Questions for a NICU nurse

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Hello! I am a first semester student in nursing school. I really hope to work in the NICU after I graduate. I am doing a paper on the different types of treatment for premature and low birth weight babies. For my paper I am required to do an interview of someone in a related field. I don't actually know any NICU nurses, so I am hoping that someone from this board would be willing to answer a few questions for me. Thank you so much! I really appreciate any answers you can give me. Here are the questions:

1. What conditions are the most common in premature infants?

2. What medications are commonly given to premature and low birth weight babies?

3. What is the most common surgery performed for premature babies?

4. How does Kangaroo Mother Care help a premature infant thrive?

5. How does occupational or physical therapy benefit a premature infant?

6. How does the family usually react to their child being in the NICU?

7. In what ways could treatment in the NICU be made better?

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Specializes in NICU.

I've only been in the NICU for a little less than a year, but this is what I've seen so far...

1. Patent ductus arteriosus, chronic lung disease, apnea of prematurity, intraventricular hemorrhage, retinopathy of prematurity (mainly if supplemental oxygen is overused). Micropreemies especially are vulnerable to necrotizing enterocolitis.

2. Betamethasone prenatally if there's time, to accelerate lung development. Postpartum, kids can be on caffeine to prevent apnea and indocin to close PDAs. A lot of our preemies are on Pepcid, too, especially the ones who are NPO.

3. Probably PDA ligations, and eye surgery in cases of severe ROP.

4. Skin-to-skin contact helps regulate the infant's temperature. It also promotes deeper sleep for the baby and parental bonding.

5. A lot of preemies have feeding difficulties, so OT is a big help in getting them to nipple their feeds.

6. It varies hugely, but anxiety and stress is pretty universal.

7. I'll have to give this one more thought :)

Interested to see replies from more experienced NICU nurses...

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Specializes in NICU.

2. Also Survanta, since preemies (depending on age) are usually lacking in surfactant.

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I've only been in the NICU for a little less than a year, but this is what I've seen so far...

1. Patent ductus arteriosus, chronic lung disease, apnea of prematurity, intraventricular hemorrhage, retinopathy of prematurity (mainly if supplemental oxygen is overused). Micropreemies especially are vulnerable to necrotizing enterocolitis.

2. Betamethasone prenatally if there's time, to accelerate lung development. Postpartum, kids can be on caffeine to prevent apnea and indocin to close PDAs. A lot of our preemies are on Pepcid, too, especially the ones who are NPO.

3. Probably PDA ligations, and eye surgery in cases of severe ROP.

4. Skin-to-skin contact helps regulate the infant's temperature. It also promotes deeper sleep for the baby and parental bonding.

5. A lot of preemies have feeding difficulties, so OT is a big help in getting them to nipple their feeds.

6. It varies hugely, but anxiety and stress is pretty universal.

7. I'll have to give this one more thought :)

Interested to see replies from more experienced NICU nurses...

My observations have been the same as Coffee Nurse except for #5 - on my unit, we have very little OT/PT involvement. Maybe we need more... the "old" micropremies just have to figure out the eating thing, though it takes some of them a long time. One of my patients had an OT due to cleft lip/palate.

More answers for 1 and 2:

1. Hypoglycemia, hyperbilirubinemia (jaundice), respiratory distress syndrome (which can develop into chronic lung disease), anemia, sepsis, transient tachypnea of the newborn, general feeding intolerance (not necessarily due to necrotizing enterocolitis).

2. Agreed that caffeine is the big one (and parents are always intrigued by it). Antibiotics: ampicillin and gentamycin started at birth till first cultures come back, and vancomycin, cefotaxime, and cloxacillin used later. Nutritional supplements (iron, trivisol multivitamin, or milk fortifier). TPN/lipids. Heparin if there is an umbilical art line. Atropine/fentanyl/succinylcholine to prepare for a non-emergent intubation. Phenobarb for seizures. Morphine for opiate withdrawal. Lots of PRBC transfusions for anemia.

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Some answers for 7:

- better developmental care - lower lighting, less noise, volunteers to cuddle the older babies when they want to be held but the nurses don't have time

- more widespread use of donor milk banking - reducing the use of formula

- PICC lines used more frequently - so the babies who take a few weeks to get off TPN aren't constantly getting new IV starts.

- the invention of a transcutaneous blood sugar test so that the "sugar babies" aren't getting their heels chopped to bits

- more "care by parent" rooms so the breastfeeding moms don't get "bumped" out of them by someone with a more urgent need

- doctors' working hours shortened to reasonable periods, so important decisions aren't being made by people who are impaired by sleep deprivation

- more wisdom, compassion, and perspective on everyone's part when considering when it's time to let a baby go instead of inflicting more pointless suffering

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Specializes in Medical and general practice now LTC.

Moved to the NICU forum

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