Baby ANN

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Behind every baby in the NICU is a network of dedicated parents & healthcare professionals. With families at the center of the care team we can & do achieve greatness!

Challenge Yourself!

Heat loss due to the infant's skin direct contact to a colder object such as instruments, metal scale, incubators, or an x-ray plate is called

a. convection.

b. radiation.

c. conduction

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The Academy of Neonatal Nursing thanks certified nurses for their dedication, achievements and deep commitment to their patients.

CHALLENGE YOURSELF!

Maternal alcohol abuse may be associated with which of the following congenital heart defects?

A. complete heart block
B. pulmonary stenosis
C. septal defects

Test Yourself!

The risk of herpes simplex virus (HSV) transmission to the fetus is highest in a woman who, during pregnancy, experiences a
A. Primary infection
B. Secondary infection
C. Tertiary infection

⭐️HERE IS YOUR SUNDAY SMARTIES ANSWER⭐️

A hypercyanotic, or "Tet spell", is typically characterized by:

A. decreased pulmonary pressure and increased systemic pressure
B. increased pulmonary pressure and increased systemic pressure
C. increased pulmonary pressure and decreased systemic pressure

ANSWER: C. increased pulmonary pressure and decreased systemic pressure

These hyper-cyanotic “tet spells” result in increased pulmonary stenosis and reduced flow to the pulmonary artery. This increases R-L shunting causing acute episodes of hypoxemia because of increases in PVR and/or decreases in SVR. The knee-to-chest position decreases R-L shunting by increasing SVR (Martin et al., 2020).

Martin, R. J., Fanaroff, A. A., & Walsh, M. C. (2020). Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. Elsevier.

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image credit: https://litfl.com/hypercyanotic-episodes-in-the-newborn/

⭐️SUNDAY SMARTIES⭐️

Baby ANN family, challenge yourself with this Sunday Smarties question.

A hypercyanotic, or "Tet spell", is typically characterized by:

A. decreased pulmonary pressure and increased systemic pressure
B. increased pulmonary pressure and increased systemic pressure
C. increased pulmonary pressure and decreased systemic pressure

Answer to be posted on Monday, December 11th.

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Share your own nursing experience in handling a patient’s tet spell.

Check this out🤔

Antimicrobial peptides modulate lung injury by altering the intestinal microbiota Researchers have identified a gut-lung axis driven by intestinal antimicrobial peptide expression and mediated by the intestinal microbiota that is linked to lung injury in newborns.

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ANN celebrates all NP's!

For most NPs, another NP or mentor helped them advance their career — answering questions, guiding progress or serving as a role model. Who has inspired you or assisted you along your NP journey? Take time to express your gratitude to another NP who has made a positive difference in your life. We can't wait to see your posts! Use the hashtags and when you post about NP Week online!

New Recommendations!

CDC Recommendations for Hepatitis C Testing ... CDC reports on CDC recommendations for hepatitis C testing among perinatally exposed infants and children in the United States in 2023.

DiGeorge Syndrome is more commonly associated with which of the following congenital cardiac defects? What else do you know about DiGeorge?

a. AV Canal

b. Truncus Arteriosus

c. Coarctation of the Aorta

Thankful for our community ❤️ Happy Neonatal Nurses Week 🍼👣🩺

During this year’s Neonatal Nurses Week from September 10-16th, 2023 we celebrate our members, recognizing the dedication of the NICU nurses who work tirelessly to care for the most fragile patients. Thank you for all you do!

Great Learning Resource from The NICU Doc 👍🏻

PPHN, or persistent pulmonary hypertension of the newborn can be extremely scar, both for families and providers.
Managing PPHN typically involves a combination of supportive care and medicines that involve the following:

1. Provide respiratory support with no acidosis: Newborns with PPHN often require respiratory support, such as oxygen therapy or mechanical ventilation, to help maintain adequate oxygenation and ventilation.

2. Maintain hemodynamic stability: Medications may be used to support blood pressure and circulation, such as intravenous fluids, vasopressors, or inotropic agents. We'll talk more about this next week.

3. Treat the underlying cause: Identifying and treating the underlying cause of PPHN, such as infection or meconium aspiration, is important to be able to recover.

4. Nitric oxide therapy: Nitric oxide is a medication that relaxes the blood vessels in the lungs. It is often utilized as a first-line treatment for PPHN as it helps to improve oxygenation and reduce pulmonary vascular resistance.

