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Advances in Neonatal Care:
doi: 10.1097/ANC.0b013e31826be234
CE Test

Developmental Care

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* Read all the articles in the supplement (pS1–S32).

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Disclosure Statement: The authors have disclosed that they have no financial relationships related to this article.

This article has been approved by the National Association for Neonatal Nurses Certification Board for Category B credit toward recertification as an NNP.

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GENERAL PURPOSE STATEMENT: To familiarize the nurse with issues related to the developmental care of premature infants.

LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to:

A Developmental Care Framework for a Cardiac Intensive Care Unit: A Paradigm Shift

Describe different interventions that could be used routinely in the provision of individualized developmentally supportive caregiving including the implementation of a developmental model of care in a cardiac intensive care unit (CICU).

Epigenetics and Family Centered Developmental Care for the Preterm Infant

Identify assessment tools that provide a window into the physiologic and behavioral effects of individualized developmentally supportive care by outlining the mechanisms of epigenetics and their effect on preterm infant brain development.

The Effects of Environmental Noise and Infant Position on Cerebral Oxygenation

Identify barriers to the integration of developmentally supportive care and choose strategies to overcome such barriers by recognizing the effects of environmental noise and infant position on cerebral oxygenation.

Application of the M Technique in Hospitalized Very Preterm Infants: A Feasibility Study

Develop individualized developmental goals including a new relaxation method for preterm infants.

A Developmental Care Framework for a Cardiac Intensive Care Unit: A Paradigm Shift

The core measures of developmental care model introduced to staff at the Children's Hospital of Philadelphia included

a. pain management.

b. thermoregulation.

c. environmental noise reduction.

d. infant stress reduction.

Positive outcomes of developmental care in neonatal intensive units (NICUs) include

a. improved psychomotor functioning.

b. decreased costs.

c. enhanced parent-infant bonding.

d. reduced risk of infection.

What was the last phase in the transition to a model of developmental care in the CICU?

a. Creation of a developmental care committee

b. Creation of policies and procedures

c. Nursing developmental rounds

d. Interdisciplinary rounds

Which developmental care tool did the team create to use during developmental rounds?

a. Flow sheet

b. Questionnaire

c. Card

d. Survey

Which of the following was an unexpected finding of developmental rounds?

a. Parental education

b. Parental sharing of stories and concerns

c. Staff education

d. Staff sharing of stories and concerns

Epigenetics and Family Centered Developmental Care for the Preterm Infant

Which of the following is an essential aspect of routine caregiving in the neonatal period?

a. Family-centered developmental care

b. Infant-centered developmental care

c. Rescue care

d. Recovery care

The effect of epigenetics on the development and function of neuronal networks starts at conception and continues into

a. infancy.

b. early childhood.

c. late childhood.

d. early adulthood.

Which has been shown to cause early adaptations in gene expression that could lead to an increase in the risk for chronic disease and mental health problems?

a. Low birth weight

b. High birth weight

c. Maternal separation

d. Multiple births

The study by Lui et al proposed which approach to family-centered developmental care?

a. Individualized

b. Bundled

c. Standardized

d. Systems based

Current evidence on the relationship between diet in the immediate postnatal period and programming comes from

a. theories.

b. full-term infant studies.

c. retrospective adult studies.

d. animal models.

The Effects of Environmental Noise and Infant Position on Cerebral Oxygenation

Noise and body position may influence the structure and function of a premature infant's brain through alterations in

a. oxygen saturation.

b. glucose metabolism.

c. cerebral blood flow.

d. neurological pathways.

One method to measure fluctuation in cerebral blood flow is cerebral

a. oximetry.

b. ultrasound.

c. angiography.

d. computerized tomography.

The current recommendation is that peak sound levels in the NICU be no greater than

a. 50 dB.

b. 65 dB.

c. 75 dB.

d. 100 dB.

Which of the following can affect infant cerebral oxygen saturation?

a. Acetaminophen

b. Aspirin

c. Caffeine

d. Corticosteroids

Lower cerebral oxygen saturation levels have been noted when the cerebral oximeter probe is placed in the

a. right frontal hemisphere.

b. left frontal hemisphere.

c. right temporal hemisphere.

d. left temporal hemisphere.

Application of the M Technique in Hospitalized Very Preterm Infants: A Feasibility Study

Up to how many children born very preterm experience cognitive impairments, learning disabilities, impaired executive function and social and emotional difficulties?

a. One-third

b. Two-thirds

c. One-half

d. Three-fourths

Criteria for discontinuing of the M Technique included

a. heart rate less than 100 for 15 seconds or more.

b. respiratory rate more than 30 for 30 seconds or more.

c. blood pressure less than 100 systolic.

d. blood pressure more than 150 systolic.

What is the rationale for set repetition of strokes in the M Technique?

a. Provide a touch cue

b. Promote sleep

c. Increase body temperature

d. Decrease anxiety

Which parameter increased over the course of the M Technique intervention based on physiologic responses?

a. Heart rate

b. Respiratory rate

c. Oxygen saturation

d. Urinary output

Results of the behavior cue responses to the M Technique found that distressed behaviors decreased during the session and were nonexistent for how long after the ended?

a. Less than 5 minutes

b. 5–10 minutes

c. 10–15 minutes

d. Over 15 minutes

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