical artery, ductus venosus, foramen ovale, ductus arteriosus, umbilical vein
a. umbilical vein, ductus venosus, foramen ovale, ductus arteriosus, umbilical artery
What characteristics of the chest wall in neonates make them susceptible to signs and symptoms of respiratory distress?
A. Overly compliant chest wall
B. Higher than normal intrathoracic pressure
C. Surfactant deficiency
D. Low oxygen consumption
A. Overly compliant chest wall
If your patient G/P/A/L is 3/1/1/3. Which of the following is false:
a. Patient is currently pregnant
b. 3 pregnancies had a live birth
c. Patient had a multiple birth
d. Patient had 1 pregnancy that was not carried to viable gestation.
b. 3 pregnancies had a live birth
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
What is the name of the interalveolar connections responsible for collateral air circulation? (newborns do not have these connections)
pores of kohn
True or False: A Lecithin-sphingomyelin (L/S) ratio 1:1 supports a diagnosis of respiratory distress syndrome?
True
How ml/kg Curosurf surfactant should an infant receive if they've had surfactant one time before?
1.25 mL/kg
During fetal development, what structure connected to the aorta, allows circulation to bypass the lungs?
A. Septum primum
B. Ductus venosus
C. Ductus arteriosus
D. Foramen ovale
C. Ductus arteriosus
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
Transition to the extrauterine world consists of all of the following rapid, physiological events EXCEPT:
a)Establishment of respirations
b)Vasoconstriction of the pulmonary vasculature and increase in pulmonary vascular resistance
c)Transition of fetal circulation to adult circulation
d)Expansion of the lungs
b)Vasoconstriction of the pulmonary vasculature and increase in pulmonary vascular resistance
An infant with this type of apnea will only start breathing once PPV has been applied.
secondary apnea
What is the main potential problem associated with the premature rupture of membranes?
fetal infection
Towards the end of which phase does mature surfactant begin to appear?
a. Embryonic
b. Pseudoglandular
c. Canalicular
d. Saccular
e. Alveolar
d. saccular
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
When an infant gets cold, how do they heat themselves up?
a. shiver to generate heat
b. increasing their metabolic rate
c. vasodilate to bring warm blood to the surface
d. convert white fat in the abdomen into heat
b. increasing their metabolic rate
What is the compressions-to-ventilation ratio used during neonatal resuscitation?
3:1
Which of the following anatomic structures constitute fetal shunts? SELECT ALL THAT APPLY
I. Foramen ovale
II. Sinus venosus
III. Ductus venosus
IV. Ductus arteriosus
I, III, and IV
I. Foramen ovale
III. Ductus venosus
IV. Ductus arteriosus
What is the smallest portion of a child's airway?
cricoid ring
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 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
A full-term newborn with PPHN is receiving high-frequency ventilation. The following data are available:
FIO2 100%
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 measures can RT's take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate? SELECT ALL THAT APPLY
I. Dry the infant’s skin.
II. Wrap the infant in prewarmed blankets.
III. Remove wet linens from around the infant.
IV. Measure the neonate’s body temperature.
I, II, and III
I. Dry the infant’s skin.
II. Wrap the infant in prewarmed blankets.
III. Remove wet linens from around the infant.
All of the following are specific issues that put preterm babies at risk after delivery except:
A. Immature tissue that is more susceptible to oxygen toxicity
B. Immature nervous system, which may not provide enough stimulation to breathe
C. Strong capillaries within the brain, which effect the risk for rupture and bleeding
D. Surfactant-deficient lungs that make ventilation difficult and more susceptible to injury by positive pressure ventilation
C. Strong capillaries within the brain, which effect the risk for rupture and bleeding
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.