Premature infants the nicu medical psychological issues
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Premature Infants & the NICU Medical & Psychological Issues PowerPoint PPT Presentation


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Premature Infants & the NICU Medical & Psychological Issues. November 13, 2007. Description. 250,000 newborn infants admitted to NICU’s annually in US Most are born premature, at low birth weight, or both Premature infant = born prior to 37 th week of gestation

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Premature infants the nicu medical psychological issues

Premature Infants & the NICUMedical & Psychological Issues

November 13, 2007


Description

Description

  • 250,000 newborn infants admitted to NICU’s annually in US

  • Most are born premature, at low birth weight, or both

  • Premature infant = born prior to 37th week of gestation

  • Low birth weight = less than 5.5 pounds


Description1

Description

  • Majority of Infants born as early as 25 weeks gestation survive

  • 5-7% of North American infants are born prematurely

  • Most are hospitalized until approx. their due date


Causes of prematurity

Social, biological, & environmental factors

Causes of Prematurity


Causes of prematurity1

Prenatal care, no drugs, & healthy diet reduce chances

Most premature births occur in middle-class women

Causes of Prematurity


The premature infant

The Premature Infant

  • Immature organ development

  • Difficulties adapting to the extrauterine environment

  • Physical appearance

    • Lanugo

    • Absence of fat

    • Elongated head


Premie development

Premie Development

  • Three stages of premie development

    • Early premie

    • Developing premie

    • Older premie


Impact of nicu

Impact of NICU

  • Lack of patterning to stimulation

    • Infants can learn to “tune out” stimuli

  • Social signals may receive no response

    • Fail to learn effective ways of eliciting responses from caregivers

    • Social signaling may be diminished or extinguished through lack of response


Positive changes in the nicu

Positive Changes in the NICU

  • Minimize unneccesary contact

  • Relocate or quiet noisy equipment

  • Shield infants’ isolettes from light

  • Provide day-night cycles in terms of light & activity

  • Supply pleasant visual and auditory stimulation

  • Provide gentle touch


Transition to home

Transition to Home

  • Anxiety about assuming full responsibility of care for the infant

  • Infant may be less than optimally responsive & still may be medically fragile

    • Infant irritability

    • Parent fatigue

    • Parent concern for infant’s developmental progress


Prematurity later development

Prematurity & Later Development

  • Growth & health

  • Cognitive development


Prematurity later development1

Prematurity & Later Development

  • Socio-emotional & behavioral development

    • Temperament

    • Bonding & attachment

    • Behavior problems


Parenting a premature infant

Parenting a Premature Infant

  • Social risk factors

    • Low income

    • Lower education

    • Minority cultural backgrounds

  • Coping strategies

    • Finding meaning in experience was superior t other coping methods 18 months post-discharge


Parenting a premature infant1

Parenting a Premature Infant

  • Other family members

    • Fathers

    • Grandmothers

    • Siblings


Parenting a premature infant2

Parenting a Premature Infant

  • Family-focused interventions

    • Support groups

    • Teach parents to care & stimulate child

    • Provide intervention beyond NICU stay


Role of pediatric psychologist

Role of Pediatric Psychologist

  • Support & services provide to family

    • Devote attention to PARENT needs

    • Organize parent support groups

    • Provide child-rearing advice

    • Be link between families and staff

    • Provide grief counseling, when needed


Role of pediatric psychologist1

Role of Pediatric Psychologist

  • Participation in follow-up clinics

    • Assess developmental status of child

    • Refer for early intervention services

    • Design IFSP, when warranted

    • Address parenting & family concerns (e.g., maternal depression, marital conflict, sibling adjustment)


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