PEDSOBRN

Yes we set out low limit for HR at 100, but some people do set them at 90. Sometimes MD will write for low limit to be set at 80 if HR is low resting.

Hello. Just wondering what other NICU nurses consider a low resting heart rate as far as a range goes. Below 100? Low 100's? We have no policy on this at my hospital. Thanks!

When giving iv push meds with running iv do you use port closest to iv site or port on iv tubing? Do you pinch off iv tubing?How much do you flush with before and after?

I dont think that I would stop the mag. I would first look at other nurses assessments to see if DTR's were at +1 earlier. If so than that is not a change. Also look at the patient is she alert or drowsy? How are her respirations? Then taking everything into consideration I may call the doctor if needed. Just remember some patients reflexes are +1. Hope that helps.

Being a new nicu nurse I have some questions on weaning babies 02 in the NICU. So if you start weaning and say go down by a few every 15 min to half hour....if you have to go back up because of desats do you immediately call the doctor? Or do you play with 02 for a couple hours and if after couple hours cant wean them, then call the doctor? Thanks guys!

I have been doing some research on acrocyanosis. I have noticed some babies to have partially purple nailbeds. Do you consider this acrocyanosis? Most things on the internet say it is hands and feet. Also.....when you chart do you chart pink with acrocyanosis? I like to be thorough. Also should you always do a pulse ox if the baby has purple nailbeds? Thanks!

Questions on suctioning of neonate after delivery.....First of all how far do you pass a suction catheter on a neonate after delivery? We want to be in the esophagus correct not the trachea? Next how do you know what size suction catheter to use? Is this considered deep suctioning? When should you suction with a catheter instead of a bulb syringe? I have gotten many different answers on this and any help would be appreciated. I also need help with charting too. Thanks:)

So you would report any BP's over 140/90? Most people where I work report 160/100. If I get one high reading (say after pt comes out to postpartum) I usually wait an hour and recheck it. You?

I am just wondering what other hospitals due on postpartum regarding BP's. Where I work we have no protocols for reporting elevated BP's. Any ideas...

jamonit, You will be fine. I have the same one and it works very well on peds pts. I love it and people who have used it can't believe how well it works.

Well, with each pediatric patient you have to consider there age and realize that they are all in a different developmental stage. Such as the younger ones, you want to make sure that you get down to there level and let them feel you about before you go right at them and poke them. Always remember to reward them for good behavior. As far as giving injections and drawaing blood, you want to get it done and over with as quickly as possible. If the parents are willing to stay in the room they are usually very helpful. Alot of times they can help you to hold the child down (depending on the age). Swaddling babes works to (obviosuly leaving out whichever extrmity you will use). I am not sure if your office has child life specialist but they are amazing and help a lot if you have them. Another thing is if you have to give more than one injection give them all at once (in different sites with assistance of other nurses if there are other nurses there) that way the child is only traumatized once. Im not sure if that helped you at all. Let me know what other kind of info you are looking for. I have done several injections and blood draws on babes and kids.

Well, as far as the neuro assessment....you want to note wether the babe is alert, sedated, lethargic, active, sleepy, note whatever the babe is doing. Also note whether the babe moves all extremities. The posterior fontanels close at 2-3 months and the anterior fontanels close at 12-18 months. The fontanels should be soft and flat when open. Bulging fontanels can mean increased intracranial pressure and depressed fontanels can mean dehydration. I hope that that all helps you with neuro assessment.

I was just wondering if you could help me with some questions on fetal assessment. I work nights on a maternity floor and I am wondering what kind of assessments I should be doing at night if the mother is sleeping (for an AP pt.). Do I wake her to ask her if the fetus is moving, because they will usually say no because they have been sleeping. I guess I am also confused as to what I should be documenting. I dont want to say the fetus isnt active. Can you please help. Thanks!