"Never trust a 35 weeker"

  1. 12 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.M om 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?
    Last edit by Joe V on May 6, '13
  2. Visit  prmenrs profile page

    About prmenrs

    prmenrs has '42' year(s) of experience and specializes in 'NICU, Infection Control'. From 'I can see La Playa'; 69 Years Old; Joined Dec '00; Posts: 12,266; Likes: 3,232.

    59 Comments so far...

  3. Visit  Gompers profile page
    0
    Quote from 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!!!
  4. Visit  TiffyRN profile page
    0
    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.
  5. Visit  SteveNNP profile page
    3
    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.
    ICUman, mustlovepoodles, and fiveofpeep like this.
  6. Visit  walkingrock profile page
    0
    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...
  7. Visit  babynurselsa profile page
    0
    I have always said they are really good babies or really bad ones. There just never seems to be an inbetween for them.
  8. Visit  unikuelady profile page
    0
    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.
  9. Visit  jellybean_1 profile page
    0
    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....
  10. Visit  prmenrs profile page
    0
    Quote from 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.
  11. Visit  Gompers profile page
    0
    Quote from 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!!!
  12. Visit  Mimi2RN profile page
    0
    We had a little one born at 33 weeks, mom was PROM at 26 weeks, had steroids, bedrest. As soon as he was eating and warm in a 72 degree nursery, he was sent out the door, barely 35 weeks. Came back to Peds 3 days later as a popsicle child, with a rectal temp 95.3F in the doctors office. Silly parents treated him like a normal newborn and took him shopping!

    We tell them to keep them home, but the parents just don't listen. It's RSV season, too!
  13. Visit  KRVRN profile page
    0
    And you have to beware of those IDM 35 weekers that LOOK like a big term baby... they are NEVER trustworthy.
  14. Visit  unikuelady profile page
    0
    Lifelines is also indexed in [I]International Nursing Index, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and MEDLINE.
    I hope this information helps.


Nursing Jobs in every specialty and state. Visit today and find your dream job.

Top
close
close