So, by popular demand..... here is a thread dedicated to questions posed to help increase one's knowledge base in regards to the acute care NICU population. If anyone desperately wants a separate thread dedicated solely to the Well Newborn, we'll have to talk to Elvish about that one
So here's the plan. I'll pose a question drawn from an experience I've had, a clinical scenario I've formulated, or concepts I come across in the literature and board exam review. I will try to keep it in the vein of the NICU nurse, which will be interesting, since I've been saturated in NNP classes for a few years now.
Let's also keep in mind (and we all know this) that practice varies WIDELY from unit to unit. Feel free to answer based on your personal practice, but let's all keep in mind that the "book" answer may be different.
A little about me:
I have been practicing in NICU for almost 5 years, two in a level IIIb, and nearly 3 in a level IIIc quaternary NICU. I have had the privilege of caring for ECMO, pre/postop open hearts, single-lung ventilation, etc, as well as the gamut of preemie and surgical diagnoses. I finished up my NNP grad degree last December, and I'm now in the process of studying for my national certification/boards, as well as looking for a NNP position.
So here goes...
Good job so far, everyone!
So, the most important thing to remember is that SGA does not necessarily mean IUGR, but IUGR babies are always SGA. IUGR is something that's prenatally diagnosed, an ultrasound-detected failure of the fetus to grow at normal rates. This is usually caused by placental insufficiency, PIH, smoking, or infection.
Head-sparing, or asymmetrical IUGR is reassuring. Babies with this have a head circ >10% pct, but the length and weight plot <10% pct. This form of IUGR occurred later in pregnancy and the brain and head were spared from lack of oxygen/nutrients. These kids almost always catch up. Symmetric IUGR kids plot <10% on all counts, and this form occurs early in pregnancy, (usually infection) and often have neurodevelopmental delays.
Last edit by SteveNNP on Mar 4, '10
: Reason: Thanks, littleneorn!