NICU Flashcards
How to assess small premie in nicu
Chart
Observation
Hands on, assessment
Subsystems: Autonomic and motor systems, state organization, attention/interaction, self reg balancing system
Stress and defense behaviors
Resp pauses Irregular resp Breath holding Bradycardia Skin color changes Seizure Tremoring/startling Visceral signs Sneezing Yawning Sighing
Visceral signs of autonomic distress
Gagging Spitting up Chocking Hiccoughing Straining as if having BM Gasping Coughing
Autonomic self regulatory and approach behavior
Stability Smooth respiration Stable or increasing O2 sat Pink, stable color Stable viscera
Motor stress - flaccidity “tuning out”
Trunk flaccid: extremity flaccid, facial facility - gape face
Hyperflexion of trunk, extremeties: fetal tuck, fisting
Frantic diffuse activity, squirming, twitching
Motor hypertonicity stress signal
Hyperextension of” Legs, arms, trunk (arching), finger splaying, facial grimace Tongue ext High guard arm position
Motor stability
Smooth, well modulated posture
Well regulated tone
Synchronous smooth movements w/ efficient motor strategies (motor stability)
Hand clasping Foot clasping Finger folding Hand to mouth maneuvers Grasping Suck searching Sucking Hand holding Tucking
State related stress signals
Diffuse sleep Awake w/ whimpering, facial twitches or discharge smiling Eye floating, roving Sustained fussing/crying/silent crying Frequently active averting Panicked/worried alertness/hyperalert Glassy-eyed, strained alertness, drowsy Rapid oscillations Irritability and prolonged diffuse arousal Frenzy and inconsolability Sleepless/restless
State stability
Clear robust sleep states Rhythmical robust crying Effective self coming Reliable consolability Robust, focused alertness w/ intent, animated facial features
Brazelton state organization
1 deep sleep 2 slight sleep 3 drowsy 4 alert and quiet 5 alters and active 6 crying
NICU active muscle strength developmental progression week 28
Active ankle movement
NICU active muscle strength developmental progression week 30
Knee and thigh movement
NICU active muscle strength developmental progression week 32
Hip
Lower ab
Finger movements
NICU active muscle strength developmental progression week 34
Mid trunk
Elbow movements
