Samuel Gepaya BSN – II RLE Nursery – B1

Activity 3 Process Questions

1. Describe the proper way of performing the following:

a) Prevent heat loss

- To prevent heat loss, infant is place under a radiant heat warmer and other interventions such as use
of thermal mattress and hat.

b) Open airway

- Ensure that head, neck, and jaw are positioned that allows airway pathway such as in a sniffling
position where head is slightly tipped back.

c) Stimulation

- Stimulation of breathing can be done through a brisk yet gentle drying on the newborn using a soft
towel.

2. How do you assess the neonatal heart rate? What intervention should be given if heart rate falls
below normal? What is the parameter used to determine that the intervention is successful?

Neonatal heart rate can be determined using the stethoscope for infants, use of touch to feel pulsations
especially at base of umbilical cord, and use of pulse oximetry.

If heart rate is below normal, interventions such as monitoring oxygen saturation, initiating immediately
assisted positive pressure ventilation, ensuring open airway, and checking for leaks or inadequate gas
flow on ventilation.

The intervention is successful if the newborn has sustained a heart rate above 100 beats/min and there
is a rise and fall of the chest and upper abdomen of the baby.

3. Discuss the purpose of PEEP? What is the appropriate level to be given to neonate? Why?

PEEP or Positive End Expiratory Pressure assist in the lung expansion of the baby, helps in establishing
functional residual capacity, and improves oxygenation.

PEEP is set to an appropriate level of at least 5. High level of this pressure of 8 and more can reduce the
pulmonary blood flow of the neonate and can case pneumothorax.

4. What should be assessed every step of the neonate resuscitation algorithm? How often should
assessment be done?

Assess for response such as breathing or the rise and fall or the chest and abdomen. This assessment is
done after each step for every 30 seconds.
5. When do you give compression? Describe the recommended technique?

Chest compressions is given is the heart rate drops below 60 beats/min despite 30 seconds of adequate
assisted ventilation.

In giving compressions, it is recommended to use the 2 thumb techniques where 3 compressions are
given to every one breath. An effective compression will show pulsations as the oximetry and the aim
here is to give 90 compressions per minute.

6. What is the preferred venous access for newborn? What is the purpose of these venous access site?

The preferred venous access for the newborn is on the umbilical vein. The venous access site is used to
give the newborn medications such as adrenaline and provide volume expansion like fluids easily.

7. Enumerate the ethical considerations that a nurse should take when discontinuing resuscitative effort.

1. Focus on the comfort the baby if life is present.

2. Focus on the dignity of the newborn.
3. Focus on support of the parents.