OT in the NICU

Quiz- Wk 12

Juanita is a NICU Occupational Therapist. She is working with a family whose child was born at 28 weeks gestation. The family is devastated by the amount of time this infant is sleeping and how even when awake there is no direct eye gaze or smile. They want to interact with this infant who seems to be so quiet. Juanita employs a technique called;

a.      “Synaptic stimulation”, a technique that helps the infant process auditory information by playing music selected to represent the family’s musical tastes.

b.    “Forced coming out”, a technique that speeds the shift from in-turning to coming-out and being receptive to more interaction.

c.    “Hand over hand” guidance to help the infant learn to reach out.

d.    “Anticipatory guidance” to help the family understand at what developmental stage the infant will be capable of more social interaction.

d.    “Anticipatory guidance” to help the family understand at what developmental stage the infant will be capable of more social interaction.

The impact of giving birth to an infant who must stay in the NICU on the occupation of parents can be disruptive due to

a. all answers

b.     Interferes with the confidence that a parent can do daily caregiving routines without hurting the infant

c. Interferes with parents building the routines and habits of parenting

d. Lack of touch which triggers oxytocin for bonding

a. all answers

An infant born at 32 weeks post conception

Question 3Answer

a.     Have some respiratory challenges requiring support, difficulty regulating temperature and potential feeding problems which typically can be supported in a Level II NICU

b.    Have sufficient lung capacity to reliably breath on their own, and will only need a Level IV NICU support if they need antibiotics

c.    Are highly vulnerable to brain bleeds, have a low chance of survival, and a smooth cortical brain surface.

d.    Have thin eyelids that can’t block light, are unable to feed orally, and statistically likely to have long term consequences

a.      Have some respiratory challenges requiring support, difficulty regulating temperature and potential feeding problems which typically can be supported in a Level II NICU

Among the core measures of neuroprotective interventions, positioning and handling includes

a.      Prevent positional deformities by positioning the infant in asymmetric positions

b.  Provide positioning supports to maintain optimal tone in a flexed contained position

c.   Allow the infant to have full movement during bathing

d.    Parents should not participate in positioning as this is the role of the highly trained nurse.

b.  Provide positioning supports to maintain optimal tone in a flexed contained position

An infant born at 24 weeks post conception

a.      Has a smooth brain surface, immature lungs and eye lids that are still developing function

b. Statistically have little or no longer-term health problems, but need some NICU support for jaundice

c.    Are too young to survive due to not having a cerebellum and immature lungs.

d.    Have well developed sulci in their brains and typically will need just a short stay in a Level II NICU

a.      Has a smooth brain surface, immature lungs and eye lids that are still developing function

Respiratory failure is related to a number of serious life-threatening conditions including

a.      Prader-Wili syndrome or myotonic dystrophy

b.     Hydrocephalus or congenital torticollis

c.  Congenital diaphragmatic hernia or persistent pulmonary hypertension

d.    Arthrogryposis or trisomy 21

c.  Congenital diaphragmatic hernia or persistent pulmonary hypertension

To protect skin

a.      Do not allow parents to bathe their child, as the infant’s skin is too delicate

b. Facilitate prolonged skin-to-skin contact with parents

c.  Infant massage should be introduced after the stay in the NICU but not during.

d.     Bath every 24 hours using a scented soap for stimulation

b. Facilitate prolonged skin-to-skin contact with parents

The element that distinguishes a Level IV from a Level III NICU is

a.      Level IV is capable of complex surgeries and procedures

b. Level III cannot handle premature infants smaller than 1500 grams

c.    Level IV are the only level that can handle respiratory care

d.    Level III less common than Level IV

a.      Level IV is capable of complex surgeries and procedures

To optimize nutrition

a.      Provide taste and smell of breast milk during gavage feedings when possible

b.    It is best to discharge as soon as possible, therefore oral feeding should be presented as soon as the infant has stabilized, regardless of gestational age

c.   Introduce bottle feeding prior to breastfeeding

d. Ensure every oral feeding gets in as many calories as possible

a.      Provide taste and smell of breast milk during gavage feedings when possible

The most concerning combination of factors in a premature infant are

a.      ELBW and average GA

b.  Low GA and ILBW

c.   Low GA and LBW

d.   High GA and VLBW

b.  Low GA and ILBW