1. Supportive Care

â–º Ongoing assessment
      ♦ Infant, interface, CPAP machine

â–º Feeding considerations

2. Ongoing assessment

Complete assessment: 4-6 hour
Vital signs: 2-3 hour

3. a. Infant monitoring

â–º Appearance: Comfort, color, posture

â–º Vitals: Temperature, HR, RR, SpO₂, BP

â–º CVS: Pulse volume, CRT, urine output, BP

â–º CNS: Activity, tone, responsiveness

â–º GIT: OGT, abdominal distension

â–º Settings: FiO₂, CPAP and flow

4. Respiratory monitoring

SILVERMAN SCORE

5. Optimal positioning

â–º Reposition every 3 to 6 hours

â–º Nesting
      ♦ Promote flexion, containment and comfort

6. Airway monitoring

â–º Note the color, consistency, & quantity of nasal secretions

â–º Suction the mouth, nose and pharynx

â–º Moisten the nares with normal saline or sterile water

7. b. Interface

â–º Prongs fitting snuggly?

â–º Symmetry of nares?

â–º Blanching of skin at nares?

â–º Skin breakdown?

â–º Gap between columella and prongs?

8. Assessing the nasal interface

â–º Is the cap appropriately placed?

â–º Is the nasal interface componenttwisted?

â–º Compress the tip of the nose

9. Assessing skin integrity

â–º Color

â–º Quality of perfusion

â–º Possible areas of pressure or excoriation

10. c. Monitoring CPAP system

11. Humidification

♦ Set the humidifier in invasive mode
♦ Water level correct
♦ No condensation in inspiratory limb
♦ Condensation in expiratory limb

12. Radiologic monitoring

13. Feeding considerations

14. Summary

â–º Monitoring of
      ♦ Infant, interface and CPAP system

â–º Respiratory monitoring

â–º Feeding consideration