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dysphagia quiz 2
Terms in this set (54)
principles of family centered and developmentally supportive care
1. communication with hospital staff
2. environmental and developmental concerns
3. pain management
4. ethical decision making
5. helping them interpret infant's nonverbal communication signals
6. premise that infant behavior gives best information to design care
7. observe infant to determine physiological stability and developmental progression)
at what age are the sensory systems structurally complete but functionally immature?
T/F: At birth, the sense of touch will be the most sensitive and well developed of all the senses
at what age are a baby's lungs mature?
frontal lobes involved in:
social and sexual behavior
T/F: For premature babies the frontal lobe may develop entirely in the NICU
what lobe is considered the emotional control center and home to the personality?
what does the NICU environment expose newborn prematurely to?
1. cold, dry temperatures
2. gravitational forces
3. loud noises
4. bright lights
5. stressful interventions
6. sleep interrupted
7. absence of parental contact
how many hours per day does a fetus sleep?
how many hours per day does a newborn sleep?
how many times per day is a NICU patient disturbed?
Early developmental supports result in:
1. decreased hospital stay
2. decreased age at discharge
3. decreased rate of IVH
4. decreased days on vent
6. increased developmental outcomes at 2 month and 9 months
6. increased weight gain
NICU assessment components:
1. Review chart
2. Assess alertness
3. Evaluate oral reflexes
4. observe and examine suck/swallow
5. Identify need for swallow study
6. Assess non-nutritive and nutritive suck
7. Assess positional needs
8. Identify need for OT/PT evaluation
9. Make positioning & nipple need compensations
10. Parent Education
To a NICU medical professional, a micropreemie or micro preemie is defined as a baby that is under ________________ pounds and is generally born before __________________ weeks gestation
1 3/4; 26
most people loosen ages up and consider preemie to be under ________ pounds and under ______________ weeks gestation
name some diagnoses we treat
difficulty with arousal
a slower than normal heart rate often occurring with apnea
less than _______________ BPM is considered bad
A pause in breathing that occurs for 15-20 seconds or is accompanied by a sow heart rate or a change in skin color
criteria for diagnosis of bronchopulmonary dysplasis (BPD)
1. Positive pressure ventilation for at least three days during the first weeks of life
2.Clinical signs of abnormal respiratory function that persist beyond 28 days of life
3. Supplemental oxygen required longer than 28 days of life
4. Diffuse abnormal findings on chest x-ray characteristic of BPD
Primitive reflexes support early feeding but are integrated and eating is solely a learned skill beginning at approximately 6 months of age
f (4 months)
T/F: Medically fragile and/or preterm infants are least at risk for feeding problems.
T/F: Immaturity and medical instability increased likelihood of negative feeding experiences
T/F: Experience directly builds brain pathways
for a good, quality feed, infant must be:
2. physiologically stable
3. actively participating
4. behaviorally organized
normal heart rate for premature infant:
normal respiratory rate for premature infant:
normal oxygen saturations for premature infant:
_________________ is the primary requirement for bottle feeding
what is physiologic stability?
1. stable vital signs
2. good color
3. good muscle tone
barriers to a quality feed:
2. respiratory compromise
3. neurological disorder
4. congenital disorder
5. degree of prematurity
6. cardiac defects
7. cerebral palsy
8. craniofacial abnormalities
assessment of oral reflexes:
4. phasic bite
5. transverse tongue
6. gag reflex
7. cough reflex
Pinelli & Symington non-nutritive suck facts
1. Calming, quieting
2. Deeper regular respirations
3. Increases in oxygen saturations
4. Gastric retention decreased
5. Stimulate gastric motor function
why are pacifiers encouraged during gavage feedings?
results in better GI transit time, increase in fat breakdown, better weight gain, good for calming
Outcomes reported with NNS in the NICU include:
1. Decreased transition from tube to oral feeds
2. Maturing suck pattern
3. Promoting oxygenation
4. Weight gain
5. Soothing during invasive procedures
6. Regulating state
7. Fewer behavioral state changes
6 levels of state:
1. deep sleep
2. light sleep
what are some approach-readiness cues?
smiling, cooing, relaxed
what are some coping cues?
hands to face or mouth, grasp, fisting, sucking
what are some stress cues?
burping, spitting up, arching, color change, hiccups, yawning, squirming
at what age is a baby ready for nippling?
assessment of nutritive sucking:
1. should look coordinated
2. calm state
3. sucking bursts & pauses equal duration
4. no audible swallows
5. closely observe breathing pattern
6. do pauses help?
7. how long did feeding take?
8. any distress?
9. where did we see changes in feeding?
10. nursing concerns?
developmental considerations of pharyngeal phase of preterm infant:
1. startle response
2. rapid, multiple swallows
4. laryngeal constriction
stage one of suck-swallow-breathe:
bolus pushed from mouth into oropharynx by tongue. voluntary stage
stage two of suck-swallow-breathe:
walls of pharynx contract, soft palate elevates, laryngeal vestibule closes. involuntary stage
stage three of suck-swallow-breathe:
bolus squeezed from laryngopharynx into esophagus by inferior constrictor muscle
types of swallowing assessments:
3. cervical auscultation
4. NOMAS (neonatal oral motor assessment scale)
purpose of NOMAS
1. differentiate between disorganized and dysfunctional
2. plan appropriate treatment
3. pre-post test measure of progress
4. reliable tool for research
defined as the "lack of rhythm in the total sucking activity"
Defined as "the interruption of the successful sucking activity by abnormal movements of the tongue and jaw"
mature sucking pattern
10-30 sucks per burst, continuous and uninterrupted breathing, 1:1:1 pattern between suck, swallow, breathe
immature sucking pattern
3-5 sucks per burst, respirations and swallows before and after burst, breathing and suck occur in alternate patterns
SLPs in NICU are competent in assessment of:
1. parent and child communication interactions
2. acquisition of expressive and receptive speech/language skills
3. swallowing and feeding functions and behaviors
feeding and swallowing evaluation and intervention:
1. prefeeding assessment
2. promoting readiness for oral feeding
3. evaluation of breast and bottle feeding ability
4. complete videofluoroscopic swallowing evaluations
premature baby's chronological age minus the number of weeks or month's he was born early
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