RNC-NIC
Correct ETT placement - Answer T1-T2
level of clavicles
Correct UVC placement - Answer T 8-9
0.5-1 cm above diaphragm
Tip in inf. vena cava
Correct UAC placement - Answer Low-L3-4
Below renal arteries
High-T6-10
Correct PICC placement - Answer T3-5
Lower 1/3 of s. Vena cava
Normal weight loss of preterm infant - Answer 10-15%
Healthy term infant requires how many kcal/kg/day for normal growth? - Answer 100-
120 kcal/kg/day
Formula to calculate GIR - Answer ml/kg/day x %dextrose ➗1.44
Normal GIR - Answer 4-6 ml/kg/min initially May go as high as 12
Anomalies associated with esophageal atresia - Answer SGA
VATER synd.
-vertebral
-imperf anus
-renal dysplasia
Increased risk of mec plug? - Answer -premature
-IDM
-small left colon
-cystic fibrosis
Signs of pyloric stenosis - Answer Distended stomach on x-ray with little or no gas
below duodenum
Can palpate "olive"
Present at 2 to 3 weeks of life with Bile stained vomiting
Normal temp range axillary - Answer 36.5 to 37.4°C
TTN vs RDS - Answer Usually requires less than 40% FI O2
,Improves quicker
Larger lung volumes
Natural diuresis occurs at_____________ hours of age as condition improves - Answer
48-72 hours
Prolonged rupture of membranes - Answer Greater than 18 hours
Difference in PaO2 of________ or greater documents ductal shunting - Answer 15%
With PPHN goal is to keep PaO2 ________or > - Answer 50
Signs and symptoms of MAS - Answer Chest hyperinflated on x-ray
Low PaO2 with O2 given
Air leaks
Prone to PPHN
Treatment of micrognathia - Answer Prone positioning
Oral airway placement
Trach in rare cases
Generally mandibular growth "catches up" by 6 to 12 months
Surgery if significant compromise
Micrognathia associated with - Answer Pierre Robin syndrome
Trisomy 18
Trisomy 21
Cri-du-chat syndrome
Causes of pulmonary hemorrhage - Answer Prematurity
Erythroblastosis
Intracranial hemorrhage
Asphyxia
Aspiration
Heart diagnosis, PDA
Sepsis
Hypothermia
Surfactant replacement
Treatment of pulmonary hemorrhage - Answer Vent and use PEEP to decrease
bleeding
Transfused PRBC's as needed
Treat clotting problems
Assess and treat PDA
Treat underlying disease processes
, Apneic event - Answer Cessation of respiration for 20 seconds, or less if accompanied
by cyanosis, pallor, decreased tone, bradycardia
Causes pulmonary hypoplasia - Answer 1) conditions that limit lung growth (CCAM, DH)
2) oligohydramnios (thoracic compression)
3) associated congenital malformations (Potters, phrenic nerve absence)
Normal blood gas results - Answer ph 7.35-7.45
PaCO2 35-45
PaO2 50-80
HCO3 22-26
BE -2 to +2
Vent Setting VT (tidal volume) - Answer -Primary factor affecting oxygenation and
ventilation
-should be 4-5 ml/kg
Vent Settings
-To increase ventilation - Answer Increase rate
Vent settings
-to increase oxygenation - Answer Increase FiO2, PEEP, or VT
Inclusion criteria for ECMO - Answer 1) GA > 34 weeks
2) BE > 2000 grams
3) reversible lung disease
4) no lethal anomalies or brain injuries
5) IVH Gr 2 or <
6) no significant bleeding issues
Vent Setting Rate - Answer Set rate at 30-40/minute for respiratory failure
Set rate at 20-30/minute for no respiratory failure
Adjust to maintain PCO2 40-50
Rate >40/minute can lead to air trapping
Vent setting PIP - Answer Determines VT and affects PaO2
Determined by weight, GA, lung compliance, & airway resistance
20 is appropriate for most preterm infants
Look at chest wall movement
Vent Setting PEEP - Answer Physiologic PEEP is about 2cm
Usually set at 4-7cm
Correct ETT placement - Answer T1-T2
level of clavicles
Correct UVC placement - Answer T 8-9
0.5-1 cm above diaphragm
Tip in inf. vena cava
Correct UAC placement - Answer Low-L3-4
Below renal arteries
High-T6-10
Correct PICC placement - Answer T3-5
Lower 1/3 of s. Vena cava
Normal weight loss of preterm infant - Answer 10-15%
Healthy term infant requires how many kcal/kg/day for normal growth? - Answer 100-
120 kcal/kg/day
Formula to calculate GIR - Answer ml/kg/day x %dextrose ➗1.44
Normal GIR - Answer 4-6 ml/kg/min initially May go as high as 12
Anomalies associated with esophageal atresia - Answer SGA
VATER synd.
