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Discussion

Starting NICU

Hello all!

I am currently an adult ICU Nurse who accepted a new position in a level IV neonatal ICU for February. I am so excited and want to be more prepared than I was for my adult ICU preceptorship. At this hospital, I will be working with a preceptor with the step down babies, then on my own for a little while, then critical babies with a preceptor. It should all be within the course of a year.

what do you guys suggest I do to prepare? Any tips/tricks? I bought the Merenstein & Gardner neonatal textbook and started studying this. I also took the NRP.

any advice would be appreciated!

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    Can you send me the link to the book you're talking about? I also start a similar program in March.

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    You can look up and familiarize yourself with the following meds:

    -ampicillin

    -gentamicin/tobramycin

    -cefotaxime

    -vancomycin

    -metronidazole

    -fluconazole

    -vitamin K

    -ferrous sulphate/iron

    -vitamin D

    -caffeine

    -human milk fortifier (don't know if this necessarily counts as a med)

    -phosphate

    -calcium

    -NaCl supplements

    -Tylenol

    You should be focusing on dosing calculations, administration guidelines, compatibility for IV drugs, risks and contraindications

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    You could also try to practice fluid calculations as fluids will always be prescribed by weight rather than just a prescribed rate. Here's an example to try,

    Baby A is on a total fluid intake of 120 ml/kg/day. He weighs 2.5 kg. At the beginning of your shift he is NPO with 10% dextrose running, what should his hourly IV rate be?

    They now want to start feeds on baby A, they start him on 5ml Q3H x24 hrs, what should the IV rate be weaned to?

    You are back the next day and baby A has tolerated his feeds for 24 hrs, the team has ordered an increase of 3ml Q3H. You start increasing the feed at 0900, how much will baby A be feeding at 1800? What will the IV rate be when you handover at 1900?

    What is full feeds for this baby on a TFI of 120 ml/kg/day?

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