NICU

Question 1

Where do I start in the NICU

Answer 1

• learn developmental progression of babie23-24 weeks gestation up to 41 weeks
• muscle tone
• active muscle strength
• reflexes
• states of alertness
• visual skills
• oral skills
• resources
• parental perceptions

Question 2

autonomic system

Answer 2

• self regulatory and approach behaviors
• autonomic stability
• smooth respiration
• stable or incr oxygen sats
• pink, stable skin color
• stable viscera

Question 3

motoric system- stress signals

Answer 3

• motoric flaccidity or “tuning out”
• trunk flaccidity, extremity flaccidty, facial
• hyperflexion of: trunk and extremities, fetal tuck, fisting
• motoric hypertonicity
• hypoerextension of : legs, arms, trunk, finger splaying, facial grimacing, tongue extension, high guard arm position

Question 4

motoric stability

Answer 4

• smooth, well modulated posture
• well regulated tone
• synchronous, smooth movements with efficient motoric strategies

Question 5

state stability and attentional regulation

Answer 5

• clear robust sleep states
• rhythmical robust crying
• effective self calming
• reliable consolability
• robust, focused, shiny-eyed alertness with intent and/or animated facial expressions

Question 6

state organizations

Answer 6

• state 1- deep sleep
• state - light sleep
• state 3- drowsy
• state 4- alert& quiet
• state 5- alert &active
• state 6 - crying

Question 7

active muscle strength development progression

Answer 7

• 28 weeks-active ankle movements
• 30 weeks- knee and thigh movements
• 32 weeks- hip, lower abdominals, finger movements
• 34 weeks- mid-trunk and elbow movements
• 36 weeks- upper trunk and shoulder movements
• 38 weeks- neck muscle tone present- bobbing head control and head turning

Question 8

general treatment for NICU

Answer 8

• auditory
• touch
• vestibular stimulation
• visual stimulation
• parent and caregiver training

Question 9

30 weeks gestation treatment plan

Answer 9

• auditory stimulation
• touch
• vestibular input
• visual
• oral motor
• parent and caregiver training

Question 10

32 weeks gestation treatment plan

Answer 10

• auditory
• calming and oral facilitation
• alerting
• visual stimulation
• active movement facilitation
• positioning
• swaddling
• parent/caregiver training
• 32 week old infant on a respirator

Question 11

34 weeks gestation treatment plan

Answer 11

• calming
• alerting
• oral/feeding facilitation
• visual skills
• active movement facilitation
• positioning
• swaddling
• parent/caregiver training
• 34 week infant on the respirator

Question 12

feeding evaluation and skills

Answer 12

• mouth is central to the infant’s being
• good tongue stability –> good head control
• physiologic flexion- importance to feeding
• premature baby with respiratory compromise
• facilitation during treatment to improve flexor muscle strength
• 34 weeks gestation- expectation that infant can feed by nipple and eat enough tomainatin wt gain and temperature as well as have enough energy for developmental activities

Question 13

36- 38 week infant treatment plan

Answer 13

• calming
• alerting
• oral/feeding skills
• visual skills
• active movement facilitation
• positioning
• swaddling
• parent/caregiver training
• 36-38 week infant on ventilator

Question 14

term infant treatment plan

Answer 14

• calming
• alerting
• oral/feeding skills
• visual skills
• active movement facilitation
• positioning
• swaddling
• parent/caregiver training
• term infant on ventilator