NRP Lesson 9 – NRP 7th Ed|answers highlighted(100% correct)

NRP Lesson 9 – NRP 7th Ed You are called to counsel the parents of a fetus who is believed to be at the lower limits of viability and whose birth is imminent. What should you tell the parents when they ask you how decisions about resuscitation are made? The decision agreed to before birth may need to be modified based on the condition of the baby after birth and the postnatal gestational age assessment. Which statement describes the ethical principle(s) that guide the resuscitation of a newborn? The approach to decisions in the newborn should be guided by the same principles used for adults and older children. In the course of planning care for a newborn with a known genetic disorder, one of your team members suggests that no resuscitation be offered. The parents agree. Other team members think this decision might jeopardize them personally. Which of the following statements is true? Withdrawal or non-initiation of support may be acceptable if there is agreement between parents and the treating team that this support will be futile. When a fetus has a borderline chance of survival, and there is a high rate of complications, what should be included in your discussion with the parents concerning options for resuscitation? The option of only providing comfort care can be considered. You are part of a team called to an emergency cesarean delivery done for apparent acute placental abruption at 41 weeks’ gestation. The newborn emerged without respirations or heart rate and has had no detectable heart rate (by palpation or by oximetry monitoring) from the time the baby was first assessed. You and the team are convinced that resuscitation has been adequate (good chest movement with positive-pressure ventilation; timely and correct placement of umbilical catheter and administration of medications; fluids; and performance of chest compressions). After what duration of time might it be appropriate to discontinue resuscitative efforts? After 10 minutes of no detectable heart rate (Asystole) In most cases, who is (are) the usual and appropriate surrogate decision maker(s) for a newborn? The parents A woman is admitted at 24 weeks’ gestation with rupture of membranes, maternal fever, and premature labor. The baby is likely to be born within the next few hours with an estimated weight of 750 g. The care team offers the parents counseling. What is likely to be helpful in this process? It is worth obtaining up-to-date outcome data for your institution or region, or using the Neonatal Resuscitation Program Web site and National Instutite of Child Health & Human Development estimator for national data. You are called to the birth of a newborn weighing 385 g and gestational age of just under 23 weeks, a birth weight that is associated with almost certain early death and nearly universal rate of severe morbidity among the rare survivors. Which action is appropriate? Attempts at resuscitation are not indicated under these circumstances; care should focus on comfort alone. You are counseling a set of 17-year-old parents, whose baby is about to be born at 23 weeks’ gestation. You have explained that survival is unlikely and that in the event of survival, the likelihood of severe long-term morbidity is high. The parents firmly request that everything be done, starting with resuscitation at birth. How might you answer them? You assure them that as the parents, they are the appropriate voice for their baby and you will support their wishes. Good decisions are based on good data. Which statement about obstetric dating and assessment is correct? Techniques for obstetric dating are accurate to within 3 to 5 days, when assessed during the first trimester. A laboring woman received a narcotic medication for pain relief 1 hour before delivery.The baby does not have spontaneous respirations and does not improve with stimulation.Your first priority is to Start positive-pressure ventilation During resuscitation, a baby is responding to positive-pressure ventilation with a rapidly increasing heart rate. Her heart rate and oxygen saturation suddenly worsen.She has decreased breath sounds on the left side and transillumination also reveals a bright glow on the left side.What is the most likely cause of this distress? Left-sided pneumothorax Which of the following is true about the preparation and resources needed for a very preterm birth? Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat. Which of the following may be associated with delayed cord clamping in vigorous preterm newborns? Decreased need for blood transfusions For a newborn weighing 1 kg, what dose of 1:10,000 (0.1 mg/mL) concentration of intravenous epinephrine is indicated? 0.1 mL