5. Extracorporeal membrane oxygenation (ECMO): ECMOBis only available in some centers but can be life-saving in severe cases of PPHN, when other treatments are not effective. This is a procedure in which an artificial lung bypasses the baby's failing lungs, providing oxygenation and removing carbon dioxide from the blood. This allows time for the lung to heal and recover.

Next week, we will talk about vasopressors and delve into more detail on each of these points.

Now, which is your favorite vasopressor for PPHN and why?

Do you premedicate in your unit?🤔

Full premedication for the win!
Intubation with full premedication assoc with ⬇️TIAEs aOR 0.26 (95%CI 0.1-0.6) vs no premedication
⬆️first attempt success aOR 2.7 (95%CI 1.3-4.5) vs premedication after adj for pt & provider characteristics.

https://pubmed.ncbi.nlm.nih.gov/36801956/

Are you seeing more r/o syphilis and/or confirmed congenital syphilis in your units?

Around 40 percent of preterm infants with BPD-PH die before the age of 2. UAB studies establish two significant risk factors Published results from two UAB studies found the duration of intermittent hypoxemia events and the presence and persistence of a patent ductus arteriosus after birth are two novel risk factors of BPD-PH in preterm infants.

To read more click: https://linktr.ee/academyofneonatalnursing

Massage, Kangaroo and oral 10% dextrose had similar effects on pain scores during venipuncture
Next up would be massage vs breastfeeding during venipuncture
pubmed.ncbi.nlm.nih.gov/36450853/

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are worth their weight in gold.
1st 24 hrs of NICU admission, >nursing provision ratio assoc w/ ⬇️ odds of morbidity and mortality(OR 0.93, 95% CI 0.89 to 0.98), & > unit occupancy assoc w/ ⬆️ odds of morbidity and mortality (OR 1.19, 95% CI 1.04 to 1.36)

Further analysis showed that 47% of the outcome was explained by nursing provision
pubmed.ncbi.nlm.nih.gov/36609411/

Male infants are at higher risk of neonatal mortality and severe morbidity. https://linktr.ee/academyofneonatalnursing

Great Article on HIE

When it comes to HIE, keep your eyes on the CO2! Hypoxic ischemic encephalopathy is a very scary condition for both families and health care providers.  In my career as a Neonatologist one of the greatest accomplishments has been the recogni…

Great learning resource!

"Newborn Exam" by Nina Gold for OPENPediatrics In this video, the viewer will learn the key aspects of the newborn physical exam, and how to distinguish between normal and abnormal findings. Direct Links ...

NICU NURSES and NNPs are an inspiration to so many ❤️🤩❤️ Happy Nurses Week!

Mom inspired to become a nurse after twins’ 87-day NICU stay Tara Wood’s experience in the NICU inspired her to become a NICU nurse and nursing professor. Now, her daughter is becoming a NICU nurse too.

An article is now available regarding the use of the laryngeal mask in neonatal resuscitation: “The Laryngeal Mask: Empowering Nurses to Rescue Newborns” by Jeanette Zaichkin, MN, RN, NNP-BC; Linda D. McCarney, MSN, APRN, NNP-BC, and Michelle Rhein, MSN, RN, CNS, RNC-NIC: https://journals.lww.com/advancesinneonatalcare/Abstract/2023/04000/The_Laryngeal_Mask__Empowering_Nurses_to_Rescue.7.aspx

What are some interventions your unit employs to prevent ELBW skin injury and minimize damage when it occurs?
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Infants with extremely low-birthweight (ELBW) are at increased risk for infection because the innate immune function of their skin is underdeveloped as they lack a competent epidermal barrier. In this review, authors describe the challenges of skin care in infants with ELBW and summarize strategies to prevent skin injury, minimize damage when it occurs, and enhance cutaneous innate immunity: https://bit.ly/3GXh70H

On Monday, April 10th, The White House released an official proclamation for Black Maternal Health Week 2023! As the founders of Black Maternal Health Week, the Black Mamas Matter Alliance is thrilled to have the support of President Joe Biden, Vice President Kamala Harris, and the White House for a third year in a row. We appreciate the administration’s commitment to eliminating disparities and creating an equitable health system inclusive of Black mamas and birthing people!

Visit http://ow.ly/LLmG50NFRIi to read more