NICQ (Lecture 4A) Flashcards
Is the NICQ a comfortable place for children?
No (bright lights, lots of noise, etc)
How to give care in a NICQ?
Cluster-caregiving interventions, more positive tactile experiences, postural support and positional changes, Kangaroo Care, cue-based feeding practices, self-comforting behavior
What is the order of development?
Touch, vestibular, olfactory, taste, hearing, vision, sensory
What are the 6 infant states?
Deep Sleep, Light Sleep, Drowsy, Quiet Alert, Active Alert, Crying
What characterizes deep sleep?
Predominantly regular breathing, eyes closed/no eye movements, relaxed facial expression, no real activity except occasional startle, preterm (no movement at all, alternating quickly with startles, jerky movements, or tremors)
What characterizes light sleep?
Eyes closed, REM
Low activity levels
Responds to internal stimuli with dampened startle
Breathing more irregular, mild sucking
May whimper at times, sign, or smile
Pre-terms = diffuse/disorganized activity, twitches, grimacing
What characterizes Drowsy?
Eyes open OR closed
Eyelids fluttering or exaggerated blinking
Glassy eyed (if eyes open)
Varied activity level, diffuse movement
Preterm - may have fussing and much vocalization, grimacing, or whimpers
What characterizes Quiet Alert?
Awake and alert - bright shiny look
Seems to focus and actively process information
Minimal motor activity
Preterm - duller look, my look through rather than at stimulus
(may be “hyperalert” - appearance of panic, fear, unable to break intensity of fixation)
What characterizes Active Alert?
Eyes may be open OR closed
Infants clearly awake and aroused
Considerable, well-defined motor activity
May fuss but does not cry
Preterm - motor activity may be disorganized, jerky, with startles
What characterizes crying?
Rhythmic, intense crying
Robust, vigorous and strong in sound
Preterm - cry may sound very strained, weak, or even absent
What are signs of an immature infant?
Poorly differentiated states (diffuse)
Difficulty transitioning between states
May be very little crying or communication of needs
May be disorganized (difficulty inhibiting movement in order to attain quiet alert state)
Physiologic variables affect state
Alert states may be brief
Attaining or maintaining an alert state may cost too much for n infant
Ability to become alert may depend on therapeutic support
NBAS- Neonatal Brazelton Assessment Scale
Assess a wide range of behavior Infant full term to 2 months of age 28 behavior and 18 reflex items Regulation of physiological processes Tone, activity level, and reflexes State control and transitions Ability to respond socially, orient
APIB - Assessment of Premature infant
Items derived from NBAS
Assesses high-risk, preterm, or full-term infants from birth to 1 month corrected age
Autonomic, Sate Organization Motor, Attention, Self-regulation, Records degree of support needed
NNNS - NICQ Network Neuobehavioral Scale
Active/passive tone, primative reflexes
CNS integrity
State
Sensory and interactive processes
Stress/abstinence items particularly for high-risk infants
Draws from several tests, including NBAS, APIB, and others
Developed to term, preterm, and at-risk infants who are medically stable(~30 weeks to 8 weeks corrected age)
What is therapeutic positioning?
Providing postural support to compensate for lack of physiological flexion in preterm infant and/or to facilitate normal movement patterns/activities
