jshupe
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Per Neonatal Hypoglycemia procedures 11/2013 at my institution - you should consult your procedures or another clinical reference as I make no guarentee, waranty or other about the accuracy of this information.

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jshupe
Created by jshupe over 9 years ago
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Perinatal pretest

Question 1 of 12

1

Neonatal hypoglycemia is defined as:

Select one of the following:

  • blood glucose < 40 mg/dL

  • blood glucose < 35 mg/dL

  • blood glucose < 45 mg/dL

  • blood glucose < 50 mg/dL

  • blood glucose < 30 mg/dL

  • blood glucose < 55 mg/dL

Explanation

Question 2 of 12

1

Immediate screening for Neonatal Hypoglycemia is NOT indicated for which of the following:

Select one of the following:

  • Jitteriness

  • Respiratory Distress

  • Poor feeding

  • Infants born to diabetic mothers

  • Cyanosis

  • Tachypnea

  • Weak cry

Explanation

Question 3 of 12

1

At risk newborns should be screened within:

Select one of the following:

  • 30 minutes

  • 35 minutes

  • 25 minutes

  • 20 minutes

  • 40 minutes

  • 45 minutes

Explanation

Question 4 of 12

1

Which of the following is NOT a risk factor for Neonatal Hypoglycemia?

Select one of the following:

  • Large for gestational age

  • Small for gestational age

  • Infants born to diabetic mothers

  • pre term infants

  • Apgars of 5 and 7

  • Maternal Temperature >101

  • Maternal infection

  • No prenatal care

  • Infants stressed due to prolonged or comlicated labor/delivery

  • At the discretion of the nurse or provider

Explanation

Question 5 of 12

1

The next step with an inital POC glucose of 24 mg/dL is:

Select one of the following:

  • Feed immediately

  • Obtain stat serum glucose and start IV glucose

  • Call the Neonatologist

  • Call your Attending

  • Recheck in 30 minutes

Explanation

Question 6 of 12

1

How long should you wait after feeding at the breast, 5mL/kg of formula or D5W to recheck the glucose level (assuming the inital glucose was low).

Select one of the following:

  • 30 minutes

  • 25 minutes

  • 35 minutes

  • 20 minutes

  • 40 minutes

  • 15 minutes

  • 45 minutes

  • 10 minutes

Explanation

Question 7 of 12

1

After rechecking an initial glucose that was below 25mg/dL, the recheck is still below 25mg/dL. The next best step is

Select one of the following:

  • Obtain stat serum glucose and start IV glucose

  • Feed immediately

  • Call your attending

  • Call the Neonatologist

  • Recheck in 30 minutes

Explanation

Question 8 of 12

1

Which of the following is NOT an appropriate next step in the management of a neonate with an initial POC glucose of 41mg/dL?

Select one of the following:

  • Breast feed, nipple 15mL or formula or D5W a symptomatic neonate.

  • Assess a symptomatic neonate for other reasons for symptoms (sepsis, hypthermia).

  • Repeat POC glucose checks every 2-3 hours on a symptomatic neonate before feeding for 12 hours.

  • Discontinue POC glucose checks on an asymptomatic low risk neonate.

  • Obtain a STAT serum glucose for a symptomatic neonate.

Explanation

Question 9 of 12

1

Care of Late preterm and SGA neonates differs in that:

Select one of the following:

  • They should be fed every 2-3 hours, and screened before feeding for 24 hours

  • They should be fed every 1-2 hours, and screened before feeding for 24 hours

  • They should be fed every 2-3 hours, and screened before feeding for 12 hours

  • They should be fed every 1-2 hours, and screened before feeding for 12 hours

Explanation

Question 10 of 12

1

Care for neonates born to mothers with diabetes and LGA neonates greater than 34w gestation differs in that:

Select one of the following:

  • They should be fed every 2-3 hours, and screened before feeding for 12 hours

  • They should be fed every 2-3 hours, and screened before feeding for 24 hours

  • They should be fed every 1-2 hours, and screened before feeding for 12 hours

  • They should be fed every 1-2 hours, and screened before feeding for 24 hours

Explanation

Question 11 of 12

1

Routine feeding is resumed for a neonate who had previously low POC glucose once the POC glucose is greater than or equal to

Select one of the following:

  • 45mg/dL

  • 40mg/dL

  • 50mg/dL

  • 35mg/dL

  • 55mg/dL

  • 60mg/dL

Explanation

Question 12 of 12

1

Which of the following is INCORRECT management of a neonate with previously low POC glucose between 4 and 24 hours of life.

Select one of the following:

  • feed every 2-3 hours and check POC glucose before each feed.

  • if POC glucose is < 35mg/dL, feed and recheck in 1 hour.

  • If glucose remains below 35mg/dL, start IV glucose

  • Return to routine feeds once POC glucose is equal to or greater than 40mg/dL.

Explanation