As a New NICU nurse, I was so overwhelmed by the amount of medical "jargon" I needed to learn in addition to mastering working at the bedside. Below, I’ve defined a set of common terms we use daily to prepare you for your first few weeks on the job!
While you are in the Neonatal Intensive Care Unit as a new nurse or parent you will hear the doctors & nurses speaking in what seems to be a foreign language. Understanding these words and adapting to this NICU culture can be quite a challenge. I have compiled a list of common terms here to help you in this process!
Common NICU Nursing Terms
When you’re new to working in the Neonatal Intensive Care Unit, you’ll hear members of the medical team using NICU-specific terminology and abbreviations to describe a patient’s status or condition. Understanding the meaning of these terms can be quite a challenge. The list below can help you navigate this process!
A's & B's
An abbreviation referring to episodes of apnea and bradycardia; see APNEA and BRADYCARDIA
ANEMIA
A lab reference signifying that there is a lower than normal number of red blood cells a sample of blood
APNEA
The cessation of breathing for greater than 20 seconds
ASPHYXIA
A condition referring to a lack of sufficient oxygen to the tissues of the body; the brain and the kidneys are the most sensitive organs to low oxygenation and show damage quicker than other body parts
ASPIRATION
Breathing a foreign material (milk/formula, stomach fluids, meconium, etc.) into the lungs
ATTENDING PHYSICIAN
The doctor who is responsible for coordinating the medical care for a patient; in the NICU the attending physician will generally be a neonatologist
“BAGGING”
A slang term used to reference the pumping of air into an infant’s lungs using oxygen and a rubber bag; “bagging” is most often implemented to assist a patient who needs help breathing
BILIRUBIN
A yellow-pigmented waste product that forms when the body naturally eliminates old or damaged red blood cells. It often makes a patient’s skin and eyes look yellow or brown. Premature infants are often put under fluorescent light or a lighted blanket to safely remove bilirubin from the body; see BILI LIGHTS and JAUNDICE
“BILI LIGHTS” or “BILI BLANKET”
This term is used in conjunction with the term phototherapy and refers to the lights used to treat jaundice; see BILIRUBIN and JAUNDICE
BLOOD GAS
This term is shorthand and refers to an arterial blood gas or a venous blood gas. These tests are used to evaluate an infant’s level of blood oxygen, carbon dioxide, and acid. This helps clinicians evaluate an infant’s respiratory status and determine a plan for managing long-term oxygenation
"BLOW BY”: A slang term that refers to the practice of giving a patient a small amount of oxygen by holding an oxygen tube or mask a centimeter or two from an infant’s nose
BP: This is an abbreviation for the term blood pressure and refers to pressure experienced exerted against the walls of the arteries during each pulsation of the heart
"BRADY"
This term is shorthand for the word bradycardia and refers to an infant heart rate below 100; it can also refer to a rapid slowing of a baby’s heart rate, even if the number sits above 100
CARDIOLOGIST
A medical doctor who manages heart functioning
CASE MANAGER
A staff member who collaborates with insurance agencies to clarify the reason for hospital admission and the length of stay required; they also help with discharge planning and arrange for medical equipment required for discharge; when necessary, they also initiate referrals to funding agencies for medically and financially eligible infants; this team member is different from the insurance company case manager who is assigned to customize and individualize benefits for those with extensive or complex health care needs
CBC
This is an abbreviation for the lab test complete blood count; this test the volume of various types of cells present in the blood, chiefly: red blood cells (oxygen-carrying cells), white blood cells (infection-fighting cells), and platelets (clot-forming cells)
CENTRAL CATHETER or CENTRAL LINE
A thin, flexible tube (catheter) placed in a vein or artery to deliver medications, vitamins, and fluids to the body; broviac catheters are usually placed in the upper chest and tunnel under the skin to enter the vena cava; PICC (peripherally inserted central catheter) lines are usually threaded through a vein in the arm to the vena cava; this term also refers to umbilical venous and umbilical artery catheters that are inserted into the vein or artery of the umbilical stump (belly button) shortly after birth
CHEST TUBE
A small plastic tube placed through the chest wall into the space between the lung and chest wall to remove air or fluid from this space; see PNEUMOTHORAX
CHRONOLOGICAL AGE
A baby’s age based on their actual birthday (not considering their gestational age/time in utero)
CIRCUMCISION
Known colloquially as a “circ”, this term refers to the surgical procedure performed to remove the foreskin of the penis; this is usually done just before the baby goes home and is only performed on request
CONGENITAL
Refers to a condition existing at the time of birth
CORRECTED AGE
A baby’s age based on their gestation; this value is calculated by adding the time spent inside and outside of the mother’s uterus
CPAP
This is an abbreviation of Continuous Positive Airway Pressure, a form of ventilator assistance used to keep an infant’s lungs properly expanded; CPAP does not breathe for the baby, but allows the baby to breathe into a "forward moving wind."
