Lucy McCarty

NURS 4832 Lab

NICU Observation

Objectives:
1. Recognize the specialized nursing care needs of premature infants.
2. Identify the physical assessment variations of premature infants compared to full term
infants.
3. Identify the role of the nurse as a part of the interdisciplinary team in meeting the
special needs of infants in the NICU.
4. Complete and submit the NICU Case Study sheet.

This week, my clinical placement was at the Neonatal Intensive Care unit at St. Elizabeth’s in

Boardman. I was extremely excited for this rotation, as I have always been interested in NICU

care and I love babies. While I was there, I was unable to do anything hands on with the infants;

which was disappointing to me, as this will likely be my only NICU experience during nursing

school and I was eager to get some experience in handling/caring for these small babies. I was,

however, able to learn about their treatments and witness the nurses caring for them, which I

really enjoyed.

The baby I had selected for my case study was a premature infant who was born at a mere

29 weeks gestational age. He had been hospitalized for about 5 weeks, at the time I was there.

His main issues were his prematurity and feeding intolerances. His nurse explained that he

frequently had emesis following feedings and that they had tried many different formulas so

far, including Alimentum. He also had Infant Respiratory Distress Syndrome since his lungs were

not fully developed d/t his prematurity, but he was on no supplemental oxygen. In addition,
maternal drug use may have played a role in some of his problems. He was being kept in an

isolette, to help him maintain his body temperature, and had an NG tube, through which he

was being given donor breast milk and Pro-Lactiv plus 8 (to increase his caloric intake). He was

being given caffeine citrate, which I found very interesting. I was able to learn that caffeine is

frequently given to premature NICU babies to help stimulate their under-formed lungs and

brains to promote breathing and reduce intermittent hypoxia. My experience in learning about

these different treatments for NICU babies was extremely interesting and thought provoking.

While I was in the NICU, I was lucky to witness a physical therapist who comes in to assess

and work with the babies. I had never thought about physical therapy for infants, but the

rationale behind it actually makes total sense. The therapist explained how she was working

with the infants on different things; such as sucking and improving their stress levels. She spoke

about how therapeutic touch was extremely important, to these babies especially, because it

decreases stress and gives them a sense of comfort and well-being. She also explained that

while full-term babies have enough muscle tone and control to keep their limbs tucked close to

their bodies (like in the womb), that premature infants do not. Because of this, the NICU uses

various positioning devices to keep the babies comfortable and in a rounded position,

mimicking the womb.

While at the NICU, I was able to witness a baby being brought in directly following delivery.

It was a very intense situation with a lot of action. The baby was having respiratory issues and

also had a condition known as Pectus Excavatum, which is a deformity of the chest wall that

causes the sternum to protrude inward into the chest. I was able to watch as the nurses
advocated for the baby and did all they could to assist her. I was also able to watch the doctor

come in to assess her, as they spoke about intubation.

My rotation in the NICU was an experience that I greatly enjoyed. I have always wanted to

care for babies and this experience just made that desire grow stronger. I was able to see what

an important role the nurses play in caring for these infants and helping them to thrive. I also

learned a great deal regarding the treatment and care of premature infants.