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Peds > NICU > Flashcards

NICU Flashcards

1
Q

LBW

A

Low Birth Weight

1501-2000 g

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2
Q

VLBW

A

Very Low Birth Weight

Below 1501 g

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3
Q

ELBW

A

Extremely Low Birth Weight

Below 1000 g

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4
Q

AGA

A

Appropriate for Gestational Age

An infant whose weight at birth falls within the 10th and 90th percentiles for his or her age

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5
Q

SGA

A

Small for Gestational Age

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6
Q

LGA

A

Large for Gestational Age

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7
Q

G

A

Gravida

Number of pregnancies

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8
Q

P

A

Para

Number of outcomes

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9
Q

F

A

Full term

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10
Q

P

A

Preterm

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11
Q

A

A

Abortions

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12
Q

L

A

Living children

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13
Q

RDS

A

Respiratory Distress Syndrome

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14
Q

BPD

A

Bronchopulmonary Dysplasia

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15
Q

PVL

A

Periventricular Leukomalacia

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16
Q

IVH or GMIVH

A

(Germinal Matrix) Intraventricular Hemorrhage

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17
Q

HIE

A

Hypoxic - Ischemic Encephalopathy

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18
Q

NEC

A

Necrotizing Enterocolitis

Breakdown of intestines

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19
Q

ROP

A

Retinopathy of Prematurity

Too much O2

Not very common now

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20
Q

Hyperbilirubinemia

A

Hyper bilirubin production from the liver

Jaundice

Rh incompatibility issue

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21
Q

Oxyhood

A

No intubation, but still receiving O2

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22
Q

Fetal Alcohol Syndrome

A

Alcohol mom

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23
Q

Fetal Abstinence (Withdrawal) Syndrome

A

Methadone
Crack
Heroine

Poor sleeping

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24
Q

HIV-AIDS

A

From childbirth or breastfeeding

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25
Q

Six Stages in Babies

A

Deep sleep or quiet sleep

Light sleep or active sleep

Drowsy or semi-dozing

Alert or quiet alert

Active or active awake

Crying

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26
Q

Best states to bother kiddos

A

Alert or quiet alert

Active or active awake

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27
Q

Brazelton States of Arousal

A

During exam look at…

Range of behavior
Variety of behavior
Duration of state

28
Q

Why assess?

A

ID impairments, neuromotor, and feeding that requires intervention

ID needs for positioning and handling

Determine how to adapt the environment to optimize development

29
Q

Tests and Measures for Preterm

A

Dubowitz Neurological Assessment of the preterm

NIDCAP by Als

NAPI Neurobehavioral assessment for preterm infants

TIMP Test of Infant Motor Performance

30
Q

Tests and Measures for Full-term

A

Dubowitz Neurological Assessment of the Full term

NBAS Neonatal Behavior Assessment Scale (Brazelton)

Morgan Neonatal Assessment Scale

31
Q

Assessment of General Movements

A

Developed in EU (Vienna?)

Video tape babies as they move

They can qualify types of movements and have been able to make some dx recommendations

32
Q

Oral-Motor Assessment

A

NOMAS Neonatal Oral-Motor Assessment Scale

NCAFS Nursing Child Assessment Feeding Scale

33
Q

Goals/Objectives in NICU

A

Limit impairment in mm tone, ROM, postural adaptation

Improve extremity movement control

Improved regulation of motor behavior and states

These should improve motor behavior and the ability to interact with caregivers and the environment

34
Q

Interventions in NICU

A

Environmental Modification

Positioning

Handling/massage

Sensorimotor stimulation

Extremity taping/splinting/casting

Hydrotherapy

Oral Motor Therapy

Parent Education and Support

35
Q

History taking

A

Medical chart

Nurses

Physician staff

Prenatal history

Birth history

Frequency and severity of episodes of apnea, bradycardia, and O2 sat, as well as interventions needed

36
Q

Examination

A

CNS, Respiratory, and GI systems

Look at baby’s initial means of getting nutrition, how it’s been tolerated, modified, regressed, and/or progressed should be understood

MEDS (seizure)

Dialogue with nursing

Observe infant at rest and during care activities

Recommend sound minimizing strategies

37
Q

Parent Education

A

Explain behaviors of a preterm baby

Explain the course of typical development and what to expect in the future

Teach them how to read their infants and respond supportively to them

Assist parents as they parent the infants

38
Q

SGA

A

Small for Gestational Age

Infants that weigh below the 10th percentile of published norms - can be term and pre-term

39
Q

Kangaroo Care

A

Skin-to-skin

Supports infant physiologic and behavioral stability and maturity as well as parent-infant interaction and attachment

Involves parent holding diaper clad infant underneath his/her clothing skin-to-skin, chest-to-chest

