Deck 15: Neonatal Intensive Care Unit

Question 1

Positioning recommendations are an important part of physical therapy treatment in the NICU. Which of the following general recommendations apply to most infants in the NICU?

A) The supine position is encouraged because prone is not a recommended sleep position in healthy infants
B) Hands and knees should not touch because it may lead to skin breakdown
C) The hands should be positioned away from the face to avoid scratching of the face
D) The infant should be positioned in flexion with the arms and legs close to the body

Answer 1

D
Explanation: The general recommendation is to position the infant in flexion with the arms and legs close to the body. Flexion is a position of comfort for the infant and assists the infant in self-calming behaviors, such as bringing the hands together and bringing the hands to the face or mouth. Infants in the NICU often need assistance maintaining a flexed position, and the physical therapist recommends use of buntings, blanket rolls, and methods of holding to help the infant achieve and maintain flexion.

Question 2

Infants needing intensive care are very sensitive to stimulation. The NICU environment is an overwhelming setting for the infant. Which following recommendation can assist in helping the infant cope with the NICU environment?

A) Place the infant under a bright light during the daytime hours
B) Keep light and noise levels as low as possible and minimize the frequency of handling the infant
C) Group quiet infants next to each other and more active infants next to each other
D) Provide a certain level of noise often to help the infant adapt to the noise level

Answer 2

B
Explanation: Infants need a calm and quiet environment to assist them in achieving optimal rest and recovery. The NICU should keep light and noise levels as low as possible to adjust the NICU environment to the needs of the infants. Handling should be done at a low frequency with care procedures clustered together to allow for needed sleep and rest of the infant.

Question 3

Behavioral signs of stress in a neonate include

A) hyperalertness and apnea.
B) finger splays and gaze aversion.
C) decreased respiratory rate and bradycardia.
D) leg extension and increased blood pressure.

Answer 3

B
Explanation: Behavioral signs of stress include gaze aversion, finger splays, trunk extension, facial grimace, leg extension, turning out/drowsiness, hyperalertness, and arm salute

Question 4

Infants that are small for gestational age

A) are premature.
B) are born after 40 weeks gestation.
C) weigh less than the 10th percentile.
D) weigh 1,000 g.

Question 5

Full-term infants are born

A) between 37 and 42 weeks gestation.
B) at 9 months gestation.
C) at 40 weeks gestation.
D) between 35 and 40 weeks gestation.

Question 6

Infants born preterm and weighing less than 1,000 g at birth are at the greatest risk for cerebral palsy and other motor, cognitive, and behavioral disorders.
Short Answer

Question 7

Describe the behavioral state of "quiet alertness."

Question 8

Which of the following can be a complication of premature birth that is often found in premature infants who have cerebral palsy?

A) Intraventicular hemorrhage
B) Periventricular leukomalacia
C) Microcephaly
D) Retinopathy of prematurity

Question 9

Physical therapy examination and evaluation of the infant in the NICU is an ongoing process and provides which of the following information?

A) The infant's physiological and behavioral responses to stress
B) The infant's active movements, strength, and muscle tone
C) The infant's ability to maintain a flexed position
D) Indications for specialty follow-up care after the infant is discharged from the NICU
E) All of the above

Question 10

Name three neonatal methods of self-calming.

Question 11

When making recommendations about the infant's active movement, the physical therapist should generally recommend

A) encouraging the infant to have several periods of active movement during the day to build body strength and endurance.
B) allowing active movement when the infant is awake and quietly alert, but helping the infant to avoid excessive, frequent movements.
C) avoiding all active movement to conserve energy, including using restraints if needed.
D) encouraging any active movement as long as the infant is not crying.

Question 12

Physiological signs of stress in a neonate include

A) increased heart rate and skin color changes.
B) gaze aversion and leg extension.
C) increased respiration and oxygen saturation.
D) facial grimace and finger splays.

Question 13

Developmentally supportive care is individualized caregiving and is based on

A) the general routine in each specific NICU.
B) using specific methods to speed up the infant's tolerance to care-giving procedures.
C) the infant's physiological reactions, behavioral cues, and signs of stress in response to the immediate environment.
D) providing an individual caregiver for the infant so the infant may adapt to that person's approach.