Normal and The High Risk Newborn Transition to Extra-Uterine Life

Slides:

Advertisements

Similar presentations

Nancy Pares, RN, MSN Metro Community College

Advertisements

Neonatal Physiology Tulane Pediatric Surgery. Topics  Fluids and Electrolytes  Cardiopulmonary  Temperature Regulation  Jaundice  Host Defenses 

Fetal Monitoring RC 290 Estriol By-product of estrogen found in maternal urine –Production requires functional placenta and fetal adrenal cortex Levels.

High Risk Newborn Mary L. Dunlap MSN, APRN Fall 10.

High Risk Neonatal Nursing Care

Neonatal Jaundice By Dr. Nahed Al-Nagger

Respiratory Distress Syndrome

Transition and Stabilization of the Newborn Letha Nix RNC.

Neonatal Nursing Care: Part 3 Nursing Care of Normal Newborn

Physiology of the Newborn

Chapter 4: Prenatal development, birth, and newborns’ readiness for life. Dr. Pelaez.

High-risk newborn. high-risk newborn Identification of high-risk newborns The high-risk neonate :can be defined as a newborn, regardless of gestational.

HIGH RISK NEWBORN: GOALS, CONCEPTS, PRINICPLES, ASSESSMENT

by Dr. Nahed Said El Nagger

Sue Ann Smith, MD Neonatologist Doernbecher Neonatal Care Center

Newborn Nutrition Dr. Twila Brown. Newborns’ Nutritional Needs Calorie requirements 105 to 108 kcal/kg/day Fluid requirements 140 to 160 mL/kg/day Weight.

Infant Of Diabetic Mother LALEH GHANEI,MD, Endocrinology Fellow,Endocrinology Research Center Taleghani Hospital.

The Infant of a Diabetic Mother Islamic University Nursing college.

Respiratory Distress Syndrome

THE “LATE PRETERM” Newborn Not Ready for “Term Time” Mary Johnson RNC/MSN Gwinnett Medical Center.

Lectur 7 Clinical aspects of Maternal and Child Nursing NUR 363.

Prematurity Module AnS 536 Spring What is Prematurity? Prematurity is defined as less than 37 weeks of gestation in humans Prior to 32 weeks is.

INTRAUTERINE GROWTH RESTRICTION

Neonatal Jaundice Hyperbilirubinemia Fred Hill, MA, RRT.

Neonatal Assessment RC 290.

Lauren Platt. BIRTHWEIGHT VARIATIONS Appropriate for gestational age (AGA) – weight within 10 th – 90 th percentile (lowest morbidity and mortality rates)

The Normal Newborn: Needs and Care. Assessment Data: Condition of the Infant Apgar scores at 1 and 5 minutes Resuscitative measures Physical examination.

Quality Education for a Healthier Scotland Multidisciplinary Neonatal Jaundice Promoting multiprofessional education and development in Scottish maternity.

Neonates Dr.I.Lakshminarayana. Structure Normal new born Adaptation to extra uterine life Nutrition Maintaining temperature Common neonatal problems Neonatal.

Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children,

Rafat Mosalli MD Abnormal Gestation. Objectives What is Normal gestation? What is Normal gestation? Newborn classification according to age and Weight.

FEEDING LOW BRITH WEIGHT/ PRETERM INFANTS RACHEL MUSOKE (UON) FLORENCE OGONGO (KNH) KNH/UON SYMPSIUM 10 TH JAN

The Neonate. Plan for session Size and Gestation Changes at birth Common Neonatal Problems Neonatal Checks.

Premature Babies Brooke Jensen. Introduction Preterm death is the leading cause of death among newborns. Prematurity is a growing, serious problem in.

Respiratory Distress Syndrome (RDS)

Respiratory Distress Syndrome Hyaline Membrane Disease

Introduction to the Child health Nursing and Nutritional Need Lecture 1 1.

Newborn infant By : Dr.Sanjeev. Thermal protection in newborn Due to reduced subcutaneous and brown fat Brown fat : - Site : adrenal glands, kidneys,

Physiologic and Behavioral Adaptations of the Newborn

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins The Normal Newborn Chapter 12.

The Biophysical Profile uses Ultrasound to determine fetal well being. These five parameters are assessed: Amniotic Fluid Tone Respiratory Movement Body.

Nursing Care of the Newborn and Family

Nursing Care of newborn

The Small for Gestational Age Infant

Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children,

Introduction to the Child health Nursing and Nutritional Need

Nursing Care of newborn Newborn Priorities

Nursing Care of newborn

Nursing Management of the Newborn

Dr.Bahareh Imani Assistant Professor Of Pediatrics-MUMS

RESPIRATORY DISTRESS SYNDROME IN NEONATES

Prematurity Lec. 6 Dr. Athl Humo

DEFINITION Respiratory problem in premature babies

Multiple Gestation Brooke Bracy, JB Kagabo, Danielle Loomis, Kristen Osip, & Jillian Queen.

Nursing care of the high-risk newborn and family

High Risk neonatal nursing

Dr. Madhavi Karki.

The Late Preterm Infant

Gestational Diabetes Lab 4.

Neonatal Nursing Care Neonatal Complications

WHO recommendations on interventions to improve preterm birth outcomes

Intrauterine Growth Restriction (IUGR). OTHER NAMES DYSMATURITY. SMALL FOR DATE. CHRONIC PLACENTAL INSUFFICIENCY.

