NCC NNP-BC flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Category I FHR tracing

Baseline 110-160 bpm with moderate variability and no late or variable decelerations. Accelerations and early decelerations may be present. It indicates a normal fetal status and requires no intervention.

Uterine tachysystole

More than five contractions in ten minutes averaged over thirty minutes. It may reduce placental perfusion. Management includes repositioning, intravenous fluids, and reducing or stopping oxytocin.

Late deceleration

A gradual decrease in fetal heart rate beginning after the contraction peak and returning after it ends. It reflects uteroplacental insufficiency and warrants intrauterine resuscitation.

Group B streptococcus prophylaxis

Penicillin G is first-line for colonized mothers in labor. Cefazolin is used for non-anaphylactic penicillin allergy. Clindamycin requires documented susceptibility testing before use.

Neonatal resuscitation compression ratio

When heart rate remains below 60 bpm despite effective ventilation, provide three compressions to one breath. This equals 90 compressions and 30 breaths per minute.

Neonatal epinephrine dose

Intravenous or intraosseous epinephrine is 0.01-0.03 mg/kg of the 0.1 mg/mL concentration. The endotracheal dose is 0.05-0.1 mg/kg of the 1 mg/mL concentration.

Apgar score components

Five components scored zero to two each: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Scores are assigned at one and five minutes and do not guide resuscitation.

Delayed cord clamping

Clamping the cord at least 30-60 seconds after birth in infants not requiring immediate resuscitation. It improves iron stores and reduces transfusion needs, especially in preterm infants.

Respiratory distress syndrome

Caused by surfactant deficiency, leading to decreased compliance and atelectasis. Chest radiograph shows ground-glass opacities with air bronchograms. Treatment includes surfactant and respiratory support.

Transient tachypnea of newborn

Respiratory distress appearing within hours of birth from delayed clearance of fetal lung fluid. Chest radiograph shows perihilar streaking. It typically resolves within 24-72 hours.

Apnea of prematurity

A pause in breathing lasting 20 seconds or longer, or shorter if accompanied by bradycardia or desaturation. Caffeine citrate is the standard treatment.

Bronchopulmonary dysplasia definition

In infants born before 32 weeks, it is an oxygen requirement for at least 28 days, graded by respiratory support needed at 36 weeks postmenstrual age.

Prostaglandin E1 infusion

Given at 0.01-0.1 mcg/kg/min to maintain ductal patency in ductal-dependent congenital heart lesions. Side effects include apnea, fever, and hypotension.

Hyperoxia test

An arterial oxygen tension above 150 mmHg after 100% oxygen suggests pulmonary disease rather than a cyanotic cardiac lesion. Lower values raise concern for cyanotic heart disease.

Hypoplastic left heart syndrome

A ductal-dependent lesion with inadequate systemic blood flow. Initial management includes prostaglandin E1 and avoiding excessive pulmonary blood flow by limiting supplemental oxygen.

Patent ductus arteriosus closure

Indomethacin or ibuprofen may close a hemodynamically significant patent ductus arteriosus. Contraindications include renal failure, thrombocytopenia, and necrotizing enterocolitis.

Therapeutic hypothermia

Cooling to 33.5-34.5 degrees Celsius for 72 hours, started within 6 hours of birth, for moderate to severe hypoxic-ischemic encephalopathy. Slow rewarming and monitoring are required.

Intraventricular hemorrhage grading

Papile grades I-IV: grade I is germinal matrix only, grade II is intraventricular without dilation, grade III adds ventricular dilation, and grade IV includes parenchymal hemorrhage.

Kernicterus

Bilirubin deposition in basal ganglia and brainstem causing lethargy, poor feeding, hypertonia, and retrocollis acutely. It can result in permanent neurologic damage.

Necrotizing enterocolitis

Presents with feeding intolerance, abdominal distension, and bloody stools. Radiograph may show pneumatosis intestinalis. Management includes bowel rest, antibiotics, and parenteral nutrition.

Physiologic jaundice timing

Jaundice appearing after 24 hours of life is physiologic. Jaundice within the first 24 hours is pathologic and requires urgent bilirubin measurement and evaluation.

Pyloric stenosis presentation

Projectile nonbilious vomiting at 3-6 weeks of age with visible peristalsis. Laboratory findings include hypochloremic hypokalemic metabolic alkalosis. Treatment is surgical pyloromyotomy.

Newborn urine output

Normal output is 1-3 mL/kg/hour. Oliguria is defined as less than 1 mL/kg/hour. Potassium should not be given until urine output is established.

Physiologic weight loss

Term infants may lose up to 7-10% of birth weight in the first week. Preterm infants may lose up to 15%. Greater loss requires feeding and hydration assessment.

Physiologic anemia of infancy

Hemoglobin nadir occurs at 8-12 weeks in term infants and 4-8 weeks in preterm infants. It results from low erythropoietin and shortened red cell lifespan.

Vitamin K prophylaxis

A single intramuscular dose of 0.5-1 mg at birth prevents hemorrhagic disease of the newborn. It is recommended for all newborns unless parents decline after informed discussion.

Early-onset neonatal sepsis

Sepsis presenting within 72 hours of birth. Risk factors include maternal group B streptococcus colonization, prolonged rupture of membranes, chorioamnionitis, and prematurity.

Congenital cytomegalovirus

The leading nongenetic cause of sensorineural hearing loss. Diagnosis uses urine or saliva polymerase chain reaction. Hearing screening and developmental follow-up are required.

Congenital hypothyroidism

Detected by newborn screening. Levothyroxine should begin within 2 weeks of life to prevent intellectual disability. Repeat testing and dose adjustment follow.

Congenital adrenal hyperplasia

21-hydroxylase deficiency causes salt-wasting crisis with hyponatremia, hyperkalemia, and hypotension in the second week of life. Newborn screening measures 17-hydroxyprogesterone.

Trisomy 21 features

Features include hypotonia, upslanting palpebral fissures, and a single palmar crease. Associated risks include congenital heart disease, duodenal atresia, and thyroid disease.

Turner syndrome

A 45,X chromosomal disorder in females presenting with webbed neck, lymphedema, short stature, and coarctation of the aorta. Pubertal hormone replacement is often needed.