Neonatal Neurological Assessment and Care Flashcards

The NICU nurse caring for an infant with HIE on therapeutic hypothermia should position the infant:

Answer: Supine with head midline and slightly elevated to 15–30 degrees

Head midline positioning with slight elevation reduces ICP and promotes venous drainage in infants with suspected brain injury.

Amplitude-integrated EEG (aEEG) in the NICU is used primarily to:

Answer: Continuously monitor background cerebral activity and detect seizures

aEEG provides continuous bedside monitoring of cerebral electrical activity to detect seizures and assess brain function in at-risk neonates.

Post-hemorrhagic hydrocephalus after IVH is identified by:

Answer: Progressive head circumference increase, bulging fontanelle, and cranial ultrasound findings

Hydrocephalus after IVH causes CSF accumulation, progressive ventricular dilation seen on cranial ultrasound, and increasing head circumference.

Cranial ultrasound screening for IVH should be performed in all infants born at:

Answer: Less than 30 weeks gestation

AAP guidelines recommend routine cranial ultrasound screening for all infants born before 30 weeks due to high IVH risk.

Which primitive reflex is normally absent at birth and indicates neurological damage if present?

Answer: Asymmetric tonic neck reflex beyond 6 months

The asymmetric tonic neck reflex (ATNR) is normal in newborns but persistent beyond 6 months suggests upper motor neuron pathology.

A neonate born at 34 weeks has decreased tone, minimal response to stimulation, and poor suck. These findings are MOST consistent with:

Answer: Hypotonia from prematurity, birth asphyxia, or CNS depression

Hypotonia, poor responsiveness, and weak suck in a preterm infant suggest CNS depression from asphyxia, metabolic causes, or prematurity.