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PHTH 564 - ICU > NICU > Flashcards

NICU Flashcards

1
Q

8 main things that bring bbs to the NICU?

A
  1. RDS
  2. Meconium aspiration syndrome
  3. Hypoxic ischemic encephalopathy
  4. Congenital diaphragmatic hernia
  5. abdominal wall defet=cts
  6. neuromuscular disorders
  7. orthopaedic issues
  8. PREMATURITY
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2
Q

NICU is a ______ environment due to premature bbs weakened immune system

A

protected

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3
Q

what is meconium?

A

thick black tar like fluid that fills bb’s intestines in womb; if bb is in distress may expel the meconium and inhale it

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4
Q

Average gestation age for an infant is ____ weeks

A

40

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5
Q

Bbs born at 40 weeks are referred to being born __ ___

A

at term

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6
Q

Bb’s born earlier than __ weeks are considered to be premature / preterm

A

37

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7
Q

Outcomes are ______ related to gestational age at birth; bbs born _____ will have a higher incidence of mortality and morbidity

A

inversely; earlier

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8
Q

Age of viability in BC?

A

23 weeks

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9
Q

Large role in the NICU not directly related to bb?

A

supporting family!!!

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10
Q

Why does corrected gestational age matter?

A
  1. 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?

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11
Q

Until term, a bb’s CGA is calculated by taking their gestational age and adding their age in ___

A

weeks

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12
Q

After term, how is CGA calculated?

A

by taking chronological age and subtracting how many months the premature baby was

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13
Q

Age is corrected with CGA until about __ years

A

2

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14
Q

_____ is an important predictor of outcomes

A

birthweight

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15
Q

Average birth weight?

A

3500g

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16
Q

Low birth weight?

A

less than 2500 g

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17
Q

Very low birth weight?

A

less than 1500g

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18
Q

Bb’s woh are not growing adequately in utero are described as having _______ ___ _____

A

intrauterine growth restriction

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19
Q

4 common causes of prematurity ?

A
  1. pregnancy of multiples
  2. fetal anomalies
  3. maternal health issues
  4. associations with low socio-economic status/poor prenatal care
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20
Q

2 resp complications of prematurity ?

A
  1. bronchopulmnoary dysplasia

2. chronic lung disease

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21
Q

2 neurological complications of prematurity?

A
  1. intraventricular hemorrhage

2. periventricular leukomalacia

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22
Q

Vision complication of prematurity ?

A

retinopathy of prematurity

23
Q

Gut complication of prematurity ?

A

necrotizing enterocolitis

24
Q

Cardiac complication of prematurity?

A

patent ductus arteriosus

25
Q

RDS is caused by a lack of ______ in premie bbs

A

surfactant

26
Q

RDS will have a ____ ____ appearance on CXR

A

ground glass

27
Q

Bronchopulmonary dysplasia (BPD) = ____ and ____ of lungs

A

scarring; stiffness

28
Q

BPD defined as O2 dependence at ___ weeks CGA

A

36

29
Q

What 2 things might BPD be accompanied by?

A
  1. pulmonary HTN

2. abnormal pulmonary vascular development

30
Q

HR of infant?

A

120-170bpm

31
Q

Bradychardia in infants?

A

HR < 100bpm

32
Q

RR of infant?

A

30-60

33
Q

Apnea in infants?

A

pause in breathing of more than 20s

34
Q

If apnea is frequent, may be treated with _____

A

caffeine

35
Q

You must keep infants SpO2 at 98-100% (T/F)

A

FALSE; too much O2 can be toxic, don’t want 100%

36
Q

3 specific NICU CI’s and precautions to chest PT?

A
  1. active brain bleeds / potential cause for bleeds
  2. brittle bones
  3. be intentional with use of supplemental O2
37
Q

4 common indications for chest PT in NICU?

A
  1. persistent focal atelectasis
  2. cystic fibrosis
  3. neuromuscular disease
  4. meconium aspiration
38
Q

____-_____ ______ = important case of brain injury in premie bb’s, related to disturbances in cerebral blood flow

A

intra-ventricular hemorrhage

39
Q

How is intra-ventricular hemorrhages dx ?

A

serial head US’s

40
Q

Intra-ventricular hemorrhage is graded __-__, and grade __ or __ can lead to hydrocephalus which might require a shunt

A

1-4; 3-4

41
Q

Most common white matter brain injury in premature infants?

A

periventricular leukomalacia

42
Q

____ = periventricular focal necrosis with subsequent cystic formation and more diffuse cerebral white matter injury

A

PVL

43
Q

PVL highest risk under __ weeks gestational age

A

32

44
Q

Although premie bbs might have various disorders, QOL is still rated highly (T/F)

A

TRUE

45
Q

All NICU care is ____ care.

A

brain!!!

46
Q

The neonatal brain grows __

times in volume from 24-40 weeks

A

4

47
Q

____ to _____ / ______ care = absolutely critical in NICU for bb and for parent

A

skin to skin; kangaroo

48
Q

Premie bbs require stimulation for brain developed but are easily overstimulated (T/F)

A

TRUE; try to find appropriate dose of sensory input

49
Q

5 premie stress cues?

A
  1. physiologic instability (Check vitals!)
  2. movement into extension / away from midline
  3. finger splaying (stop sign hands!)
  4. open or gaping mouth
  5. hiccuping/ yawning
50
Q

5 signs of premie stability / coping?

A
  1. stable vials
  2. stable colour
  3. movement towards flexion / midline
  4. hands to mouth
  5. grasping
51
Q

Short term important of positioning support?

A

lack of boundaries / support will:

  1. increase agitation
  2. use up more energy
  3. decrease physiologic stability
  4. result in poor growth
52
Q

Long term important of positioning support?

A

lack of boundaries / support:

  1. bb will rest in postures that are extended and asymmetrical
  2. bbs may develop plagiocephahly, retracted shoulders, extended and abducted hips, poor quality of movement
53
Q

Test of Infant Motor Performance (TIMP) is appropriate for __ weeks - __ months CGA

A

34;4

PHTH 564 - ICU (15 decks)

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