USF College of Nursing NUR 4467L

Special Care Nursery or NICU Worksheet

Student____Shawn Hekkanen__________ Date____2/1/2016_________
Instructor___Danielle Beasley________________
M/F_Male_Gestational Age at
birth:___27.512weeks_________BW:_1.115kg_____ Length at birth:
36cm__Current Wt.:__1.99kg____
APGARs: 1min: 6__5 min:__7__ Vital Signs: T:__98.1 F___
HR:_177_____ RR:__52_____ BP__75/43____
O2 SAT:__100____Oxygen/Type____room air_______________________
Blood type/Coombs:___O positive_________
1. Indicate the diagnosis/reason the neonate was admitted to
the NICU and define treatments for the diagnosis:
Admitted for prematurity, respiratory distress syndromecaffeine, possible sepsis-was not septic but at risk d/t having
NEC risk factors. CPAP w/ RAM cannula until 32 weeks. Bilirubin
test.
2. Identify the complications associated with prematurity in
the infant you are caring for.
Aenemia-received transfusion of PRBCs, iron multivitamin
supplement, iron is not in natural breast milk but infant
primarily on formula
Patent Ductus Arteriosus with positive murmur, not
symptomatic, likely to close without surgical intervention
Respiratory Distress Syndrome- CPAP to room air by 32 weeks,
caffeine
3. Review the medications pertaining to the premature infant
you are caring for. Describe use, usual dosage, side effects,
and nursing considerations.
(Examples: Ampicillin, Gentamicin, Indocin, Curosurf, Survanta,
Caffeine Citrate, Morphine, and Methadone.)
caffeine citrate= 0.25mL/kg, prevent apnea and bradycardic
episodes, discontinued 1/17; tachycardia side effect,
irritability, CNS stimulation, GI upset, glucose fluctuations,
increased renal activity. Nurse to monitor vital signs, sleeping
patterns.
multivitamin w/ iron oral liquid 0.5mL daily (could cause
constipation, dark stool, ensure adequate hydration, nurse
only puts multivitamin in last 5mL of feeding due to poor taste.

USF College of Nursing NUR 4467L

Special Care Nursery or NICU Worksheet
4. Document the infants weight from the growth chart
including the percentile and range. Examine and interpret the
trend in weight gain or loss.
Current: 1.99kg, 34.57weeks, 18.18%
Birth: 27.5 weeks gestational age, 1.115kg, 12/7 birth, 67.15%
Lost weight initially until 12/12, and continuously stable
positive growth curve since 12/14, 1.075kg.
5. Explain the feeding protocol for your patient. Include the
method of feeding, content of feedings (breast milk, formula,
fortified?), guidelines for feeding, and infants tolerance to
feedings.
Bottle feeding with formula, Similac Neosure 22cal/fl oz.
Mother drops off breast milk intermittently and unreliably.
Feedings every 3 hours, 40mL ad lib(allowed to take more),
tolerates feedings well, no emesis, gulps feedings, frequent
burpings due to swallowing air during gulping, adjust bottle
angle to slow down feeding
6. Why are abdominal girths important to monitor in the care
of NICU babies?
Necrotizing Enterocolitis (NEC), intestinal lining fails. Higher
risks include prematurity, formula feeding, transfusion,
department outbreaks of NEC. A primary sign is abdominal
bloating. Often surgical intervention. Can be fatal.
7. How is maternal-infant bonding encouraged in the NICU?
Cite examples observed in the care of your patient.
Single rooms, breast feeding promoted with consultations and
encouragement, 24/7 visiting and parents are encouraged to
have full involvement with care and training while
hospitalized, rocking chairs, toys, furnishings are homey and
comfortable, swings and mobiles and other gadgets available,
8. What is family/social situation? Indicate strategies and
support services utilized.
Premature infant is child number 8 with married man and
woman, oldest 17 years old, next youngest is 3 years old, all
children by same father, 34 year old mom, mom works, dad
works, all children in school, very involved family, visiting

USF College of Nursing NUR 4467L

Special Care Nursery or NICU Worksheet
infant daily after work day. No prior history of premature
births.
9. What is the anticipated length of stay? Identify actual or
potential discharge planning needs.
Due for discharge Thursday, 1/28. Original anticipated LOS was
the original due date but going home early if maintains
temperature, performs all feedings by mouth every three
hours, no episodes of oxygen desaturation, no bradycardic
episodes, no apneas, parents to watch safe baby video and
safe car seat video, 90 minutes car seat test was already
passed, hearing screen after moved into crib unit already
passed, 2 weeks from now eye exam, cardiology follow-up for
PDA w/ echocardiogram