10-12 Neonatal Flashcards
1
Q
Very low birth weight
A
- Equal or less than 3 lb 5 oz (1500 g)
- 23-24 wks gestation
- Increases incidence in birth defects
2
Q
Gestational Age (GA)
A
- Length of time in utero
3
Q
Chronological Age (CA)
A
- Age based on birthday
4
Q
Corrected/Adjusted Age (AA)
A
- Considers age baby is from due date
5
Q
Post-Conceptual Age
A
- AA prior to achieving term age
- GA + CA
6
Q
Term Adjusted Age
A
- CA - #weeks missed in utero
7
Q
NICU Levels
A
- Level 1: Minimal observation or care; small community hospital; “Well-baby nursery”
- Level 2: Step down from Level III; continued care from Level III, IV meds or alimentation, tube feedings, O2; regional or community hospitals
- Level 3: Highly specialized services for sickest and most fragile infants - complex, medical interventions, advanced diagnostic testing, surgery, resp. support; Teaching hospitals and affiliated with medical schools
- Level 4: Level III plus ECMO (extracorporeal membrane oxygenation)
8
Q
Family-Centered Care
A
- Parents, children, significant others
- The “constant” in an infant’s life
9
Q
Coping and Grief
A
- Stages of grieving: Shock, Denial, Anger, Guilt, Adjustment, Acceptance
- May interfere with bonding
- Staff facilitates bonding, provides empathy
10
Q
Basic requirements for survival
A
- Physiological: breathing, feeding, growing
- Sensorimotor: rooting, sucking, grasping, clearing the airway in prone, horizontal and vertical tracking
- Affective/Communications: crying, self-consoling, eye contact, facial animation, eye aversion
- Complex: auditory preferences, taste preferences, visual preferences, imitative capacities
- Primary “work”: feeding (sucking + swallowing + breathing requires skill as well as energy
11
Q
Failure in Feeding in Pre-Term or Sick Full-Term Babies
A
- Learned oral aversion resulting from NICU care
- Lack of flex/ext balance and chin tuck to assist with sucking, swallowing, breathing
- Residual lung disease may cause tachynea; interferes with sucking and swallowing
- Lack of self-regulation; unable to calm self with environmental stressors
- Apnea
- Bradycardia
- Unable to coordinate sucking, swallowing, breathing, and becomes physiologically unstable
- Immature GI Tract
12
Q
PM: Respiratory Distress Syndrome
A
- Pulmonary immaturity, inadequate pulmonary surfactant
- Surfactant lowers the surface tension and allows the alveoli to maintain its shape
13
Q
PM: Patent Ductus Arteriosus
A
- Structure bypasses circulation to lungs pre-birth
- Normal fetal circulation: Hole in R ventricle and L pulmonary artery allows blood to circulate in utero
- Closes within 10-15 hours after delivery
- If does not close, prevents oxygenation of blood, results in hypotension, poor perfusion, CHF
14
Q
PM: Hyperbilirubinemia
A
- Accumulation of bilirubin (liver enzyme) in the blood
- Caused by immature hepatic function
- Bilirubin can accumulate in the brain and cause neuronal damage - must be addresed right away
15
Q
PM: Gastroesophageal Reflux (GER)
A
- Some degree is normal, asymptomatic
- Frequent episodes can damage esophageal lining - inflammation, dysmotility, pain
- Leads to poor oral feeding patterns, oral aversion and excessive crying due to pain