-vertebral
-imperf anus
-renal dysplasia
Increased risk of mec plug? - Answer -premature
-IDM
-small left colon
-cystic fibrosis
Signs of pyloric stenosis - Answer Distended stomach on x-ray with little or no gas
below duodenum
Can palpate "olive"
Present at 2 to 3 weeks of life with Bile stained vomiting
Normal temp range axillary - Answer 36.5 to 37.4°C
TTN vs RDS - Answer Usually requires less than 40% FI O2
,Improves quicker
Larger lung volumes
Natural diuresis occurs at_____________ hours of age as condition improves - Answer
48-72 hours
Prolonged rupture of membranes - Answer Greater than 18 hours
Difference in PaO2 of________ or greater documents ductal shunting - Answer 15%
With PPHN goal is to keep PaO2 ________or > - Answer 50
Signs and symptoms of MAS - Answer Chest hyperinflated on x-ray
Low PaO2 with O2 given
Air leaks
Prone to PPHN
Treatment of micrognathia - Answer Prone positioning
Oral airway placement
Trach in rare cases
Generally mandibular growth "catches up" by 6 to 12 months
Surgery if significant compromise
Micrognathia associated with - Answer Pierre Robin syndrome
Trisomy 18
Trisomy 21
Cri-du-chat syndrome
Causes of pulmonary hemorrhage - Answer Prematurity
Erythroblastosis
Intracranial hemorrhage
Asphyxia
Aspiration
Heart diagnosis, PDA
Sepsis
Hypothermia
Surfactant replacement
Treatment of pulmonary hemorrhage - Answer Vent and use PEEP to decrease
bleeding
Transfused PRBC's as needed
Treat clotting problems
Assess and treat PDA
Treat underlying disease processes
, Apneic event - Answer Cessation of respiration for 20 seconds, or less if accompanied
by cyanosis, pallor, decreased tone, bradycardia
Causes pulmonary hypoplasia - Answer 1) conditions that limit lung growth (CCAM, DH)
2) oligohydramnios (thoracic compression)
3) associated congenital malformations (Potters, phrenic nerve absence)
Normal blood gas results - Answer ph 7.35-7.45
PaCO2 35-45
PaO2 50-80
HCO3 22-26
BE -2 to +2
Vent Setting VT (tidal volume) - Answer -Primary factor affecting oxygenation and
ventilation
-should be 4-5 ml/kg
Vent Settings
-To increase ventilation - Answer Increase rate
Vent settings
-to increase oxygenation - Answer Increase FiO2, PEEP, or VT
Inclusion criteria for ECMO - Answer 1) GA > 34 weeks
2) BE > 2000 grams
3) reversible lung disease
4) no lethal anomalies or brain injuries
5) IVH Gr 2 or <
6) no significant bleeding issues
Vent Setting Rate - Answer Set rate at 30-40/minute for respiratory failure
Set rate at 20-30/minute for no respiratory failure
Adjust to maintain PCO2 40-50
Rate >40/minute can lead to air trapping
Vent setting PIP - Answer Determines VT and affects PaO2
Determined by weight, GA, lung compliance, & airway resistance
20 is appropriate for most preterm infants
Look at chest wall movement
Vent Setting PEEP - Answer Physiologic PEEP is about 2cm
Usually set at 4-7cm