CT SCAN (of the head)
This is an abbreviation for the imaging method called computerized tomography; this imaging is usually performed in the NICU to identify skull or brain damage, though CT scans can also be done on other parts of the body; the baby must be transported to the hospital radiology department to get their CT scan
"CULTURE"
This is shorthand for a laboratory test called a blood culture. Here, a collection of blood, spinal fluid, urine, or other specimens identifies the presence and type of germs present in an infant’s blood
CYANOSIS
Blue color of the skin that occurs when there is a lack of oxygen in the blood.
DIFFERENTIAL
A test which divides the white blood cell count (from the CBC) into several categories, chiefly: "polys" (short for polymorphonuclear leukocytes), "bands" (immature "polys"), "lymphs" (lymphocytes), "monos" (monocytes), "cos" (eosinophils), "basos" (basophils); the percentages of each cell type may vary in different kinds of infections and can help establish a plan for treating the infection; for example, polys and bands usually will predominate in bacterial infections, while the number of lymphs usually will increase in viral infections
ECHOCARDIOGRAM
Also known as an “echo”, this term refers to a test used to look at the heart using soundwaves through the chest wall; this is much like an ultrasound done during pregnancy and is neither harmful nor painful to infants
EDEMA
Puffy and inflamed skin that results from a build-up of intra and extracellular fluid in body tissues and spaces
ENDOTRACHEAL TUBE
Commonly referred to as an “ET” tube by NICU nurses, this refers to a plastic tube which goes from the baby's nose or mouth past the vocal cords and into the upper trachea (windpipe); see INTUBATION
EXCHANGE TRANSFUSION
A treatment which removes the baby's blood in small quantities and replaces it with donor blood; this procedure is most frequently used to lower the level of bilirubin in an infant’s blood, but may also be used to raise or lower the number of red blood cells to improve the blood’s clotting ability
EXTUBATION
The intentional or unintentional removal of the breathing tube that goes from the nose or mouth into the trachea; see ENDOTRACHEAL TUBE
FELLOW (in Neonatology)
A trained pediatrician who is receiving additional specialized training in the care of sick newborns (neonatology)
GAVAGE FEEDINGS
Also known as tube feedings, this practice refers to nutrition that travels through a plastic tube inserted through a baby’s mouth or nose and into the stomach; this is used to nourish extremely premature newborns or babies who are too weak to suck and swallow
GENETICS
The branch of medicine that deals with heredity and the variation of individuals; these doctors can provide family members with a prognosis for development and function, and assess for risks of recurrence of certain genetic conditions
HEAD ULTRASOUND
An imaging technique that uses sound waves to look at a baby’s brain; this painless test can be done at the NICU bedside and is often completed while a baby is sleeping
HEART MURMUR
A rushing sound made by the blood within the heart, usually heard with a stethoscope
HEELSTICK
A quick prick of the heel with a sharp needle to obtain small blood samples for tests; this is the method of blood collection for a blood sugar or capillary blood gas
HEMATOCRIT
Known casually as a “crit”, this lab test is completed to determine the amount of red blood cells in a patient's blood
HIGH-FREQUENCY OSCILLATORY VENTILATOR
Casually referred to as an oscillator, this special ventilator provides breaths at a rate that exceeds the maximum rate of a normal ventilator
HYDROCEPHALUS
An abnormally large accumulation of cerebrospinal fluid (the fluid which bathes the brain and spinal cord) in the ventricles of the brain
HEAD ULTRASOUND (HUS):
A painless test that uses sound waves to look at a baby’s brain. This test can be done at the bedside in the NICU.
"HEEL STICK”: A slang term often used in the NICU meaning, to obtain a blood sample by pricking the baby’s heel.
HIGH-FREQUENCY OSCILLATORY VENTILATOR
A special ventilator capable of breathing for a baby at rates exceeding those of a normal ventilator.
