Back Off, Mom!

I visited Henry this morning. Gene was his day nurse again. Henry looked quite comfortable. His oxygen level was in the 30s. His oxygen saturation levels were good. For the most part, they were in the high 90s. He did a little sat surfing, but not enough to set off the alarms. His respiration and heart rate also looked good.

The lasix continues to do its job. His previous diapers were adequate but rather low in the weight department. Gene showed me the diaper weights over the last few cares, and they looked much improved since he started taking the lasix yesterday.

I tried to keep to the "Let sleeping Henry lie" rule. But when I saw him wiggle and drop his sats to 92%, I decided to touch his hand. He immediately gave me the "Back off!" signal. His hands arms shot up in the air and crossed slightly, shielding his face. This is one of the preemie signals indicating that they do not want to participate in activity. So, I closed up the isolette and just watched him.

Preterm babies communicate their needs differently than do full term babies. There are several behavioral cues that let their caretakers know that they are ready or do not want to interact. Since they still have a lot of developing to do, it is easy to overstimulate them, so it is very important to pay attention to the "Leave me alone. I need my rest." cues.

Often during cares, preemies get agitated because the cares can be very stimulating (often too stimulating for their systems). Desating during cares is pretty common. Other cues include:
* coughing, sneezing, and/or hiccuping
* changing color (when Henry's mad, he turns dark purple)
* irregular breathing
* changes in heart rate
* abrupt moments of the arms and legs way from the body and then back to the midsection
* quivering or twitching
* becoming hypertonic (body becomes stiff or rigid)
* becoming hypotonic (body becomes limp)
* both arms and/or both legs shooting straight up in the air
* high arm position (the use of the hands and arms to shield the face in a self-protecting matter)
* splayed fingers (fingers extended and separated)
* tightly clinched fists

My mom came into the NICU just as I was leaving. I become more relaxed knowing that my family comes into watch him.