Gained wider acceptance in US for use in NICU over past decade

40
Q

Preterm Positioning

A

Avoid extension postures

Promote neutral head and neck

Slight chin tuck, scapular protraction to promote UE flexion and hands to midline

Use blanket rolls or commercially available devices

41
Q

Prone positioning

A

Unsupported prone px promotes shoulder retraction, neck hyperext, truncal flattening, and hip ABD and ER

42
Q

Side-lying positioning

A

Demonstrates decreased stress behaviors more than supine

Respiratory diaphragm is placed in gravity-eliminated plane, which lessens work of breathing

GER is decreased in left side-lying, and gastric emptying is increased in RIGHT side-lying

43
Q

Supine positioning

A

Allows maximal observation and access to the infant by caregivers

Poses the most challenges to the infant

Does not promote calming and self-regulation

44
Q

Supported supine positioning

A

Should be supported with rolls to promote midline symmetrical flexion with head and trunk in midline, hands near mouth and fact, and legs tucked close to the body with neutral hip position

Unique potential for WB on posterior skull

Affects cranial molding and head shapes

Risk of cranial deformations as they have softer, thinner skulls than full-term infants

45
Q

In sleep state….

A

Serial responses to repeated light (flashlight across the eyes) and sound (a soft rattle) are used to assess the baby’s ability to filter repetitive stimuli

Provides info regarding the stability of the sleep state

Gives therapist a chance to determine the readiness for handling

46
Q

Babies likely to experience rapid changes in physiological and behavioral states during routine care due to…

A

Metabolic instability

Incomplete development of neuromm, cardiopulmonary, and integumentary systems

47
Q

Risks of routine care

A 
Hemodynamic complications
Respiratory complications
Cardiac
Metabolic
Orthopedic
Integumentary
Risk of infection
48
Q

Preparation to Work in NICU

A

Observe healthy, term infants in nursery, home, or daycare

Provide direct service to hospitalized children on physiologic monitoring equipment, supplemental O2, vents, or with augmentative feeding

Participate in NICU follow-up clinics

Complete preempted training with an experienced PT in NICU and intermediate care units (2-6 mos)

49
Q

Biggest risk?

A

Bonding process is at risk between preterm infant and family

50
Q

Problems with NICU environment

A

Light disrupts normal sleep wake cycles

Sound-harsh sounds increase startle, speech sounds muffled, less ability to localize sound

Medical procedures disrupt sleep

Infant learns to respond negatively to touch

51
Q

Environmental Changes to NICU

A

Dimming lights, covering isolettes, day/night cycling of lights, not placing items on isolettes

Clustering of medical care, having specific rest periors

Nesting, kangaroo care, hammocks, put twins together

Music, clocks, mother’s clothing/smells

52
Q

Environmental changes to NICU can…

A

Produce changes in state, behavior, weight gain, days on vent, OR days in NICU

53
Q

Infants Classified by…

A

Weight

Gestational Age

Pathology

54
Q

Clinical Assessment of Gestational Age

A

Most often used to determine gestational age based on external signs

55
Q

Level I Nursery

A

Well-baby nursery

Newborns who require minimal observation of care

Warming in an isolette, phototherapy, circumcision

Located in small community hospitals

56
Q

Level II Nursery

A

Intermediate

Step-down from a Level IIl Nursery

Intravenous medications, tube feedings, O2 support

Neonatologists and neonatal nurses

Contained in regional or community hospitals

57
Q

Level III Nursery

A

Neonatal intensive care unit

True NICU

Provides highly specialized services

Neonatologists, fellows, specially trained nurses

Provides complex medical interventions, advanced diagnostic testing, surgery, and respiratory support

58
Q

Level IV Nursery

A

Level III Nursery

Provides extracorporeal membrane oxygenation therapy (ECMO)

59
Q

Family-Centered Care

A

Address the loss of the final stages of pregnancy and preparation for infant

Foster hope

Encourage the positive

Facilitate bonding between parents and babies

60
Q

Competencies of a term baby

A

Physiologic

Sensorimotor

Affective/communication

Complex

61
Q

Physiologic competencies

A

Include the functional maturity capability of all organ systems to allow breathing, feeding, and growing

62
Q

Sensorimotor Competencies

A

Include rooting, sucking, grasping, clearing the airway in prone

Horizontal and vertical tracking

63
Q

Affective/Communication Competencies

A 
Include crying
Self-consoling
Eye contact
Facial animation
Eye aversion
64
Q

Complex competencies

A

Newborn’s auditory preferences (mother’s voice)

Taste preferences (mother’s breast milk)

Visual preferences (faces)

Imitative capacities (sticking tongue out)

65
Q

Preterm infant characteristics

A

Age of viability is 23-24 weeks

Perceived as small and unattractive

Less responsive

More difficult to calm

Cry elicits negative emotions in the caregiver

Peds (25 decks)

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