NICU Critical Thinking Experiences

I started this thread to share NICU bedside Critical Thinking (CT) experiences. I believe that we can learn from these experiences as we all come across different scenerios with our babies everyday. Please feel free to share your CT experiences. Thank you!

1. Do not place a pulse oximeter on a PICC line dressing. Reason: The light from the pulse ox will melt the dressing and as you take the pulse ox off the dressing will come up resulting in breaking sterility.

2. If an infant is in an open crib and body temperature is on the low end. Make a blanket nest to help increase and maintain body temperature.

3. If an infant has a g-tube and is on continous feed. No need to check residuals unless there is an order.

4. If an infant has a PIV and the rate of the fluid is < 0.5. Flush the IV to verify patency and that the site is not infiltrated. Reason: When the rate is running that slow the pumps will not recognize an occlusion.
Number 2: if they are in anopen bassinet, you should be implementing safe sleep. No rolls, etc. Number 5: what would be running thru there at such a slow rate, and if it a number of meds that do run that slow, you wouldn't want to push them and bolus the kid (ie fentanyl, versed, vasopressors, etc)