CCRN-K Neonatal key terms

A pause in breathing lasting 20 seconds or more, or any shorter pause accompanied by bradycardia or oxygen desaturation, caused by an immature respiratory control center in infants born before term.

A heart rate below 100 beats per minute in a preterm infant, usually triggered by apnea, hypoxia, or vagal stimulation, and often resolving with gestational maturation or treatment of the underlying cause.

A drop in oxygen saturation below the alarm limit set for the infant, commonly below 85 to 90 percent, prompting assessment of airway, breathing effort, oxygen delivery, and possible intervention.

A methylxanthine given to preterm infants to stimulate the respiratory center, reduce apnea and bradycardia, and decrease the need for mechanical ventilation and extubation failure.

A condition of preterm infants caused by surfactant deficiency, producing grunting, retractions, tachypnea, and low oxygen levels, treated with surfactant replacement and respiratory support.

Instillation of exogenous surfactant into the trachea to lower alveolar surface tension, improve lung compliance, and reduce the severity of respiratory distress syndrome in premature infants.

Noninvasive respiratory support that delivers a steady distending pressure to keep alveoli open, reduce work of breathing, and prevent atelectasis, commonly used for apnea and respiratory distress.

A set pressure maintained in the airway at the end of exhalation during mechanical ventilation, intended to keep alveoli recruited and improve oxygenation while avoiding overdistension.

Placement of a tube through the mouth or nose into the trachea to provide a secure airway for ventilation, surfactant administration, or airway protection in a critically ill neonate.

Respiratory distress in a newborn who inhaled meconium before or during birth, causing airway obstruction, inflammation, and poor gas exchange, sometimes requiring ventilation or extracorporeal support.

Failure of the pulmonary vascular resistance to fall after birth, causing right-to-left shunting, severe hypoxemia, and labile oxygenation, often treated with inhaled nitric oxide or high-frequency ventilation.

A vasodilator gas delivered to the lungs to relax pulmonary vasculature and improve oxygenation in newborns with pulmonary hypertension, with monitoring for methemoglobinemia and rebound effects.

A calculated score combining mean airway pressure and fraction of inspired oxygen relative to arterial oxygen pressure, used to grade respiratory failure severity and guide decisions about advanced therapies.

Chronic lung disease of prematurity marked by ongoing oxygen or respiratory support at a defined postnatal age, resulting from injury and impaired alveolar and vascular development.

Continued patency of the fetal vessel connecting the aorta and pulmonary artery after birth, which can cause pulmonary overcirculation, widened pulse pressure, and difficulty weaning from ventilation.

A prostaglandin inhibitor used to close a hemodynamically significant patent ductus arteriosus, requiring monitoring of urine output, renal function, and gastrointestinal bleeding risk.

An infusion that keeps the ductus arteriosus open to preserve pulmonary or systemic blood flow in ductal-dependent congenital heart lesions until surgical or catheter intervention.

A congenital heart defect in which survival depends on blood flowing through the ductus arteriosus, so closure causes rapid deterioration and prostaglandin therapy is needed.

A group of congenital cardiac defects producing right-to-left shunting and low systemic oxygen levels, often presenting with cyanosis that does not fully respond to supplemental oxygen.

A diagnostic maneuver measuring arterial oxygen after breathing high-concentration oxygen, helping distinguish cyanosis caused by lung disease from cyanosis caused by a fixed intracardiac shunt.

An inflammatory bowel disease of preterm infants causing feeding intolerance, abdominal distension, bloody stools, and risk of perforation, managed with bowel rest, antibiotics, and sometimes surgery.

Small-volume enteral feedings given to stimulate intestinal maturation and motility in preterm infants while total nutrition is provided parenterally, advanced as tolerance allows.

Intravenous delivery of carbohydrates, amino acids, lipids, and additives to provide complete nutrition when the immature or diseased gut cannot absorb adequate enteral feeding.

Elevated serum bilirubin in a newborn that can cause jaundice and, at extreme levels, bilirubin encephalopathy or kernicterus, treated with phototherapy or exchange transfusion.

Treatment using blue-green light to convert bilirubin in the skin into forms that can be excreted without conjugation, with attention to eye protection, hydration, and irradiance.

Removal and replacement of the infant's blood in small aliquots to rapidly lower bilirubin or correct severe anemia, used when phototherapy fails or kernicterus risk is high.

Permanent neurologic injury from bilirubin deposition in the basal ganglia and brainstem, producing movement disorders, hearing loss, and gaze abnormalities after severe untreated jaundice.

A blood glucose concentration below the accepted treatment threshold for the infant's age and risk category, which can cause jitteriness, lethargy, apnea, or seizures if not corrected.

Elevated blood glucose common in very preterm infants because of immature insulin regulation and stress, sometimes requiring reduced glucose infusion or insulin therapy.

Bleeding into the germinal matrix and ventricles of the premature brain, graded by severity, with risk factors including prematurity, unstable blood pressure, and respiratory distress.

White matter injury near the ventricles of the preterm brain caused by ischemia or infection, a major contributor to cerebral palsy and later motor impairment.

Enlargement of the ventricles and increased head circumference after severe intraventricular hemorrhage, when blood products obstruct cerebrospinal fluid flow and absorption.

Controlled cooling of a newborn with hypoxic-ischemic encephalopathy to about 33.5 degrees Celsius for 72 hours, started soon after birth, to reduce brain injury and mortality.

Brain injury from reduced oxygen and blood flow around birth, staged by clinical exam and neurologic signs, and managed with supportive care and therapeutic hypothermia when criteria are met.

A simplified bedside brain monitoring method displaying a compressed tracing used to detect seizures and assess background activity in newborns with suspected encephalopathy.

A withdrawal syndrome in newborns exposed to opioids or other substances before birth, marked by irritability, tremors, poor feeding, and autonomic signs, scored and managed with comfort measures or medication.

A standardized tool that rates signs of neonatal withdrawal to guide nonpharmacologic care and decisions to start, adjust, or wean medication such as morphine.

A function-based care method for infants with antenatal substance exposure that emphasizes feeding, rest, and soothing, reserving medication for infants who cannot function despite comfort measures.

Skin-to-skin contact between a parent and infant that supports thermoregulation, breastfeeding, bonding, and stability of heart rate, breathing, and oxygen saturation.

Care practices that reduce stress and support neurodevelopment by clustering handling, dimming light and noise, positioning the infant, and involving parents in caregiving decisions.

A framework of observation and caregiving strategies that adapts handling, positioning, and sensory input to the infant's behavioral cues and tolerance for interaction.

An approach that treats parents as essential members of the care team, supporting their presence, participation in rounds and caregiving, and shared decision-making in the neonatal intensive care unit.

A collaborative process in which clinicians and parents exchange information about benefits, risks, and values and jointly choose a care plan, especially when outcomes are uncertain.

Permission obtained after explaining a procedure's purpose, benefits, risks, alternatives, and right to refuse, using language the parent or guardian can understand.

Noninvasive monitoring of arterial oxygen saturation using light absorption through tissue, with attention to probe placement and signal quality to avoid misleading readings.