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30 Cards in this Set
- Front
- Back
**** What 8 factors would you look at in the nutritive suck swallow breath synchrony when assessing feeding in the NICU?
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1) efficiency of nutritive suck (energy use versus calories)
2)patterning of SSB 3) poor SSB and/or stress 4)cervical auscultation 5)quantity 6)duration of feeding (10 min normal-less than 30 minutes acceptable) 7)trial therapy 8)emesis (throwing up) |
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3 impressions and recommendations in feeding assessment in NICU?
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1)include feeding guidlines
2) include prognosis 3)response to techniques also provide education and training |
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what 7 aspects of the medical history do you look at in OM and Feeding assessment?
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1)birth/neonatal history and etiology
2)medications 3)surgeries 4)neurological or genetic testing 5)diagnosis 6)physician/other health professionals 7)therapeutic support (PT,OT, Educ. AR,Vision) |
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name 10 aspects of feeding/respiratory history do you look at in OM and feeding assessment?
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1)tube feeding (presence? why? how long?)
2)prodcedures used to transition from tube (how did they tolerate it?) 3)description of feeding in the past 4)ventilator/respiratory support 5)coughing, choking, gagging during feeding 6)reflux, vomiting, and/or spitting up during, after feeding 7)history of frequent irritibility 8)history of chronic constipation 9)history of pneumonia, bronchitis,or frequent respiratory infections 10)history of persistent ear infections--food could be going up eustachian tube |
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name 5 things would you look at when assessing current feeding/nutrition information
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1- daily feeding schedule- (if their last meal is the worst, maybe they have emptying problems)
2-intke amounts 3-types of foods/liquids presently receiving 4)food likes/dislikes 5)temperature of foods/liquids |
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name the responses to sensory stimulation that you would look at in assessment
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1) touch
2)gustatory-does child respond to new tastes (hot/warm/cold/room temp. sweet/sour/salty/spicy) 3)olfactory 4)does child own sensory stim? typically developing provide oral tactile sensory stimulation constantly to their mouth with toys, fingers, toes. If a child is motorically impaired and can't we must provide it for them 5)vestibular-look in relation to balance 6)tooth brushing-reaction 7)oral reflex development-rooting (if still has over 4 months of age) suspect oral hypersensitivty, gag-hyper,hypo,absent-will see many kids with hypersensitive gag response in the NMD population |
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How would you assess communication development in OM and feeding assessment?
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You would look at communication development; modes of communication, gestures, eye pointing,facial expressions
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how would you assess phonation
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evaluate jaw position during phonation-in kids with NMD laryngeal blocking and laryngeal tensionis common. May have difficulty with pitch. Check out 1) quality of speech-breathy, hoarse, nasality,pitch and stress 2)can phonation be sustained, varied? 3)try different positions to see if phonation improves over ball, sidelying, chair, feeding chair
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When looking at respiration you are interested in the infant's _________ and _______ with _______ activity during ______, _____, and ______.
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When looking at respiration you are interested in the infant's respiratory function and coordination with oral activity during feeding, general movement and sound production.
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Be aware of _______ during respiration.
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breathing pattern
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concerning respiration, phonation, and rib cage patterns
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high rib cage with flaring of lower ribs, sternal retraction, deep breathing-may see rectus and poor mobility of rib cage
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if they have been on a ventilator, respirator what sould you find out
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how long--you will see a high and rigid shoulder girdle-respirators did not create active trunk musculature
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why would you work with an OT or PT in respiration?
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initially want to increase belly breathing-increase RC mobility, activating diaphragm--also wll work with you on position ing to bring the SG down-increasing downward pull or RC by elongating the muscles between the ribs (intercostals)
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NEVER go right on the _____ during handling, positioning.
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spine
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what should you look at during the oral peripheral exam?
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high vaulted palates-- tubed at birth??? also, lip strength, tongue strength, symmetry, tone, etc. etc.
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IN your observations of feeding you are looking at _____ OM skills and _____ OM skills which include what 5 structures?
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Normal OM skills and limiting OM skills which include jaw, cheeks, lips, tongue, and coordination
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what should you pay attention to in assessing sucking-bottle drinking?
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1)what type of bottle?
2)what type of nipple? 3)rhythmical suck swallow breathe, 4)transitions 5) strength/coordination 6)pathologies observed |
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***any child over ____ with oral problems shouldn't have the botle****
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18 months
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there are many norms on straw drinking, true or false
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false-no norms
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if kids have _____ tone, get them on a _____: good for ______, _____, and ______ to help influence tone during function.
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If kids are low tone, get them on a straw--good for obicularis oris, cheeks, tongue to help influence tone during fucntion
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is straw drinking good for hypertonic kids as well?
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might not be the best method to try but if this will allow them to be independent
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what do you look at in assessing cup driniking
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types of cups used- tippy with lid, spouted- can evaluate several types of cups during diagnostic
lip closure excessive drooling external jaw support types of liquids that can be handled: thin, thick |
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assessing spoon feeding-- 3 things
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1) type of spoon used--appropriateness for size of mouth, shape, depth of bowl,
2) lip function-- both upper and lower lip stability and mobility issues 3)variety of textures accepted from spoon |
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assessing biting and chewing- 5 things
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1) look at various food textures--crunchy, hard-cewy, soft
2)look at both sides of mouth 3)loss of food 4)tongue function to assist with chewing 5)jaw approximation |
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Any medication can be_____. Most often meds will _________ Consult the PDR.
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Any med can be desensitizing, most often meds will dampen the sensory base.
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toxicity
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not due to overdosing but due to decreased movement and smaller amounts of oxygen
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medications may reduce the amount of _______ we can give--________ may be decreased.
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Medications may reduce the amount of therapuetic imput we can give- therapeutic expectations may be decreased.
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If the child is on meds, ask the parents about....
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1) impact it has on appetite
2)impact on OM functioning (tooth brushing, senstivity issues) 3)hyper/hypo trophy of gums 4)hyper/hypo responsiveness to touch and around mouth 5)time of administration and changes before and after |
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After completing the assessment ___________________.
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Organize the observations nd ideas to creae an initial feeding plan hat will help the child and family make changes in the eating patterns.
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Which environments are you considering after completing your assessment
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1) learning environment
2)communication environment 3)physical environment 4)sensory environment |