Neonatal Nurse Practitioner Practice Exam

Prior to administering sodium bicarbonate for resuscitation, what should be established?

1. Adequate ventilation

2. Correction of hypovolemic shock

3. Documentation of respiratory acidosis

4. Normal blood pressure

The correct answer is: Adequate ventilation

Administering sodium bicarbonate during resuscitation is a critical intervention that should be approached with caution. The correct choice of ensuring adequate ventilation prior to administration is essential for several reasons. Adequate ventilation helps to ensure that carbon dioxide levels in the blood are appropriately managed. When ventilation is insufficient, carbon dioxide accumulates, leading to respiratory acidosis, which is the very condition sodium bicarbonate is intended to address. If ventilation is not adequate, the bicarbonate may not act effectively to buffer the acidosis that is typically present in a poorly ventilated infant, as the underlying issue (hypoventilation) is still unresolved. Moreover, inadequate ventilation can lead to further respiratory distress and compromise oxygen delivery, thus complicating the resuscitation efforts. Ensuring proper ventilation allows for a more effective and holistic approach to stabilization during resuscitation. While other factors like correcting hypovolemic shock, documenting respiratory acidosis, and achieving normal blood pressure are also important in the resuscitation process, they do not take precedence over ensuring that adequate ventilation is established first. Addressing ventilation optimally sets the stage for any subsequent interventions, including the administration of sodium bicarbonate.