Neonatal Cardiovascular Assessment and Care Flashcards
7 cards from real RNC-NIC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Neonatal Cardiovascular Assessment and Care flashcards as text
What is the normal resting heart rate range for a term neonate?
Answer: 100-160 bpm
Term neonates have a normal resting heart rate of 100-160 bpm, which is higher than adult norms due to their elevated metabolic demands.
Which clinical finding is most characteristic of a hemodynamically significant patent ductus arteriosus (PDA) in a premature neonate?
Answer: Bounding peripheral pulses with a continuous murmur
A hemodynamically significant PDA causes bounding pulses due to wide pulse pressure and a characteristic continuous 'machinery' murmur from left-to-right shunting.
Four-extremity blood pressure measurement in a neonate is performed primarily to screen for which condition?
Answer: Coarctation of the aorta
Coarctation of the aorta creates a pressure gradient between the upper and lower extremities; a difference greater than 10-20 mmHg suggests significant coarctation.
A neonate has a pre-ductal SpO2 of 98% and a post-ductal SpO2 of 88%. What does a difference greater than 3-5% most likely indicate?
Answer: Persistent pulmonary hypertension or a ductal-dependent cardiac lesion
A pre-to-post-ductal SpO2 difference greater than 3-5% indicates right-to-left shunting through the ductus arteriosus, suggesting PPHN or a duct-dependent cardiac defect.
Which congenital heart defect is considered ductal-dependent for systemic circulation, requiring prostaglandin E1 to maintain cardiac output?
Answer: Hypoplastic left heart syndrome (HLHS)
HLHS has a severely underdeveloped left heart, making systemic perfusion entirely dependent on right-to-left flow through the ductus arteriosus; closing the ductus is fatal.
A cyanotic neonate fails to improve despite administration of 100% supplemental oxygen (hyperoxia test). What is the most likely underlying cause?
Answer: Cyanotic congenital heart disease
Failure to improve SpO2 above 95% with 100% oxygen (hyperoxia test) strongly suggests cyanotic congenital heart disease with intracardiac right-to-left shunting that bypasses the lungs.
What is the recommended SpO2 target range for most very preterm infants (less than 32 weeks) in the NICU to balance risk of retinopathy of prematurity against mortality?
Answer: 91-95%
Current guidelines recommend SpO2 targets of 91-95% for very preterm infants, as targets below 90% increase mortality risk while targets above 95% increase risk of retinopathy of prematurity.