Clinical tools
Interventions
Growers and feeders
Risk factors
100
This growth chart is used for premature infants.
What is the Fenton Premature Growth Chart.
100
This medication is recommended for pregnant women between 24 0/7 weeks and 34 0/7 weeks of gestation, and may be considered for pregnant women as early as 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days.
What is corticosteroids.
100
This component of meconium can may help you estimate the [gestational] age of a preemie, much like the balding head of an elderly person.
What is lanugo.
Anchors the vernix caseosa thermoregulation, prevention of water loss, and innate immunity
100
We all know UTIs can contribute to early labor. Before I give you too many CLUEs-you'll tell me that this infection in pregnant women is also implicated in preterm labor.
What is bacterial vaginosis.
200
This world famous research center developed a calculator that uses data based on specific characteristics for infants who were born at Network hospitals between 1998 and 2003 to provide a range of possible outcomes given a gestational age.
What is the NIH.
https://www1.nichd.nih.gov/epbo-calculator/Pages/epbo_case.aspx
200
For infants younger than one year with bronchopulmonary dysplasia (i.e. who were born at <32 weeks gestation and required supplemental oxygen for the first 28 days after birth) the AAP recommends this prophylactic measure:
What is Palivizumab for RSV bronchiolitis prophylaxis.
200
Start using the same growth chart in an otherwise healthy premature child at this age.
What is two years old.
200
10% of all term and 25% of all preterm infants require phototherapy for hyperbilirubinemia. It is recommended to obtain total serum bili in babies who are less than this gestational age at birth _____
What is 35 weeks.
Indications
- newborns with jaundice in first 24 hours of life
- preterm newborns < 35 weeks gestational age
- newborns receiving phototherapy
- transcutaneous bilirubin level > 14.6 mg/dL (250 mcmol/L)
300
This assessment tool may be useful in estimating gestational age when dates are questionable.
What is the Ballard Maturational Assessment.
300
This lab may help detect PDA before symptoms develop and may indicate response to treatment.
What is a BNP.
300
Standard formula is typically this many calories per ounce.
20kcal/oz
300
This is the reason that premature infants are at risk for greater insensible losses than term infants.
What is greater surface area to body mass ratio.
400
These guidelines are the place to look to on use of parenteral and enteral nutrition in pediatric (and adult) patients, including specific guidelines for infants at risk for necrotizing enterocolitis.
American Society of Parenteral and Enteral Nutrition (ASPEN)
Ex.
- start trophic feeds within first few days of life of 10-20 kcal/ounce feedings per day (ASPEN Evidence A)
- advance feeds by 20-35 mL/kg/day as tolerated (ASPEN Evidence A)
- enteral feeds may be delivered by nasogastric or orogastric tube (ASPEN Evidence A)
- consider gastrostomy if enteral nutrition is expected for > 2-3 months (ASPEN Evidence C)
400
Based on data from randomized controlled trials this is the gestational age before which magnesium sulfate is recommended for protection against cerebral palsy.
What is 32 0/7.
400
______ is the amount of weight gain a term infant should have per day after 10 days of life.
What is 1oz/30 grams per day.
(Or more specifically, 10g/kg/day-and preterm infants should gain 15-20g/kg/day).
400
This is the most common neuropathological lesion of premature infant, reported to occur in 15%-25% of premature infants and up to 45% of infants weighing < 750 g
What is intraventricular hemorrhage of infancy
- usually presents within 7 days of birth, often within 72 hours of birth
- if symptoms present (typically in < 30% of cases), will present as either
- acute crisis with rapid onset of severe symptoms within first 24 hours, which may progress to coma or death
- slow progression within 3-7 days
500
7-day course of therapy with a combination of these antimicrobials is recommended during expectant management of women with preterm PROM who are less than 34 0/7 weeks of gestation.
What is intravenous ampicillin and erythromycin followed by oral amoxicillin and erythromycin.
500
This lab value increases in the first 48 hours of life, particularly in babies <30 weeks gestational age.
Creatinine
500
Factors found not to be associated with preterm labor include prior abortions, time since LEEP, SSRIs and GBS colonization. Among these is a staple of southern European hygiene, known as this:_____
What is the bidet.