PT in NICU Flashcards
(30 cards)
Give the progressions of natural labor.
Stretching of uterus and vagina–> Sends impulse to hypothalamus–> Stimulates post. pituitary to produce oxytocin–> Uterus contracts and cervix dilates
What are the two non-medically induced reasons for premature babies?
Multiple babies (premature stretching) Trauma causing placenta to separate from wall of uterus
There are 4 medical reasons to induce labor with a premature baby. Name those 4.
- Pre-eclampsia (High BP)
- Mom is at risk
- Baby with poor vitals
- Intrauterine Growth Restriction (IUGR)
Baby in <10th percentile for wt and length for gestational age
Risk factors for preemies are what?
- Previous preemies
- Inadequate prenatal care (#1 reason)
- Younger than 16 y/o
- Drug or alcohol use during pregnancy
- High stress
- Waited less than a year since last birth
A baby born before what age is considered a preemie?
Before 37 weeks
Give the percentiles for: small for gestational age (SGA), large for gestational age (LGA), and appropriate for gestational age (AGA).
SGA: 90th percentile
AGA: 10-90th percentile
What are the values for low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW)?
LBW: 1501-2500 g
VLBW: <1000 g
Give the definition for gravida and para.
Gravida: # of pregnancies
Para: # delivered alive
What are full term and pre term babies labeled as in their chart?
Full Term= Term
Pre Term= PR
The letters “Ab” and “LC” stand for what?
Ab= abortions (spontaneous or voluntary) LC= Living children
If you saw G5 P3 T1 Pr2 Ab2 LC3 on a mothers chart what would that mean?
G5= 5 pregnancies P3= 3 delivered alive T1= 1 full term birth Pr= 2 pre-term births Ab= 2 abortions LC= 3 living children
What does APGAR stand for?
Appearance Pulse Grimace Respiration Activity
The APGAR is scored out of ____ points. After ___ points resuscitation begins.
10; 6/10
At what intervals is the APGAR taken for a baby and what trend do you want to see?
1, 5, 10, and 20 minutes
Want to see an increase in the score
Which nursery level has ECMO, a long term heart/lung machine for babies?
Level 4
Which nursery level is in regional hospitals where they can provide IV meds, tube feedings, O2 support, and neonatologists/neonatal nurses?
Level 2
Level 1 nurseries in small community hospitals include what?
Well baby nursery, minimal observation, warming isolette phototherapy, and circumcision
A level 3 nursery is equipped to handle what kinds of babies?
NICU; specialists beyond neonatologist; provides complex medical interventions, advanced diagnostic testing, sx, and therapies
What is RDS?
Respiratory distress syndrome; condition due to pulmonary immaturity and inadequate pulmonary surfactant.
A decrease in surfactant causes a chain reaction leading to RDS. What is the chain of events after a decrease in surfactant?
Increased surface tension–> collapse of alveoli–> Atelectasis–> decreased lung function
Give 4 factors that lead to RDS.
1) Decreased surfactant
2) Maternal diabetes (dictates how much surfactant baby makes)
3) Thoracic malformation (decreased surfactant)
4) Genetic factors
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.
23 weeks; 28 weeks; 32 weeks
What are the S/S of RDS?
Increased respirations Expiratory grunting Nasal Flaring Cyanosis Hypoxia, hypercarbia Sternal and intercostal mm retractions
How would you treat RDS?
- Oxygen (might work at 32-34 weeks)
- Mechanical ventilation
- Surfactant Administration
- ECMO
