[prmenrs]

What in the world does she mean????

I get asked that a lot.

35 week gestation premies (either newly born, or finally after 4-5 weeks of NICU stay) frequently act like they know what they're doing. They stay warm in an open crib, they've learned how to eat, they've even learned to breathe on a regular basis. They're gaining wt., and they're cuter than just about anything on the planet. Mom and Dad are bonded, providing care, breastfeeding. (Well, maybe not Dad.)

DON'T TRUST THEM! AND TRY NOT TO LET ANYONE SEND THEM HOME!

In a heartbeat, they can remember that they're only 35 wks, and, by rights, they don't HAVE to know how to do any of the above. They can get cold, have residuals and have Apnea of Prematurity, get septic, even die.

As long as you remember they're not trustworthy, you won't completely relax around them.



Gompers, Dawngloves, KRVRN, and all the other experienced NICU nurses--what do you think?

[Gompers]

Originally Posted by prmenrs

Gompers, Dawngloves, KRVRN, and all the other experienced NICU nurses--what do you think?

I agree! It's such a weird gestation - they can either act premature or full-term, yet underneath it all, they DO have premature lungs, guts, brains, and immune systems...

I've seen quite a few 35-week gestation babies do some horrible things...

Getting NEC in step-down and dying in 12 hours.

Suddenly getting so septic in step-down that before we can physically put the baby on a radiant warmer and move him/her to the ICU, there is a code situation.

Room air, taking all PO, in step-down, getting ready to go home...and then deciding to stop breathing, then aspirate during a feeding, requireing a full code.

Doing extremely well, getting ready to go home, then going to OR for a "routine" hernia operation - and ending up coding in the OR, then being on the vent in the NICU for another week, on pressors and steroids.

The other side of the coin - a newborn 35-weeker in RDS who should be cured with a dose of surfactant, but ends up acting full-term and goes into full-blown PPHN. You never know what to expect with that gestation!!!

[TiffyRN]

First off, I agree with prmenrs though I'm not the an experienced NICU nurse like some here. However, our unit regularly sends home infants whose adjusted ages are 33-34 weeks (usually they've been there several weeks to get there). Now, I'm not sure the gestational age is accurate (whose really sure about those anyway except IVF babies?) but according to the MD's documentation that's their age.

We are supposed to admit all infants <35 weeks 0 days but sometimes they will let younger than that go to the floor if they are bigger and staying warm, breathing right.

Once more, though I agree with the 35 week thing, I feel better when we keep them a little longer, but those poor kids get pushed right out the door.

[SteveRN21]

OMG, you are so right....I didn't know what you meant until I started off orientation in NICU. Can't tell you how many times we get called to L&D for a blue, limp 35 and "change" weeker. Personally, I don't relax until I put that baby in his carseat and shut the car door. We recently had a feeder go ragingly septic with positive fungal B/C and die within a few days. NICU is so unpredictable. That's what makes it exciting and absolutely terrifying at diffent times.

[Tina B]

Ditto! I'd rather admit a 34 wkr than a 35 wkr any day. Those 35 wk babies can be the sickest in the unit...

[babynurselsa]

I have always said they are really good babies or really bad ones. There just never seems to be an inbetween for them.

[unikuelady]

Caring for the Near-Term Infant is an AWHONN Initiative that is addressing the issues and needs of babies born between 34-37 weeks. There are some good articles about this in Lifelines publication aug/sept 2005 and dec2005/jan2006 issues. It addresses many of the problems already stated and more.

[jellybean_1]

My daughter gave birth for the first baby, a boy, 5 weeks premature, 5lbs11oz he did well, he will be 4 in April...also she gave birth to twins,girls, 10 weeks premature,2lbs7oz and 3lbs7oz, they turned 2 in Nov14.both were home for Christmas..yes it can be scary....

[prmenrs]

Originally Posted by unikuelady

Caring for the Near-Term Infant is an AWHONN Initiative that is addressing the issues and needs of babies born between 34-37 weeks. There are some good articles about this in Lifelines publication aug/sept 2005 and dec2005/jan2006 issues. It addresses many of the problems already stated and more.

Can you find a link for that?? Thanks.

[Gompers]

Originally Posted by prmenrs

Can you find a link for that?? Thanks.

http://awhonnlifelines.awhonn.org/cg...t/long/9/4/336

There you go - but you need a subscription, I believe.

I <heart> Google!!!