Week 4: prematurity Flashcards
prematurity
<37wks
egg within follicle
oocyte
egg traveling down fallopian tube
ovum
conception =
zygote
implantation in uterus
blastocyte
at 2-8 weeks the baby is called
an embryo
at 9wks-birth it is called
a fetus
infant axillary temp
98.6-99.8
infant HR
80-140
RR of infant
40-60
infant birth weight
6-9 lbs
premature infant birth weight
2-5lbs
common conditions that premature infants can have
TTN - transient tachypnea of newborn
Apnea and Bradycardia (As and B)
low birth weight
3-5 lbs
very low birth weight
2-3 lbs
extremely low birth weight
1-2 lbs
oocyte to fetus order
oocyte – zygote– blastocyte – embryo– fetus
lungs will require mechanical ventilation before ___wks
34 weeks
APGAR scoring system
premature infant forsiflexion
<40 degrees–> should be able to touch tibia
muscle tone develops in a caudal –> cephalo pattern
true
PT goals for prematurity
maintain vitals w positioning, calming, self soothing, non nutritive sucking
developmental positioning to minimize alterations in tone, prevent contracture, minimize reflexes
provide optimal positioning for visual, social, fine, gross, and cognitive development
tone observations
- heel to ear - closer to eat=less tone
- scarf sign - hand across more than across chest is concerning
- ventral suspension prone-
- pull to sit - head lag
baby signs of stress
yawning
crying
tremor of jaw hands legs
cycling mvmts
stiffening
hand placement
sneeze
cough
FLACC pain rating scale for infants to 7 yrs
face
legs
activity
cry
consolability
scored 0,1,2 –lower score = better
test of infant motor performance TIMP-2
34 wks to 3.5 mo
antigravity hip flexion response loooking for ability to flex and extend hip
orientation to sound
roll from leg response (BOB)
HINE Hammersmith test
clinical neurological exam for infants between 2-24 months
looks @ cranial nerve, reflexes, tone, reactions
0,1,2,3 for each category
provides prognostic info on severity of motor outcome
4 main intervention
encasement swaddling
graded sensory motor input
non nutritive sucking
positioning : prone, supine, sidelying, sitting
supine positioning
early WB through LE
towel rolls to decrease effect of reflexes
facilitates use of UE for object exploration and visual regard
sidelying posture
scapular protraction and trunk elongation, working on subtle WS
disassociating the upper and lower trunk using a BOB reaction
ideal for HR RR BP O2- shown to improve weight gain
prone positioning
promotes WB through UE
stretches hip, knee, RF
facilitates extension and head ctrl
eye hand awareness and proprio
BUT BREATHING MAY BE MROE DIFFICULT
improved hip positioning
sitting upright posture
active head and trunk control
WB through spine UE LE
frees hands for exploration
disassociation of trunk w UE and LE
visual regard! BETTER COGNITION
carrying rocking holding positioning
for infants who cant tolerate prone, sidelying, sitting (too much extensor tone)
