Oxygen Administration and Monitoring Flashcards
5 cards from real NRP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 5 Oxygen Administration and Monitoring flashcards as text
Why is pulse oximetry preferred over visual assessment of skin color for monitoring oxygenation during neonatal resuscitation?
Answer: Visual assessment of skin color is unreliable, especially in darker-skinned infants and in the first minutes of life
Skin color assessment is subjective, affected by lighting, infant skin tone, and peripheral vasoconstriction, and is an unreliable indicator of oxygenation. Pulse oximetry provides continuous, objective SpO2 data independent of these factors.
What is CPAP (continuous positive airway pressure) used for in the delivery room setting for preterm infants?
Answer: To provide continuous distending pressure that maintains functional residual capacity in spontaneously breathing preterm infants
CPAP maintains positive airway pressure throughout the respiratory cycle in spontaneously breathing infants, preventing alveolar collapse and supporting FRC — particularly valuable in preterm infants with surfactant deficiency.
How does the SpO2 target change for an infant with suspected critical congenital heart disease (CCHD) with ductal-dependent circulation?
Answer: SpO2 targets may be lower than standard NRP targets; supplemental oxygen should be used cautiously as it may promote ductal closure
In ductal-dependent congenital heart disease, excessive oxygen can promote ductus arteriosus closure, worsening systemic or pulmonary blood flow depending on the lesion. Oxygen should be used cautiously and SpO2 targets individualized.
What is the significance of a large difference between preductal (right hand) and postductal (left hand or feet) SpO2 readings in a newborn?
Answer: It suggests right-to-left shunting through the ductus arteriosus, consistent with persistent pulmonary hypertension or structural heart disease
A significant preductal-postductal SpO2 differential (preductal SpO2 higher than postductal by >3–5%) suggests right-to-left shunting through the ductus arteriosus, indicating PPHN or ductal-dependent congenital heart disease.
If a pulse oximetry reading cannot be reliably obtained during neonatal resuscitation, how should the team guide oxygen therapy?
Answer: Use clinical assessment including breathing effort, heart rate response, and skin color, and continue troubleshooting the oximeter
When pulse oximetry is unavailable or unreliable, clinical assessment — evaluating heart rate response to ventilation, breathing effort, tone, and color — guides management while the team troubleshoots to obtain reliable monitoring.