NICU Flashcards

Question

Six Stages in Babies

Answer 1

Deep sleep or quiet sleep Light sleep or active sleep Drowsy or semi-dozing Alert or quiet alert Active or active awake Crying

Answer 2

Alert or quiet alert | Active or active awake

Answer 3

During exam look at... Range of behavior Variety of behavior Duration of state

Answer 4

ID impairments, neuromotor, and feeding that requires intervention ID needs for positioning and handling Determine how to adapt the environment to optimize development

Answer 5

Dubowitz Neurological Assessment of the preterm NIDCAP by Als NAPI Neurobehavioral assessment for preterm infants TIMP Test of Infant Motor Performance

Answer 6

Dubowitz Neurological Assessment of the Full term NBAS Neonatal Behavior Assessment Scale (Brazelton) Morgan Neonatal Assessment Scale

Answer 7

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

Answer 8

NOMAS Neonatal Oral-Motor Assessment Scale NCAFS Nursing Child Assessment Feeding Scale

Answer 9

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

Answer 10

Environmental Modification Positioning Handling/massage Sensorimotor stimulation Extremity taping/splinting/casting Hydrotherapy Oral Motor Therapy Parent Education and Support

Answer 11

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

Answer 12

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

Answer 13

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

Answer 14

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

Answer 15

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

Answer 16

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

Answer 17

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

Answer 18

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

Answer 19

Allows maximal observation and access to the infant by caregivers Poses the most challenges to the infant Does not promote calming and self-regulation

Answer 20

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

Answer 21

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

Answer 22

Metabolic instability Incomplete development of neuromm, cardiopulmonary, and integumentary systems

Answer 23

``` Hemodynamic complications Respiratory complications Cardiac Metabolic Orthopedic Integumentary Risk of infection ```

Answer 24

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)

Answer 25

Bonding process is at risk between preterm infant and family

Answer 26

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

Answer 27

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

Answer 28

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

Answer 29

Weight Gestational Age Pathology

Answer 30

Most often used to determine gestational age based on external signs

Answer 31

Well-baby nursery Newborns who require minimal observation of care Warming in an isolette, phototherapy, circumcision Located in small community hospitals

Answer 32

Intermediate Step-down from a Level IIl Nursery Intravenous medications, tube feedings, O2 support Neonatologists and neonatal nurses Contained in regional or community hospitals

Answer 33

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

Answer 34

Level III Nursery Provides extracorporeal membrane oxygenation therapy (ECMO)

Answer 35

Address the loss of the final stages of pregnancy and preparation for infant Foster hope Encourage the positive Facilitate bonding between parents and babies

Answer 36

Physiologic Sensorimotor Affective/communication Complex

Answer 37

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

Answer 38

Include rooting, sucking, grasping, clearing the airway in prone Horizontal and vertical tracking

Answer 39

``` Include crying Self-consoling Eye contact Facial animation Eye aversion ```

Answer 40

Newborn's auditory preferences (mother's voice) Taste preferences (mother's breast milk) Visual preferences (faces) Imitative capacities (sticking tongue out)

Answer 41

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