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Umbilical Catheter Placement and Vascular Access Flashcards

6 cards from real NRP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. What is the recommended insertion depth for a UVC in a 3 kg term newborn for emergency delivery room resuscitation?

    Answer: Just until blood is freely aspirated (~2–4 cm from the skin)

    For emergency delivery room use, insert the UVC just until blood can be freely aspirated (~2–4 cm), regardless of birth weight. Precise depth calculation is for elective NICU placement, not emergency access.

  2. When preparing an umbilical venous catheter for insertion, which of the following sterile preparation steps is MOST important in the emergency delivery room setting?

    Answer: Applying a sterile field around the umbilicus with povidone-iodine or chlorhexidine cleansing

    In the emergency setting, a sterile field should be established around the umbilicus using antiseptic cleansing. Sterile gloves and a sterile technique are essential. Full surgical preparation may not be possible in a time-critical resuscitation, but basic sterile precautions must be maintained.

  3. What is the significance of a UVC that was easy to insert but flushes with resistance and no blood can be aspirated?

    Answer: The catheter may have entered a false passage, portal branch, or become kinked — do not infuse until position is verified

    Inability to aspirate blood combined with resistance to flushing suggests the catheter may be malpositioned — in a false passage, portal branch, or kinked. Medications should not be infused until position is confirmed or the catheter is repositioned.

  4. In which clinical scenario would IO access be MOST appropriate during neonatal resuscitation?

    Answer: A newborn with omphalocele requiring emergency vascular access for medications

    Omphalocele is a contraindication to UVC insertion. IO access is the appropriate alternative for emergency vascular access in a newborn with an umbilical abnormality requiring medications.

  5. What is the recommended gauge and type of needle for emergency intraosseous access in a full-term neonate?

    Answer: 18 gauge IO needle or EZ-IO pediatric needle (15 mm)

    An 18-gauge IO needle or a 15 mm pediatric EZ-IO needle is recommended for neonatal IO access. Standard hypodermic or IV needles are not appropriate as they can bend or be displaced in the bone.

  6. What complication of umbilical arterial catheter (UAC) insertion is specific to the arterial system and does not occur with UVC?

    Answer: Vasospasm causing blanching or cyanosis of the lower extremities

    Umbilical arterial catheters can cause vasospasm in the arterial supply to the lower extremities or buttocks, resulting in blanching, cyanosis, or mottling — a complication that does not occur with venous catheters.