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Nicu Case Study

1) XP is a 51-day-old premature infant born at 27 weeks and 1 day gestation weighing 1184g who is currently being treated in the NICU. 2) XP receives breast milk via NG tube, oxygen via CPAP, medications to prevent anemia and support heart and lung function, and kangaroo care for thermoregulation and bonding. 3) The nurse's role in the NICU is to closely monitor the infant's vital signs, administer medications and feedings, provide comfort care, and communicate with the family on the infant's progress towards stability and discharge.

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526 views4 pages

Nicu Case Study

1) XP is a 51-day-old premature infant born at 27 weeks and 1 day gestation weighing 1184g who is currently being treated in the NICU. 2) XP receives breast milk via NG tube, oxygen via CPAP, medications to prevent anemia and support heart and lung function, and kangaroo care for thermoregulation and bonding. 3) The nurse's role in the NICU is to closely monitor the infant's vital signs, administer medications and feedings, provide comfort care, and communicate with the family on the infant's progress towards stability and discharge.

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© © All Rights Reserved
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NURS 4832L NURSING CARE OF CHILDREN

NICU CASE STUDY

Sabrina Nichols
Choose any premature infant in the NICU. Review the infant’s medical record
and answer the following:
Infant’s Initials: XP Sex: M
Medical Dx: extreme prematurity Birth Date: Sept. 25, 2019
Gestation at age at birth: 27 W 1 D Today’s age: 51 days
Birth Weight: 1184 g Today’s Weight: 2081 g
Apgar’s scores: (1 min. 5 min.) 4/6
Vital signs: T – 36.7 P – 134 R – 36 BP – 82/51 SpO2 – 100%
Type of bed: isolate
Temperature control: yes (if yes, specify degree) 37.0
Oxygen: yes (if yes, state % and method of delivery) 21% cpap
Nutrition: (amount/ type/ route/ frequency): breast milk at 35 mL per NG tube q3h.
Donor milk = (20 cal/oz).

Medications: (name, dose, route, action, recommended dose, side effects, and
reason for use)
1. Fer-in-sol elemental Iron – 5 mg oral at bedtime
 Prevent anemia
 SE: constipation, upset stomach, black or tarry stool,
2. Caffeine Citrate 20 mg/ml – 16.6 mg oral solution in the morning
 Maintain elevated heart rate
 SE: tachycardia, tachypnea, agitation, irritability, tremor, hypertonia, seizure
activity with tonic-clonic movement
3. MCT oil – 0.5 ml q6h oral
 Provide fat to the babies to help them gain weight
 SE: N/V/D
4. Vitamin D3 – 400 units/ml oral solution daily
 Prevent Rickett’s, ensure proper growth and development
 SE: N/V, loss of appetite, excessive thirst, frequent urination, constipation, abd.
pain, muscle weakness, muscle and joint aches, confusion, fatigue, kidney
damage
5. Poly-vi-sol – 17.5 mg oral daily
 Multivitamin to ensure adequate nutrition
 SE: constipation, diarrhea, upset stomach
6. Folacin – 0.05 mg oral at bedtime
 Prevent folate deficiency and anemia
 SE: very few side effects

Treatments: (include rationale for each treatment)


Nasal / oral tube 5 fr; left nostril – nutrition therapy.
Kangaroo Care (skin-to-skin). – thermoregulation, attachment and bonding, increased milk
production in the mother, reduced infant mortality, decreased risk of hospital-acquired
infection
Vital Signs 3x q h – consistent monitoring of infant status.
Measure head/height/length q Sunday – monitoring of growth status.
Reposition q3h – appropriate positioning is important for airway, ensuring security and
comfort, ensuring proper flexing of muscles for development, decreasing the risk for
plagiocephaly, and decreasing the risk for skin breakdown.

Define prematurity. Identify 3 major risks of the premature infant. Discuss the
role of the nurse in the NICU. Reflect on your clinical experience in the NICU.
A premature baby is born at less than 37 weeks gestation. The infant can have major

complications such as difficulty breathing on their own, keeping a constant and stable body

temperature, and underdevelopment of major organs, such as the lung, heart, and liver, which

impairs their functioning significantly.

The role of the nurse for a NICU patient include maintaining IV lines, managing ventilators,

assessing vital signs, administering medications, drawing blood, providing comfort, record

progress, and communicate with family members about the baby’s progress. In many cases, a

nurse may only be assigned to one patient that needs around-the-clock monitoring. They
usually cultivate relationships with the parents of the babies, especially when they stay long

periods of time.

The special needs of a premature infant include intense protection from possible infection,

thermoregulation, hydration, skin care, nutritional needs, and environmental stimulation. To

protect from infection, gloves are always worn during care, and handwashing is done before

and after all care, and before entering the unit. Premature babies are especially at risk to

developing infection, as with most of their other organs and systems, the immune system is

underdeveloped. Thermoregulation is hard for babies that are premature due to their low body

fat, it is maintained through an incubator and kangaroo care. Hydration and nutritional needs

are of utmost importance to a premature infant. Ensuring adequate nutrition will help in weight

gain, since most of them are severely underweight. While babies are being fed through an NG

tube, the nurse offers a binky to suck on, so that the premature infant may get used to sucking

on something while their belly is being filled, essentially training them to nurse or bottle feed as

they get healthier. Skin care is important due to a risk of breakdown. Environmental stimulation

was given to babies from soft music playing in some of their rooms.

Compared to full-term infants, the physical assessment varies in a few ways with that of a

premature infant. Since they are so tiny, errors cannot be made, especially with medication.

This could be fatal. We do vital signs much more frequently than a full-term infant. We also

have to be conscious of position. Repositioning the infant who cannot do so themselves is

important because appropriate positioning is important for airway, ensuring security and

comfort, ensuring proper flexing of muscles for development, decreasing the risk for
plagiocephaly, and decreasing the risk for skin breakdown. During assessments, we pay close

attention to skin, breathing, and stomach.

I enjoyed my experience in the NICU. The particular baby I did my case study on was a baby

born to a mother on cocaine. I learned that her breast milk could not be used for the baby due

to the many risks, but most other drugs that a mother may be on, we still choose to use the

mother’s breast milk because it can help with the withdrawal process. I would definitely see

myself possibly working in this area one day.

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