* Read all the articles in the supplement (pS2-S17).
* Take the test, recording your answers in the test answers section (Section B) of the CE enrollment form. Each question has only one correct answer.
* Complete registration information (Section A) and course evaluation (Section C).
* Mail completed test with registration fee to: Lippincott Williams & Wilkins, CE Group, 333 7th Avenue, 19th Floor, New York, NY 10001.
* Within 4-6 weeks after your CE enrollment form is received, you will be notified of your test results.
* If you pass, you will receive a certificate of earned contact hours and answer key. If you fail, you have the option of taking the test again at no additional cost.
* A passing score for this test is 13 correct answers.
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Registration Deadline: October 31, 2012
LWW, publisher of Advances in Neonatal Care, will award 3.3 contact hours for this continuing nursing education activity.
LWW is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 3.3 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454.
Your certificate is valid in all states.
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Disclosure Statement: The authors have disclosed that they have no financial relationships related to this article.
This article has been approved by the National Association for Neonatal Nurses Certification Board for Category B credit toward recertification as an NNP.
Payment and Discounts:
This continuing education activity is free of charge to NANN members and nonmembers thanks to an educational grant from Dräager.
CE Test Questions
GENERAL PURPOSE STATEMENT: To familiarize the nurse with hypothermia in preterm infants, nursing interventions to prevent heat loss, and the effects of seasonal temperature differences in the NICU.
LEARNING OBJECTIVES: After reading this article and taking this test, the nurse will be able to:
Seasonal Mapping of NICU Temperature
1. Describe seasonal temperature differences in the NICU.Thermoregulation and Heat Loss Prevention After Birth and During Neonatal Intensive-Care Unit Stabilization of Extremely Low-Birthweight Infants
2. Identify nursing interventions that may prevent heat loss.Transitional Hypothermia in Preterm Newborns
3. Define hypothermia in preterm infants.
Questions 1 to 6 apply to the article “Seasonal Mapping of NICU Temperatures.”
1. Incubators act to decrease heat loss by
2. Typically, monitoring of NICU thermal environment involves temperature and
a. heat conduction.
b. heat radiation.
c. heat index.
3. Cool nursery air temperature promotes infant
a. conduction heat loss.
b. radiation heat loss.
c. convection heat loss.
d. evaporation heat loss.
4. What type of thermometer can assess the effect of evaporation?
a. dry bulb
b. wet bulb
5. Results of the study assessing seasonal NICU temperatures found that which differed by both season and nursery room?
a. temperatures only
b. humidity only
c. temperatures and humidity
d. heat index
6. The study assessing seasonal NICU temperatures found that the room air temperature ranges were generally
a. much lower than the recommended range.
b. somewhat lower than the recommended range.
c. higher than the recommended range.
d. within the recommended range.
Questions 7 to 13 apply to the article “Thermoregulation and Heat Loss Prevention After Birth and During Neonatal Intensive-Care Unit Stabilization of Extremely Low-Birthweight Infants.”
Which is the main mechanism in neonates to produce heat through metabolic activity?
a. shivering thermogenesis
b. nonshivering thermogenesis
c. peripheral vasoconstriction
d. inhibition of sweating
Approximately what percentage of ELBW infants are admitted to NICUs with hypothermic temperatures?
a. less than 33%
b. 33% to 66%
c. 66% to 93%
d. more than 93%
If left unchecked, hypothermia can lead to
a. permanent respiratory damage.
b. permanent brain damage.
d. cardiac arrhythmias.
For infants 25 to 27 weeks gestational age in dry environments, which is the major form of heat loss during the first 10 days of life?
When is cold stress in infants most likely?
a. immediately after birth
b. 30 minutes after birth
c. one hour after birth
d. two hours after birth
To maintain a warm environment for the infant, NICU nurses can do all except
a. prewarm the incubator.
b. use a plastic bag or wrap after drying the infant.
c. add humidity to the incubator.
d. prewarm linens and clothing.
Before delivering intravenous fluids to the ELBW infant, they should be prewarmed by
a. covering them with a heated blanket.
b. using a microwave oven.
c. using a heat pump.
d. placing them in the incubator.
Questions 14 to 20 apply to the article “Transitional Hypothermia in Preterm Newborns.”
According to WHO, potential cold stress occurs when a newborn infant's temperature is between
a. 36.5 and 37.5 degrees C.
b. 36 and 36.5 degrees C.
c. 32 and 36 degrees C.
d. 30 and 32 degrees C.
According to the NRP, the goal of the first postnatal temperature should be an axillary temperature of approximately
a. 37 degrees C.
b. 36.5 degrees C.
c. 36 degrees C.
d. 35.5 degrees C.
Which of the following does the NRP suggest placing an infant's body from the neck down in when the infant is born at less than 28 weeks?
a. heated wool warming sack without first drying the skin
b. heated wool warming sack after first drying the skin
c. recloseable polyethylene bag without first drying the skin
d. recloseable polyethylene bag after first drying the skin
Delivery room temperatures should never be below what temperature according to the ASHRAE guidelines?
a. 72 degrees F
b. 70 degrees F
c. 68 degrees F
d. 66 degrees F
Recommendations for prevention of hypothermia in infants include which of the following in every delivery room?
a. individual thermostat control.
b. institutional thermostat control
c. heated towel racks.
Until continuous temperature monitoring can be established, infant temperatures should be recorded as soon as possible after birth and then every
a. 2 to 3 minutes.
b. 5 to 10 minutes.
c. 10 to 15 minutes.
d. 15 to 30 minutes.
According to WHO, delivery room temperature should not be determined by
a. birthweight of the infant.
b. gestational age of the infant.
c. previous experience.
d. comfort level.