NICU Flashcards
8 main things that bring bbs to the NICU?
- RDS
- Meconium aspiration syndrome
- Hypoxic ischemic encephalopathy
- Congenital diaphragmatic hernia
- abdominal wall defet=cts
- neuromuscular disorders
- orthopaedic issues
- PREMATURITY
NICU is a ______ environment due to premature bbs weakened immune system
protected
what is meconium?
thick black tar like fluid that fills bb’s intestines in womb; if bb is in distress may expel the meconium and inhale it
Average gestation age for an infant is ____ weeks
40
Bbs born at 40 weeks are referred to being born __ ___
at term
Bb’s born earlier than __ weeks are considered to be premature / preterm
37
Outcomes are ______ related to gestational age at birth; bbs born _____ will have a higher incidence of mortality and morbidity
inversely; earlier
Age of viability in BC?
23 weeks
Large role in the NICU not directly related to bb?
supporting family!!!
Why does corrected gestational age matter?
- for accurate ax of developmental delays
2. to reduce stress for parents (who might compare their bb to other bbs of the same chronological age?
Until term, a bb’s CGA is calculated by taking their gestational age and adding their age in ___
weeks
After term, how is CGA calculated?
by taking chronological age and subtracting how many months the premature baby was
Age is corrected with CGA until about __ years
2
_____ is an important predictor of outcomes
birthweight
Average birth weight?
3500g
Low birth weight?
less than 2500 g
Very low birth weight?
less than 1500g
Bb’s woh are not growing adequately in utero are described as having _______ ___ _____
intrauterine growth restriction
4 common causes of prematurity ?
- pregnancy of multiples
- fetal anomalies
- maternal health issues
- associations with low socio-economic status/poor prenatal care
2 resp complications of prematurity ?
- bronchopulmnoary dysplasia
2. chronic lung disease
2 neurological complications of prematurity?
- intraventricular hemorrhage
2. periventricular leukomalacia
Vision complication of prematurity ?
retinopathy of prematurity
Gut complication of prematurity ?
necrotizing enterocolitis
Cardiac complication of prematurity?
patent ductus arteriosus
RDS is caused by a lack of ______ in premie bbs
surfactant
RDS will have a ____ ____ appearance on CXR
ground glass
Bronchopulmonary dysplasia (BPD) = ____ and ____ of lungs
scarring; stiffness
BPD defined as O2 dependence at ___ weeks CGA
36
What 2 things might BPD be accompanied by?
- pulmonary HTN
2. abnormal pulmonary vascular development
HR of infant?
120-170bpm
Bradychardia in infants?
HR < 100bpm
RR of infant?
30-60
Apnea in infants?
pause in breathing of more than 20s
If apnea is frequent, may be treated with _____
caffeine
You must keep infants SpO2 at 98-100% (T/F)
FALSE; too much O2 can be toxic, don’t want 100%
3 specific NICU CI’s and precautions to chest PT?
- active brain bleeds / potential cause for bleeds
- brittle bones
- be intentional with use of supplemental O2
4 common indications for chest PT in NICU?
- persistent focal atelectasis
- cystic fibrosis
- neuromuscular disease
- meconium aspiration
____-_____ ______ = important case of brain injury in premie bb’s, related to disturbances in cerebral blood flow
intra-ventricular hemorrhage
How is intra-ventricular hemorrhages dx ?
serial head US’s
Intra-ventricular hemorrhage is graded __-__, and grade __ or __ can lead to hydrocephalus which might require a shunt
1-4; 3-4
Most common white matter brain injury in premature infants?
periventricular leukomalacia
____ = periventricular focal necrosis with subsequent cystic formation and more diffuse cerebral white matter injury
PVL
PVL highest risk under __ weeks gestational age
32
Although premie bbs might have various disorders, QOL is still rated highly (T/F)
TRUE
All NICU care is ____ care.
brain!!!
The neonatal brain grows __
times in volume from 24-40 weeks
4
____ to _____ / ______ care = absolutely critical in NICU for bb and for parent
skin to skin; kangaroo
Premie bbs require stimulation for brain developed but are easily overstimulated (T/F)
TRUE; try to find appropriate dose of sensory input
5 premie stress cues?
- physiologic instability (Check vitals!)
- movement into extension / away from midline
- finger splaying (stop sign hands!)
- open or gaping mouth
- hiccuping/ yawning
5 signs of premie stability / coping?
- stable vials
- stable colour
- movement towards flexion / midline
- hands to mouth
- grasping
Short term important of positioning support?
lack of boundaries / support will:
- increase agitation
- use up more energy
- decrease physiologic stability
- result in poor growth
Long term important of positioning support?
lack of boundaries / support:
- bb will rest in postures that are extended and asymmetrical
- bbs may develop plagiocephahly, retracted shoulders, extended and abducted hips, poor quality of movement
Test of Infant Motor Performance (TIMP) is appropriate for __ weeks - __ months CGA
34;4
