NICU Study Material with Complete Solutions

NICU Study Material with Complete Solutions What is the normal temperature for a neonate? - Answer- 36.5 to 37.2 degrees Celsius. This is equal to 97.7 to 99 degrees Fahrenheit. How often is IV tubing changed? - Answer- Every 3 days. How often is feeding tubing changed? - Answer- Every feeding. What is gastroschisis? - Answer- Gastroschisis is a birth defect where the baby is born with a hole in the abdominal wall, and organs are outside the body. What is the treatment for gastroschisis? - Answer- A plastic pouch or "silo" is placed around the bowel and attached to the belly. Everyday the silo is tightened and some of the bowel is gently pushed inside. When all the bowel is inside, the silo is removed and the belly is closed What are the risk factors for neonatal sepsis? - Answer- Chorioamnionitis, GBS positive, prolonged rupture of membranes, and maternal fever. What are the signs and symptoms of sepsis in a neonate? - Answer- Tachycardia, tachypnea, apnea, temperature instability (fever, hypothermia), hypoglycemia, hypotonia, pallor, hyperbilirubinemia, abdominal distention, lethargy, and increased Intra-cranial pressure. Where to check pulses on a neonate? - Answer- Palpate the inside of the elbow and the pedal pulse. What three criteria must an infant have to begin the transition to an open crib? - Answer- The infant must have 1. A weight greater than or equal to 1500 grams. 2. Consistent weight gain over the past five days. 3. Be an otherwise stable baby who is tolerating enteral feeds. When starting a crib wean, what temperature should we start the NTE on? - Answer- Start with the temperature the infant is requiring on ISC. What is a baby allowed to wear during the crib weaning process? - Answer- Diaper, onesie, sleeper, hat, and 1 blanket. That's all. What temperature must the baby have to be weaned down by 0.5 degrees celcius? - Answer- Temps greater than or equal to 36.7 degrees celcius will allow the baby to decrease the NTE by 0.5 degrees celcius during each care time. What is the low cutoff temperature for crib weaning, and what do we do when the baby has this temp? - Answer- 36.5 is the cutoff temp. Anything lower, and we need to turn up the NTE by 0.5 degrees. If the next consecutive temperature is below 36.5, switch back to ISC. What is the lowest NTE level, and what happens when the baby reaches it? - Answer- The lowest NTE level is 26 degrees. They must hold at 26 degrees NTE for 24 hours and demonstrate good axilllary temps and weight gain. After 24 hours, the baby can be put in the crib. What are O2 sat limits set at for babies recieving O2? - Answer- For babies less than 34 weeks, 90-96. For babies greater than 34 weeks, 87-100. What is the caryna - Answer- Bifurcation of lungs What is the glottis? - Answer- opening of the airway Disinfectants by gestational age - Answer- Less than 28 weeks=betadine. Greater than 28 weeks=Chlorhexidine gluconate. Which clave goes with which line - Answer- Light blue claves go for locked lines. Dark blue claves go for running lines. When to flush with saline and heparin - Answer- Flush both at least q8h and after meds. Visitation policy highlights - Answer- Three people can come in at a time. The only children who can come in are the siblings of the patient. What do I draw as part of a septic workup? - Answer- CBC, type and cross, 2 blood cultures, and a blood gas. How long do cultures take to grow all samples? - Answer- Three days. Major side effect of Versed? - Answer- Pseudoseizures. At what gestational age do we wean caffeine? - Answer- approximately 34 weeks OFCs and lengths should increase by how many centimeters per week? - Answer- 1cm. What is considered "normal" weight gain? - Answer- 30g per day. How long does each baby get complimentary antibiotics? - Answer- 48 hours. When does Dr. Deem begin eye exams? - Answer- 30 weeks. What is meconium aspiration? - Answer- Baby has 1st stool in utero due to stress. Pitocin can cause this stress. Baby then breathes the meconium into the lungs which supresses respirations. Usually happens in a full term infant. What is HIE? - Answer- Hypoxic Ischemic Encephalopathy. Brain death occurs due to a hypoxic event. Blood O2 drops, cerebral blood flow increases, BP increases and then decreases, then cerebral blood flow drops. Brain tissue is then hypoxic. Long term effects from the decreased APGAR. Nipple speeds - Answer- Green=slow flow, blue=mid flow, white=fast flow. Common causes of bowel obstruction in a newborn? - Answer- Cystic fibrosis, meconium ileus, and duodenal atresia. Age for humidity? - Answer- 29 weeks or less. 29.1 is too old. Rules for humidity? - Answer- Humidity reservoir is changed at one week. At two weeks, humidity is d/c'd and bed is changed. Side effect of Fentanyl? - Answer- Chest wall rigidity. When are trophic feeds given? - Answer- First five days of life. When are triglyceride levels checked? - Answer- Usually soon after starting lipids. Night shift duties: Who gets a BP taken, and at what time? - Answer- At midnight,