HYPOTENSION
Low blood pressure; while there is now standard value used to identify hypotension, this term usually refers to a blood pressure reading that falls below the 5th or 10th percentile for the infant's gestational age, postnatal age, and weight
HYPOGLYCEMIA
A low amount of sugar (glucose) in the blood; this value will be different for each infant, but can generally refer to any blood glucose of less than 40 mg/dL
"I's and O's”
A slang abbreviation often used in the NICU to refer to the amount of fluid a baby takes in compared to how much the baby pees and poops out; this is why NICU nurses document all diaper weights
I:E RATIO
The ratio of the length of the forced breath provided by a ventilator to the length of the time between two breaths
INFILTRATE
The inappropriate accumulation of IV fluid in body tissues; this most often occurs when an IV is misplaced or falls out of the vein
INSPIRATORY TIME
Casually called “i-time” by NICU nurses, this value refers to the length of a forced breath provided to a baby by a ventilator
INTRAVENOUS LINE
Casually called an IV by NICU nurses, this is a small plastic tube or hollow needle placed into one of the baby's veins, used to infuse fluids, medications, and vitamins can be given when a baby cannot take all of their nourishment by feedings
INTRAVENTRICULAR HEMORRHAGE (IVH)
A collection of blood in and around the ventricles (hollow portions) of the brain
INTUBATION
The insertion of a tube into the trachea (windpipe) through the nose or mouth to allow air to reach the lungs; see ENDOTRACHEAL TUBE
ISOLETTE
Sometimes referred to as an incubator, this is a type of enclosed bed for an infant who is not mature or healthy enough to maintain their body temperature in an open crib
JAUNDICE
A yellow coloration of the skin and eyes that results from an increased amount of bilirubin in the blood; treatments for jaundice include phototherapy and (rarely) exchange transfusion; see EXCHANGE INFUSION and BILIRUBIN and BILI LIGHTS
KANGAROO CARE
A cute way to describe skin-to-skin care where the baby is placed on the bare chest of the mother or father for comfort
LUMBAR PUNCTURE
Sometimes called a "spinal tap, this procedure involves a small needle being placed in the small of the back, between the vertebrae (back bones), to obtain spinal fluid for bacterial cultures and other lab tests
MECONIUM
The first bowel movements that a baby has; these are thick, sticky, and range from dark green to black in color
MECONIUM ASPIRATION (Meconium Aspiration Syndrome or MAS)
The inhalation of meconium into the lungs; if a baby passes meconium before delivery, the meconium may be inhaled into the lungs, causing problems with breathing after the baby is born; this condition is called meconium aspiration syndrome (MAS)
MENINGITIS
An infection of the fluid that cushions and surrounds the brain and spinal cord
MONITOR
A screen that displays the heart rate, respiratory rate, blood pressure and blood oxygen saturation of the baby
MRI (Magnetic Resonance Imaging)
A computerized method of viewing any portion of the body. It uses magnetism rather than x-rays. All metal must be removed from around the baby. The baby must go to another area of the hospital to have an MRI.
NASAL CANNULA
A clear plastic tube which passes under the nose to provide supplemental oxygen.
NECROTIZING ENTEROCOLITIS (NEC)
An infection of the wall of the intestines, which may spread to the blood; premature babies are particularly vulnerable to this disease; surgery is sometimes necessary to remove damaged intestine, and the baby may need prolonged IV nutrition until he recovers; see also PARENTERAL NUTRITION and SEPSIS
NEONATOLOGY
The medical specialty that focuses on managing diseases and conditions of newborn infants (neonates); neonatologists are pediatricians who have received several years of additional specialized training
NEPHROLOGIST
A medical doctor who specializes in disorders of the kidneys
NEUROLOGIST
A medical doctor who specializes in the brain and nervous system
NPO
A Latin abbreviation for “nothing by mouth”; if the baby is kept NPO, all nutrition will need to be given intravenously
OPHTHALMOLOGIST
A medical doctor who specializes in managing eye disorders
OTOLARYNGOLOGIST
A medical doctor who specializes in conditions of the ear, nose, and throat
PARENTERAL NUTRITION (Total Parenteral Nutrition or TPN)
Protein, fats (lipids), sugars, and salts are provided by IV to babies who cannot tolerate complete feedings by bottle or gavage
PATENT DUCTUS ARTERIOSUS (PDA)
A small vessel that allows blood to bypass the lungs; this vessel is open while the baby is in the womb, but normally closes shortly after delivery; if the vessel fails to close on its own, special medication or surgical intervention may be required
PEAK INSPIRATORY PRESSURE (PIP)
The highest pressure that is delivered to the baby by the ventilator during a forced breath
PEDIATRICIAN
A medical doctor who provides care to infants and children
PERIPHERALLY INSERTED CENTRAL CATHETER (PICC LINE)
A PICC is a line inserted through a vein and then advanced through increasingly larger veins, toward the heart; these are placed when IV therapy, antibiotics, or nutrition (TPN/lipids) are administered for a long period of time
PHOTOTHERAPY
Light therapy to treat jaundice; bright blue fluorescent lights called bili lights are placed over the baby’s incubator or around the baby as a lighted blanket; see also BILIRUBIN and JAUNDICE.
