Neonatal Nurse Practitioner Practice Exam

In case of failed resuscitation after emergency cesarean due to fetal-maternal hemorrhage, what should be administered next?

1. sodium bicarbonate

2. volume expanders

3. epinephrine

4. antibiotics

The correct answer is: volume expanders

In the scenario of a failed resuscitation after an emergency cesarean due to fetal-maternal hemorrhage, administering volume expanders is the most appropriate next step. This is because fetal-maternal hemorrhage can lead to significant blood loss, and volume expanders help to restore intravascular volume, thereby improving blood pressure and perfusion. By increasing the circulating blood volume, volume expanders can enhance organ perfusion, which is critical in cases of hemorrhagic shock. This approach is especially vital in a neonatal context, where stabilization of hemodynamics is crucial for the viability of the neonate following a traumatic delivery. Other options, while having their own roles in different clinical scenarios, may not be immediately appropriate in this context. For example, sodium bicarbonate is useful for treating metabolic acidosis but does not address the underlying cause of hypovolemia. Epinephrine is indicated for cardiac arrest situations but may not be effective if the primary issue is volume depletion. Antibiotics, although important in infections, do not play a role in acute hemorrhagic events and would not be the immediate priority following resuscitation attempts.