NICU

Question 1

The survival rate of preterm infants is (decreasing/increasing)

Answer 1

increasing

Question 2

What is the leading cause of long term neuro disabilities in children?

Answer 2

preterm birth

Question 3

1 in ___ infants are born prematurely each year

Answer 3

1 in 10

Question 4

Premature babies cost __x more than healthy babies

Answer 4

10 x

Question 5

Premature rates are highest in infants who are (caucasion/black/latino)

Answer 5

black

Question 6

Preterm babies are born at __-__ weeks

Answer 6

23-25

Question 7

80% of infants born after __ weeks survive.

Answer 7

26

Question 8

The survival rate of birth at 30 weeks is __%

Answer 8

90%

–> increases 1% each week after

Question 9

(smaller/larger) babies are more likely to be preterm

Answer 9

larger

Question 10

What is the leading cause of infant death in the US as of 2020?

Answer 10

congenital malformations

Question 11

Premature birth is birth before ___ weeks.

Answer 11

37 weeks

Question 12

Most NICU birth weights are < ___ grams

Answer 12

2500 grams

Question 13

definition: head size significantly below the median of the infant’s age and sex

Answer 13

microcephaly

Question 14

definition: Full term infant who has had a significant episode of intrapartum asphyxia

Answer 14

hypoxic ischemic encephalopathy

Question 15

definition: Intrauterine development of amniochorionic strands leading to limb and digital amputations / constrictions and other deformities

Answer 15

amniotic band syndrome

Question 16

definition: Malformation of the spinal cord resulting from defective closure of the neural tube

Answer 16

myelomeningocele

Question 17

definition: Assessment of physiological function that is assigned to all infants at 1 and 5 minutes after birth

Answer 17

APGAR

Question 18

Low AGPAR scores are associated with _____ complications.

Answer 18

neuro

–> increases risk for CP and epilepsy

Question 19

What is the more prevalent disability related to prematurity?

Answer 19

CP

Question 20

32-50% of infants born before ___ weeks gestation OR weighing less than 1500 grams are diagnosed with IVH

Answer 20

32 weeks

Question 21

IVH may lead to ____.

Answer 21

hydrocephalus

Question 22

definition: bleeding in the ventricles of the brain; detected on cranial ultrasound

Answer 22

IVH

Question 23

Why is IVH a concern?

Answer 23

Bleeding in the brain can put pressure on the nerve cells and damage them. Severe damage to cells can lead to brain injury.

Question 24

Nearly all IVH cases occur within the first ___ days of life.

Answer 24

3 days

Question 25

What are s/s of IVH?

Answer 25

- apnea - pale/blue coloring - weak sucking - high pitched cry - Sz - swelling of the fontenelles - anemia

Question 26

definition: Ischemic infarction of white matter adjacent to the lateral ventricles

Answer 26

Periventricular Leukomalacia (PVL)

Question 27

How is PVL diagnosed?

Answer 27

MRI after d/c from the NICU

Question 28

PVL is very common in premature infants with ___.

Answer 28

CP

Question 29

What is the leading cause of mortality in neonates?

Answer 29

RDS (Respiratory distress syndrome)

Question 30

What are the risk factors for RDS?

Answer 30

- premature - LBW - low AGPAR - increased maternal age - gestational DM - neonatal transport

Question 31

What are causes of RDS?

Answer 31

- pulmonary immaturity - deficiency of surfactant

Question 32

What are s/s of RDS?

Answer 32

- rapid breathing - SOB - nasal flaring - apnea - blue skin color - swollen arms or legs

Question 33

What are treatments for RDS?

Answer 33

- oxygen supplementation - assisted ventilation - surfactant - ECMO

Question 34

definition: inflammation and scarring of the lungs

Answer 34

BPD/chronic lung disease

Question 35

BPD is associated with ___ for > 28 days.

Answer 35

ventilation

Question 36

What are causes of BPD?

Answer 36

- prematurity - assisted ventilation - pulmonary oxygen toxicity

Question 37

What are treatment options for BPD?

Answer 37

- respiratory support - nutrition - infection control - bronchodilator - steroid therapy

Question 38

___% of toddlers who had BPD had abnormal findings on their CT scan and ___% had current respiratory symptoms.

Answer 38

90%; 25%

Question 39

definition: Respiratory distress in an infant born through meconium-stained amniotic fluid whose symptoms cannot be otherwise explained

Answer 39

meconium aspiration syndrome (MAS)

Question 40

20% of infants with MAS have delays at age ____.

Answer 40

3 y/o

Question 41

definition: Abnormal development of vascularization of the retina that can lead to severe visual impairments

Answer 41

retinopathy of prematurity (ROP)

Question 42

Who is at risk of ROP?

Answer 42

- prolonged duration of oxygen - presence of concomitant neonatal sepsis - BPD - IVH - PDA - NEC

Question 43

What are medical treatments for ROP?

Answer 43

- cryotherapy - laser surgery

Question 44

Level of care: well newborn nursery; basic level of care to low risk infants

Answer 44

level 1

Question 45

level of care: care for stable or moderately ill infants (>32 weeks)

Answer 45

Level 2

Question 46

Level of care: prepared for smallest and most ill infants; neonatologist and range of specialists on staff; neonatal therapist (PT or OT) on staff

Answer 46

Level III

Question 47

level of care: all level III capabilities, plus experience in caring for most complex/ill infants

Answer 47

level IV

Question 48

What are infants at increased risk of forming if they have toxic stress?

Answer 48

Violent suicide attempts Cardiovascular disease Obesity Metabolic syndrome Fibromyalgia Mental health disorders

Question 49

Infants with Toxic stress has symptoms of ___.

Answer 49

ADHD

Question 50

(true/false) Premature infant screening should have the infant's development being assessed using the adjusted age.

Answer 50

true --> Use the baby's due date... not birthday --> do this until the infant is 2 y/o

Question 51

What often determines d/c?

Answer 51

Feeding

Question 52

When does suck swallow reflex begin in preterm babies?

Answer 52

28-30 weeks --> poorly coordinated until weeks 33-35

Question 53

What is the important defense against aspiration?

Answer 53

gag reflex

Question 54

What are contraindications to handling indicating that the exam should be modified or stopped?

Answer 54

- skin color change - hiccups - finger splays - LE stiffness - frowning - turning from stimulus --> infants may be experiencing a medical complication

Question 55

Who primarily performs infant massage?

Answer 55

parents

Question 56

What treatment has positive effects on infants exposed to HIV and cocaine?

Answer 56

infant massage

Question 57

What position assists in maintaining flexion?

Answer 57

sidelying

Question 58

(true/false) switch sides that you hold babies to prevent preferential head positioning over the shoulder that can cause torticollis

Answer 58

true

Question 59

Infants have more difficulty coping with exposure to light and noise if they're < ___ weeks

Answer 59

< 32 weeks

Question 60

definition: skin to skin contact

Answer 60

Kangaroo care