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OT 421: Occ Performance & Context Child/Adol > Chapter 22: NICU > Flashcards

Chapter 22: NICU Flashcards

1
Q

Based on the Dynamic Systems Theory, what is interacting and how is it impacting the child’s performance?

A

Child and environment are all interacting to positively impact child’s performance

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2
Q

Neurodevelopmental Theory: In-turning

A

Easily stressed from movement, touch, or stimuli
- Go into visible stress response

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3
Q

Neurodevelopmental Theory: Coming out

A

Medical maturity and more stable
- Can be handled more without as much negative stress responses

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4
Q

What is anticipatory guidance?

A

Anticipatory needs of the infant, NICU has protocols for infants and provides guidance for parents and staff

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5
Q

Based on the Synactive Theory, what is the infant always interacting with?

A

The environment
- Can be too stimulating
- Make sure parents are involved as much as possible
- Monitor infant in environment to encourage development

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6
Q

How does the brain develop differently in the NICU vs. in the womb?

A

Exposed to stress, increased cortisol levels which affects development

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7
Q

IDC Model

A

Model of developmentally supportive care

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8
Q

IDC Model components

A

Healing environment- dim lights, minimal noise
Partnering with families- skin to skin contact to create a bond
Positioning and handling- swaddling during painful procedures
Safeguarding sleep
Minimizing stress and pain
Protecting skin- layers of skin are underdeveloped
Optimizing nutrition

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9
Q

Interdisciplinary care in the NICU

A

OT- sensory experiences, family and infant support
SLP- feeding and swallowing
PT- positioning

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10
Q

Level I

A

Support for healthy newborns who may require additional assessment and intervention

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11
Q

Level II

A

Staff are equipped to provide close observation with continuous monitoring of heart rate, respiration, oxygen saturation levels, and basic respiratory support (nasal cannula and IV)

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12
Q

Level III

A

More intensive services including higher levels of respiratory support

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13
Q

Level IV

A

Cares for infants undergoing highly complex, life-saving interventions

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14
Q

What levels of NICU care are provided at specialized hospitals?

A

Levels III and IV

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15
Q

What levels of NICU care are provided at local hospitals?

A

Levels I and II

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16
Q

Basics of NICU care practice

A

Evidence-based, cost-effective, and provide only necessary intervention

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17
Q

Insurance reimbursement is contingent upon…

A
  • Cost containment
  • Reduction of length of stay
  • Avoid readmissions
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18
Q

Do many NICUs allow parents to visit around the clock?

A

Yes

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19
Q

Single family rooms

A

Instead of having baby in large nursery, they are in a room with their parents

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20
Q

Pros of single family rooms

A

Private and intimate setting, easier to control stimuli, less germs

21
Q

Cons of single family rooms

A

Parents may be unable to be there, isolation, can be overwhelming for parents who are not prepared for their role

22
Q

What is the average birth weight for a baby in the U.S?

A

7 lbs. 7 oz.

23
Q

What weight is considered normal for a baby in the U.S?

A

5 lbs. 5 oz. - 11 lbs.

24
Q

Low birth weight (LBW)

A

3.3-5.5 lbs

25
Q

Very low birth weight (VLBW)

A

2.2-3.3 lbs

26
Q

Extremely low birth weight

A

Less than 2.2 lbs

27
Q

Incredibly low birth weight/micropreemie (ILBW)

A

1.6 lbs or less

28
Q

Appropriate gestational age BW (AGA)

A

90%-10%

29
Q

Small for gestational age BW (SGA)

A

10% or less

30
Q

Large for gestational age BW (LGA)

A

90% or more

31
Q

What types of health challenges can be a result of a NICU stay?

A

Cardiopulmonary issues
Underdeveloped lungs→ chronic lung disease
Stress
Low stamina
Suck/swallow/breathe issue→ NG tube does not help
Retinopathy of prematurity→ babies are given supplemental oxygen for extended period of time→ stops retinas from developing
Corrective surgery can help this
Necrotizing enterocolitis→ tissue and cell damage in the colon, enflamed or ripped colon
Hemorrhaging or bleeding in the brain
Long term issues→ developmental disabilities or delays, learning challenges (ex. ADD), behavior challenges etc.

32
Q

Neonatal abstinence syndrome

A

Challenges a baby has due to their mother using drugs during pregnancy (usually opioids)

33
Q

Persistent pulmonary hypotension

A

The blood vessels to the lungs don’t fully open, causing too much blood to bypass into the lung, brain and body don’t get enough oxygen, high BP in the lungs hurt the baby’s heart and lungs

34
Q

Tracheo-esophageal fistula

A

Abnormal connection between esophagus and trachea, diagnosed by inability to insert NG tube

35
Q

Hypoxic ischemic encephalopathy

A

Type of brain injury that occurs when the brain experiences a decrease in oxygen or blood flow
Neurological signs→ severe respiratory difficulty, atypical posturing, seizures, dysregulation states of arousal

36
Q

Congenital diaphragmatic hernia

A

Hole in the diaphragm which forms during development, another organ moves into chest cavity interfering with lung development

37
Q

Prader-Willi syndrome

A

Genetic disorder with low muscle tone
Deletion in a chromosome from father

38
Q

Arthrogryposis

A

Associated with multiple joint contractures and stiffness, no muscle around the joint causes joint to build other tissues to hold in place

39
Q

Outcomes of NICU survivors

A

Survival improves with each week of gestation
24 weeks: 35%-84% chance of survival

40
Q

Any baby that spends time in the NICU is at an increased risk of…

A

Having a developmental delay

41
Q

It is important to provide consistent ______ in the NICU

A

Support and occupation based care

42
Q

What should the child be receiving after their NICU stay?

A

Early intervention

43
Q

Sensory habitat of a typical fetus

A

Unrestricted access to mother
Flexible boundaries that offer containment and support
Opportunities for movement against fluid resistance without the pull of gravity
Limited exposure to external stimuli

44
Q

Sensory based interventions in the NICU consider what?

A

Type of sensory stimuli and the amount of exposure
Conditions under which these interventions are being implemented
Timing of intervention with regard to the infant’s gestational age and ability to process the intervention

45
Q

OT assessment in the NICU

A

Safety, collaboration, observation, checklists, and interview (nurse and parents)

46
Q

Specific therapeutic interventions in the NICU

A

Address sensory needs
Promote therapeutic handling and positioning
Breast and bottle feeding
Being close with the family
Modifying the environment

47
Q

Partnering with families in the NICU

A

Family has greatest influence over infant’s health and well-being
Parents should be included as partners in care planning

48
Q

How do we support parental participation in the NICU?

A

Explaining procedures
Encouragement to participate and practice skin to skin contact
Giving ideas of what is to come

OT 421: Occ Performance & Context Child/Adol (5 decks)

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