PKU
A rare disorder in which one of the amino acids (a building block of protein) cannot be handled normally by the baby, leading to elevated levels in the blood; babies with PKU require a special diet; all babies are routinely tested for PKU before discharge from the hospital; this test is required by law
PNEUMOMEDIASTINUM
Leakage of air from the normal passageways of the lung into the space surrounding the heart; a pneumomediastinum is usually harmless, but can be associated with a pneumothorax which is often more serious; see PNEUMOTHORAX
PNEUMOTHORAX
A collapsed lung causes a collection of air to form in the space around the lungs; this buildup of air puts pressure on the lung, so it cannot expand normally when a baby tries to breathe
POSITIVE END-EXPIRATORY PRESSURE (PEEP)
The lowest pressure that is delivered by the ventilator to the baby between forced breaths; see also PEAK INSPIRATORY PRESSURE (PIP)
PROGNOSIS
What health outcomes are expected for a baby given the nature of their condition
PKU
A rare disorder in which one of the amino acids (a building block of protein) cannot be handled normally by the baby, leading to elevated levels in the blood. Babies with PKU require a special diet. All babies are routinely tested for PKU, as well as several other disorders, before going home from the nursery. This test is required by law.
PNEUMOMEDIASTINUM
Leakage of air from the normal passageways of the lung into the space surrounding the heart inside the chest. A pneumomediastinum is usually harmless in itself, but is often associated with a pneumothorax (which can be life-threatening if large). See PNEUMOTHORAX.
PNEUMOTHORAX
Leakage of air from the normal passageways of the lung into the space surrounding the lung inside the chest wall, causing a partial or complete collapse of the lung.
POSITIVE END-EXPIRATORY PRESSURE (PEEP)
The lowest pressure that is delivered by the ventilator to the baby between forced breaths. See also PEAK INSPIRATORY PRESSURE (PIP).
PROGNOSIS
What health outcomes are expected for a baby given the nature of their condition
RED BLOOD CELLS
The cells in the blood which carry oxygen
REFLUX
A return or backward flow of fluid; gastroesophageal reflux (GERD) occurs when feedings or other stomach contents flow back up into the esophagus
REGIONAL CENTER
A network of state-funded agencies that help to coordinate community services and resources to infants at risk of having a developmental delay; these teams also provide services and coordinate resources for children and adults with specific developmental disabilities
RESIDENT
A medical doctor who is training to become a pediatrician; a residency program is usually three years long; first year residents are referred to as interns; third year residents are called senior residents
RESPIRATORY DISTRESS SYNDROME (RDS)
A common breathing problem of premature infants caused by insufficient levels of surfactant in the lung; this results in an excessive stiffness of the baby's lungs; see also SURFACTANT
SEIZURE
A "short circuiting" of the electrical activity in the brain, which can cause involuntary muscle activity or stiffening
SEPSIS
A potentially fatal and dangerous condition during which the body is fighting a severe infection that has spread to the bloodstream; see also MENINGITIS and NECROTIZING ENTEROCOLITIS.
SEPTIC WORKUP
An assortment of tests is performed on an infant who is suspected of having an infection; this may include a chest x-ray and/or abdominal x-ray, as well as blood, urine, and spinal fluid cultures; because infections in babies can progress very rapidly, the baby is frequently started on antibiotics until the results of the cultures are known
SUCTIONING
The process of removing secretions from the baby’s nose, mouth or lungs by using either a bulb syringe or suction catheter
SURFACTANT
A substance secreted by special cells within the alveoli (air sacs) of the lung that makes the lung flexible and keeps it from collapsing; surfactant deficiency is the main cause of Respiratory Distress Syndrome (RDS); commercial products are available which can be put into the lungs through the tube in the windpipe; these products are frequently used to treat RDS in a premature baby
TACHYCARDIA: A fast heart rate
TACHYPNEA: A fast breathing rate
TRACHEOSTOMY
A surgical opening in the trachea, below the larynx (voice box) that allows air to enter the lungs
TRANSFUSION
Giving donor blood to a baby by IV infusion
UMBILICAL CATHETER
A small plastic tube in one of the umbilical (belly button) blood vessels (either an artery or a vein).
WEAN
To take away gradually; in the NICU, this term is often used to describe the process of removing an infant from a ventilator or incubator
Want to Ensure a Strong Start to Your NICU Career?
Now that you’re familiar with the NICU lingo, you might be looking for more ways to prepare for your first nursing job. At NICUity, we have all of the educational resources you need to ensure your first shift is a great experience!
HEAD OVER TO THE PODCAST!
EPISODE 1 & 2 ANSWER MANY NICU 101 QUESTIONS!
Another great resource for you BELOW. I was featured on The Morning Rounds and talked all things NICU Nursing. Dynamics, my personal journey, NICU Nurse Tips & Tricks!
NICU Nurse Essential Resources
March of Dimes! Resources for parents & providers
Tori Meskin MSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com
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