Week 3- Development of Infant Born Prematurely Flashcards
PART 1
PART 1
How many NICU levels are there?
- Level 1 = Well-baby nursery
- Level 2 = Special Care nursery
- Level 3 = NICU
- Level 4 = Regional NICU
What are each of these abbreviations?
- CP
- RDS
- BPD
- ROP
- NEC
- ID
- HI
- DCD
- CP – cerebral palsy
- RDS – respiratory distress syndrome
- BPD – bronchopulmonary dysplasia
- ROP – retinopathy of prematurity
- NEC – necrotizing enterocolitis
- ID – intellectual deficit
- HI – hearing impairment
- DCD – developmental coordination disorder
Children born at less than ___ weeks’ gestational age and with VLBW (very low BW) are 30% more likely to develop CP, ID, RDS, BPD, ROP, HI.
37 weeks
The prevalence of perceptual motor problems is reported as high ass 48%. What are 2 tests recommended to assess motor development?
- MABC
- VMI
What are some characteristics of preemies? (4)
- Hypotonia
- Decreased ratio of T1:T2 muscle fibers (results in muscular fatigue, particularly respiratory muscles)
- Incomplete ossification and ligament laxity (results in greater effects of positioning and gravity)
- Increased reactivity to sensory stimuli
Describe the evolution of the 5 sensory responses in order from first to last.
- ) Touch
- ) Movement
- ) Smell/Taste
- ) Hearing
- ) Sight
Vestibular System Development:
- Is mature in the ____-_____ newborn.
- Modifications with development due to synapses and dendrites. This is dependent of what?
- Vestibular stimulation is known to enhance _______ states.
- full-term newborn
- Dependent on what child is exposed to.
- behavioral states
Olfactory/Gustatory Development:
- Olfactory development begins at __ weeks’ gestation.
- The ability to smell begins at ___ weeks.
- Taste buds begin to mature at approximately ___ weeks.
- The fetus experiences a variety of taste and smells in utero.
- 5 weeks
- 28 weeks
- 13 weeks
Auditory System Development:
-By ___ weeks’ gestation, cochlea and peripheral sensory end organs are developed but the pathways continue to mature.
The preemie is exposed to NICU noise that may cause cochlear damage, sleep disturbances, and disturbed growth and development.
-24 weeks
Visual System Development:
- Vision is the least mature at term birth.
- From ___ weeks to term, the retina and visual cortex undergo extensive maturation and differentiation.
- By ___ weeks, pupillary reflex present, may see brief eye opening and fixation on a high contrast form under low illumination.
- By ___ weeks, saccadic visual following horizontally and vertically.
- At term, vision is 20/400. What does this mean?
- 24 weeks
- 34 weeks
- 36 weeks
- Babies are near sighted.
- Describe the difference between flexor tone of a preterm infant at 40 weeks and a infant born at term.
- Preterm infants have less predictable __________ and _________ patterns.
- Preterm infants have less flexor hypertonicity resulting in ________ ROM.
- The flexor tone of a preterm infant who has reached full-term is never as great as the flexor tone of an infant born at term.
- sleep-wake cycles and feeding patterns
- greater ROM
Describe the difference between gestational age, post conceptual age, and corrected age/adjusted age/post-term corrected age.
-Gestational Age (GA): Age of infant based on mom’s last menstrual period. (weeks in womb)
-Post Conceptual Age: GA plus the number of weeks since the infants birth.
Corrected age/adjusted age/post term corrected age: gestational age plus weeks since birth minus 40 weeks.
- Full-term = _______
- Post-term = ________
- Pre-term = ________
- Full-term = 37-41 weeks
- Post-term = >42 weeks
- Pre-term = <37 weeks
- Extremely low birth weight (ELBW) = ________
- Very low birth weight (VLBW): _______
- Low birth weight (LBW): _________
- ELBW: <1000g
- VLBW: <1501g
- LBW: 1501g-2500g
**The lower the birth weight the higher the chance of neurological problems.
- The size of an infant at birth is based on what 3 things?
- What does AGA, SGA, LGA, and IUGR stand for?
-length, head circumference, and weight
- AGA: appropriate for gestational age
- SGA: small for gestational age (<10th percentile)
- LGA: large for gestational age (>90th percentile)
- IUGR: intrauterine growth retardation
- What does APGAR stand for?
- What is it?
- A: Activity
- P: Pulse (HR)
- G: Grimace to stim
- A: Appearance
- R: Respiratory Rate
-APGAR scores the 5 things listed above from a scale of 0-2 to help determine the condition of the newborn infant immediately after birth. (10 = good, 0 = bad)
What is Respiratory Distress Syndrome (RDS)?
- Respiratory distress syndrome (RDS) occurs in premature babies whose lungs are not fully developed. The earlier the infant is born, the more likely it is for the baby to have RDS and to need extra oxygen and help breathing.
- RDS is caused by the baby not having enough surfactant in the lungs. Surfactant coats the tiny air sacs in the lungs and helps to keep them from collapsing.
What are the (3) factors that increase risk for RDS?
- Degree of prematurity (<34 weeks)
- Maternal diabetes (insulin interferes with surfactant production)
- Thoracic malformations
- What is used to prevent RDS?
- Why is this controversial?
- Antenatal steroids to accelerate lung maturity.
- Controversial because it may lead to poor neurobehavioral problems.
RDS S/Sx. (8)
- Increased RR
- Expiratory grunting
- Sternal and intercostal retractions
- Nasal flaring
- Cyanosis
- Decreased air entry on auscultation
- Hypoxia
- Hypercarbia
RDS Interventions. (6)
- Oxygen supplementation
- ECMO – extracorporeal membrane oxygenation
- CPAP – continuous positive airway pressure
- PEEP – positive end expiratory pressure
- Mechanical Ventilation
- Surfactant administration prophylactically
What are (4) complications of RDS treatment?
- Barotrauma = increased airway pressure
- Volutrauma = large gas volume
- Atelectotrauma = alveolar collapse
- Biotrauma = increased inflammation
What is Bronchopulmonary Dysplasia (BPD)? This is a complication of what?
- In BPD the lungs and the airways (bronchi) are damaged, causing tissue destruction (dysplasia) in the tiny air sacs of the lung (alveoli).
- Complication of immature lungs along with prolonged mechanical ventilation.
