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Pediatrics Lecture Material > PT in NICU > Flashcards

PT in NICU Flashcards

1
Q

Give the progressions of natural labor.

A

Stretching of uterus and vagina–> Sends impulse to hypothalamus–> Stimulates post. pituitary to produce oxytocin–> Uterus contracts and cervix dilates

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2
Q

What are the two non-medically induced reasons for premature babies?

A 
Multiple babies (premature stretching) 
Trauma causing placenta to separate from wall of uterus
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3
Q

There are 4 medical reasons to induce labor with a premature baby. Name those 4.

A
  1. Pre-eclampsia (High BP)
  2. Mom is at risk
  3. Baby with poor vitals
  4. Intrauterine Growth Restriction (IUGR)
    Baby in <10th percentile for wt and length for gestational age
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4
Q

Risk factors for preemies are what?

A
  1. Previous preemies
  2. Inadequate prenatal care (#1 reason)
  3. Younger than 16 y/o
  4. Drug or alcohol use during pregnancy
  5. High stress
  6. Waited less than a year since last birth
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5
Q

A baby born before what age is considered a preemie?

A

Before 37 weeks

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6
Q

Give the percentiles for: small for gestational age (SGA), large for gestational age (LGA), and appropriate for gestational age (AGA).

A

SGA: 90th percentile
AGA: 10-90th percentile

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7
Q

What are the values for low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW)?

A

LBW: 1501-2500 g
VLBW: <1000 g

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8
Q

Give the definition for gravida and para.

A

Gravida: # of pregnancies
Para: # delivered alive

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9
Q

What are full term and pre term babies labeled as in their chart?

A

Full Term= Term

Pre Term= PR

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10
Q

The letters “Ab” and “LC” stand for what?

A 
Ab= abortions (spontaneous or voluntary) 
LC= Living children
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11
Q

If you saw G5 P3 T1 Pr2 Ab2 LC3 on a mothers chart what would that mean?

A 
G5= 5 pregnancies 
P3= 3 delivered alive 
T1= 1 full term birth 
Pr= 2 pre-term births 
Ab= 2 abortions 
LC= 3 living children
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12
Q

What does APGAR stand for?

A 
Appearance
Pulse
Grimace
Respiration 
Activity
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13
Q

The APGAR is scored out of ____ points. After ___ points resuscitation begins.

A

10; 6/10

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14
Q

At what intervals is the APGAR taken for a baby and what trend do you want to see?

A

1, 5, 10, and 20 minutes

Want to see an increase in the score

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15
Q

Which nursery level has ECMO, a long term heart/lung machine for babies?

A

Level 4

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16
Q

Which nursery level is in regional hospitals where they can provide IV meds, tube feedings, O2 support, and neonatologists/neonatal nurses?

A

Level 2

17
Q

Level 1 nurseries in small community hospitals include what?

A

Well baby nursery, minimal observation, warming isolette phototherapy, and circumcision

18
Q

A level 3 nursery is equipped to handle what kinds of babies?

A

NICU; specialists beyond neonatologist; provides complex medical interventions, advanced diagnostic testing, sx, and therapies

19
Q

What is RDS?

A

Respiratory distress syndrome; condition due to pulmonary immaturity and inadequate pulmonary surfactant.

20
Q

A decrease in surfactant causes a chain reaction leading to RDS. What is the chain of events after a decrease in surfactant?

A

Increased surface tension–> collapse of alveoli–> Atelectasis–> decreased lung function

21
Q

Give 4 factors that lead to RDS.

A

1) Decreased surfactant
2) Maternal diabetes (dictates how much surfactant baby makes)
3) Thoracic malformation (decreased surfactant)
4) Genetic factors

22
Q

At ___ weeks type II alveolar cells are produced; ___weeks is when they start producing surfactant; and ___ weeks is when the baby should have enough surfactant to be adequate.

A

23 weeks; 28 weeks; 32 weeks

23
Q

What are the S/S of RDS?

A 
Increased respirations
Expiratory grunting 
Nasal Flaring 
Cyanosis
Hypoxia, hypercarbia 
Sternal and intercostal mm retractions
24
Q

How would you treat RDS?

A
  1. Oxygen (might work at 32-34 weeks)
  2. Mechanical ventilation
  3. Surfactant Administration
  4. ECMO
25
Q

What are the requirements for babies being allowed to start ECMO?

A

Must 4.5 lbs and 34 weeks

26
Q

How does the ECMO machine work?

A

Deoxygenated blood is drained from the heart to an external pump. The pump then pushes blood through a membrane gas oxygenator and the oxygenated blood is then pushed to the baby.

27
Q

What is commonly the maximum numbers of days a baby is allowed to stay on ECMO?

A

21 days

28
Q

T/F It is not necessary to have any medications while the baby is on ECMO.

A

False, they need heparin to decrease blood clots since they are not moving and blood is being taken out of the body.

29
Q

Give some of the complications that can arise with ECMO.

A

CNS damage, Sepsis, Seizures, cardiac complications, and renal failure.

30
Q

What are some of the complications that can be seen with RDS?

A

Increased risk for: ROP, NEC, IVH

With prolonged mechanical ventilation the baby could suffer from chronic lung disease (at 9 months) or BPD.

Pediatrics Lecture Material (7 decks)

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