Pediatrics: Conditions and Interventions: Permaturity

Question 1

Prematurity: Meconium Aspiration Syndrome: What it is

Answer 1

• Bowel movement in utero that mixes with amniotic fluid
• Infant inhales substance and can cause respiratory distress
• Infants are Hypersensitive to environmental stimuli - treat in a quiet environment

Question 2

Prematurity: Respiratory Distress Syndrome/Hyaline Membrane Disease: What it is

Answer 2

• Surfactant does not develop in lungs until 24 weeks gestational age
• Lungs are no ready for air exchange until 26 weeks gestational age
• Atelectasis is caused by insufficient surfactant in premature lungs

Question 3

Prematurity: Respiratory Distress Syndrome/Hyaline Membrane Disease: What is causes

Answer 3

• May cause acute respiratory failure

- Chronic RDS can cause bronchopulmonary spasm

Question 4

Prematurity: Bronchopulmonary Dysplasia: What it is

Answer 4

• Chronic lung disease as a result from damage to lungs from mechanical ventilation, Oxygen administration, chronic RDS.
• Predisposes child to frequent respiratory infections and development disability

Question 5

Prematurity: Periventricular Leukomalacia: What it is

Answer 5

• Necrosis of white matter adjacent to ventricles of the brain due to systemic hypotension or ischemia

Question 6

Prematurity: Periventricular Leukomalacia: What it causes

Answer 6

• May result in cerebral palsy

Question 7

Prematurity: Periventricular-intraventricular Hemorrhage: What it is

Answer 7

• Bleeding into premature ventricular matrix

Question 8

Prematurity: Periventricular-intraventricular Hemorrhage: Grading and What it causes

Answer 8

• Graded I to IV

- Grades II-IV may result in Cerebral Palsy

Question 9

Prematurity: Retinopathy of Prematurity: What it is

Answer 9

• Due to combination of low birth weight and high oxygen levels
• Can result in detachment of retinas and blindness
• Eyes are covered in NICU to protect from bright light

Question 10

Prematurity: Necrotizing enterocolitis: What it is

Answer 10

• Ischemia results in inflammatory, infected bowel

Question 11

Prematurity: Patent Ductus Arteriosus: What it is

Answer 11

• Ductus arteriosus
• Temporary vessel between aorta and pulmonary artery
• Should close soon after birth
• If it does not close non oxygenated blood is circulate

Question 12

Prematurity: Patent Ductus Arteriosus: Physcial Therapy Considerations

Answer 12

Physical Therapist should monitor

• O2 saturation
• Signs of cyanosis
• Shortness of breath
• Respiratory Rate

Question 13

Prematurity: Failure to Thrive: What it is

Answer 13

• Infant lacks adequate nutritional intake

- Infant can present with developmental delays

Question 14

Prematurity: Other:

Answer 14

• Increased fragility of skin
• Premature infants lack adipose tissue and the CNS is unable to control body temp prior to 32 weeks gestational age. Need to keep infant warm otherwise they expend energy needed for other vital body functions such as respiration.
• Feeding problems
• Interaction/attachment problems with caregivers

Question 15

Prematurity: Interventions

Answer 15

• Play activities that promote shoulder protraction and adduction
• Midline positioning of head
• Encourage reaching
• Avoid activities that increase extensor tone like infant jumpers and walkers

Question 16

Prematurity: Interventions: Positioning Goals

Answer 16

• Supervised sidelying and prone positioning (tummy time) for periods throughout the day
• These promote physiologic flexion

Question 17

Prematurity: Interventions: Sleeping positions

Answer 17

• Supine position/on back is recommended

Question 18

Prematurity: Interventions: Other

Answer 18

• Place hands close to face to help children self regulate/soothe or comfort themselves.
• Provide barriers to push against