NPS Exam Review
1. Ventilation - inhale O2, exhale CO2
2. Oxygenation - getting O2 into the blood
3. Circulation - heart beating to move blood around to get O2 to all parts of body
4. Perfusion - blood pressure; pressures to perfuse tissue to deliver oxygen to body cells -
ANS-What are the four critical life functions listed in order of priority?
10-14 g/dL - ANS-What is the normal PEDICATRIC value for hemoglobin?
15 minutes - ANS-How long does it take to get the results of the Shake Test?
2 mL/kg per hour - ANS-What is the normal urine output level for an infant?
3 or less = Bad = resuscitation
4-6 = stimulate, PPV
7-10 = routine care, monitor - ANS-What treatment would be indicated for a neonate with an
Apgar score of 1?
30-60 bpm
apnea = greater than 20 seconds without breathing - ANS-What is the normal respiratory rate
for a term infant?
32-40% - ANS-What is the normal PEDIATRIC value for hematocrit?
4-5 mg/dL at birth - ANS-What is the normal value for bilirubin for a full term infant at birth?
4-5 million cells/mm3 - ANS-What is the normal PEDIATRIC value for RBC?
5,000 - 10,000 mm3 - ANS-What is the normal PEDIATRIC value for WBC?
55-115 mg/dL - ANS-What is the normal glucose level for a term infant?
60/40 - ANS-What is normal blood pressure for the term infant?
7 physical and 6 neurologal findings; higher the score the higher the gestation - ANS-Describe
Dubowitz Method.
A change in heartbeat of how much = an adverse reaction? - ANS-20 beats per minute
Acute airway obstruction most often occurs in what age group? - ANS-4 and under
,alteration of strong and weak beats - ANS-Write a brief description for pulsus
alternans.
amniocentesis; very invasive - ANS-What procedure is required to obtain fluid for L/S ratio
measurement?
any vaginal bleeding after first trimester - ANS-What is maternal bleeding?
Anything less than
2:1 = not mature lungs = increased risk for RDS - ANS-What is the significance of an L/S Ratio
of 1:1?
asthma, RDS, BPD
unilateral = foreign object obstruction - ANS-What pathologies would be associated with
wheezes?
At approximately what age should cuffed ET tubes be used? - ANS-8 years old
At what age can a child begin to perform basic spirometry testing? - ANS-5 years of age or older
so they can follow instructions
At what age is alternative airway clearance therapy appropriate? - ANS-When the child is old
enough to understand and follow instructions
At what level should CPAP be started? - ANS-Same FiO2 or a little higher and same PEEP as
on ventilator but breathing spontaneously
At what level should PEEP be initiated for pediatric patients? - ANS-3-5 cmH2O
At what point in the breathing cycle should the tube be removed? - ANS-Peak inspiration
atelectasis, fibrosis - ANS-What pathologies would cause the trachea to shift toward the affected
side?
axillary
rectal
tympanic - ANS-What are the four methods used to measure an infant's temperature?
Big babies; they look full term, but they aren't - ANS-What size of babies will diabetic mothers
deliver?
blood pressure - ANS-What is the main parameter to know if someone is perfusing?
,bradycardia = less than 100; give oxygen - ANS-What term would describe a heart rate of 55
and what would cause this?
bradypnea; drugs given to mom - ANS-A respiratory rate of 5 in a neonate would be described
how, and what would be the causes of this?
bright illumination - ANS-How does a pneumothorax respond to transillumination?
bright light placed against chest wall; halo = normal
bright illumination = pneumothorax - ANS-When is transillumination of the chest recommended?
Can pass right on to baby during delivery. Baby will be in distress. - ANS-What is the
significance of a Group B Strep Infection in the mother?
Central cyanosis = due to hypoxemia; central part of body is cyanotic
Acrocyanosis = cyanosis of hands and feet; peripheral vasoconstriction - ANS-Explain the
difference between central cyanosis and acrocyanosis.
Check the chart - ANS-What is the first step in patient assessment?
conduction
convection
evaporation
radiation - ANS-Identify the four mechanisms by which infants lose heat to the environment.
current age - less than 16 or older than 40; prenatal care; smoking; caffeine; fetal alcohol
syndrome; nutrition; diabetes; how many previous live births - ANS-What factors in the maternal
history would indicate a high risk pregnancy?
decreased - ANS-How would the breath sounds change with Hyaline Membrane Disease?
decreases - ANS-What happens to an infant's O2 consumption as the infant loses heat?
Define kyphoscoliosis. - ANS-hunch back with lateral curvature
Define mean airway pressure. - ANS-average pressure in the airways; includes both inspiratory
and expiratory pressures; 10-14 cmH2O is normal amount of MAP
Describe a fenestrated trach tube. - ANS-hole in the outer cannula
Describe a metered dose inhaler? - ANS-delivers medication by aerosol
Describe a pneumogram. - ANS-sleep study; 12 - 24 hour continuous study of respiratory
movement
, Describe a polysomnogram. - ANS-sleep study; details of different sleep stages
Describe a trach button. - ANS-Maintains the stoma
Describe an HME and where in the breathing circuit should it be located? - ANS-Hygroscopic
condenser = HME
Between the patient and the Y adapter so the patient can inhale and exhale through the HME
Describe autogenic drainage. - ANS-Breathing exercises used to improve mucus clearing and
ventilation; cystic fibrosis, bronchiectasis patients
Describe croup or LTB. - ANS-Etiology - caused by virus, subglottic swelling, inspiratory stridor
with barking cough
URI - viral
Incidence - more common in winter
Age - little ones
Signs and Symptoms - x-ray will show steeple sign due to subglottic swelling
Onset - gradual; within days
Treatment and Drugs - cool aerosol, with stridor oxygen, racemic epi, steroids, intubate with
marked stridor
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