CHAPTER 54 NEWBORN CARE Part 2.

Low birth weight By : - dr . sanjeev.

Nutrition in Premature Infants 3/17/10

Presentation transcript:

Normal and The High Risk Newborn Transition to Extra-Uterine Life Prof. Carole A. Devine RN.MSN.

Respiratory System: Initiation of Breathing Successful Transition: Pressure Changes in Lungs S/S of Respiratory Distress Prevention of Aspiration /Airway Management Prof. Carole A. Devine RN.MSN.

Meconium Aspiration Syndrome Can Cause Severe Respiratory Distress in Three Ways: Inflammation Obstruction Decreased Surfactant Production Outcome= Hypoxia and CO2 Retention and Possible Pneumonitis Prof. Carole A. Devine RN.MSN.

Meconium Aspiration Syndrome Cont. Assessment Therapeutic Management Prognosis Complication Prof. Carole A. Devine RN.MSN.

Immune System/Integumentary System Prevention of Infection Safety Issues/Newborn Care Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. Sepsis Neonatorum Definition: Transmission/Etiology Types: Early Onset vs Late Onset S/S Management Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. THERMOREGULATION Necessity of A Neutral Thermal Environment Too Hot = Must decrease metabolism to cool their body Too Cool =Must Increase Metabolism to stay warm This effects the Preterm Baby especially Because: Has a large surface area per pound of body Wt. Extended body rather than flexed Decreased subcutaneous fat Poor Muscular Development Limited amt. of brown fat Prof. Carole A. Devine RN.MSN.

Thermoregulation Cont. Maintain a Neutral Thermal Environment/Prevent Hypothermia Newborn Care: Drying Infant after Birth Cover Head Use A Heated Radiant Warmer Kangaroo Care Breast Feeding !!!! Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. Endocrine System Potential Risk for Hypoglycemia Definition of Hypoglycemia for a Newborn: Glucose < 30-40 during first 72 hrs. of life in full term infant Problem/S/S Newborn Care: Prof. Carole A. Devine RN.MSN.

Cardiovascular /Hematopoietic System Potential Risk For Hemorrhage/ Cardiovascular Compromise Newborn care: Administer Vitamin K (Phytonadione) give 0.5mg -1.0 mg IM in the Vastus Lateralis Muscle at birth V.S. every 15 min. after birth for one hour, then every ½ hour x 2,then every two hours until stable Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. Renal /G.I.System Potential for Inadequate Elimination Patterns Newborn Care: Daily Wt. Nutrition /Fluid and Electrolyte Balance Premie.Vs Full Term: Calorie Concentration in formula fed Infants will be different i.e. Full Term = 20 cal./fl. ounce Premie. = 24 cal./fl. ounce Breast Feeding: Advantages Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. Hepatic System Bilirubin Hyperbilirubinemia ( Jaundice): Definition: Conjugated vs. Unconjugated: Unconjugated =Fat soluble=Indirect Conjugated = H2O soluble=Direct Etiology/Normal Conjugation of Bilirubin: S/S Complications Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. Types of Jaundice Physiologic Onset : occurs on the 2-3rd day of life Cause: Bili. Level: <10-12 Tx. Encourage feeding and elimination Pathologic: Onset: during first 24 hrs. of life Cause: Bili. Level: 13 and> in full term; 15 in Premie Tx. Phototherapy i.e. (Bili-lights) Exchange Transfusions Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. Jaundice (Cont.) Breast Milk Jaundice: Onset: Between the 4 -7th day after Birth Bilirubin Levels Can peak at two weeks up to 15-20 Causes: Tx. D/C Breast Feeding temporarily for 24-48 hrs. and place infant in a sunny window Prof. Carole A. Devine RN.MSN.

Gestational Age Assessment Indicators of Maturity in the Newborn Dubowitz and Ballard Scales are used to Determine Categories: SGA (small for Gestational Age) IUGR (Intrauterine Growth Restriction) VS LGA (Large for Gestational Age) (Macrosomia) Prof. Carole A. Devine RN.MSN.

Small for Gestational Age Neonates (SGA) Definition/Appearance: Etiology: Diagnosis: Risk Factors/Common Cause: Nursing Management: Developmental Outcome: Prof. Carole A. Devine RN.MSN.

Large For Gestational Age Neonate (LGA) Definition/Appearance: Etiology: Diagnosis: Risk Factors/Common Cause: Nursing Management: Developmental Outcome: Prof. Carole A. Devine RN.MSN.

The Premature (Preterm) Infant Criteria/Definition: Wt. <2500G ( 5 1/2 lbs ) at Birth Infant born between the 20th week and <end of 37th week Gestation General Appearance: Small and underdeveloped Head is large General Appearance cont: Ruddy skin-little subcutaneous fat Veins are readily noticeable Extensive lanugo with little vernix Little or no creases on sole of foot Prof. Carole A. Devine RN.MSN.

Collaborative Problems of the Preterm Infant Respiratory Distress Syndrome (RDS) Definition/Etiology Underdevelopment of lungs Chief feature= fibrous membrane formed by exudate of infant’s blood that forms lining of respiratory tract (prevents exchange of CO2 and O2) Problem: decrease production of Surfactant L/S ratio is low (Lecithin/Sphingomyelin) Management Prevention Prof. Carole A. Devine RN.MSN.

Collaborative Problems Cont. Broncopulmonary Dysplasia (BPD) Etiology/Incidence S/S Management Prof. Carole A. Devine RN.MSN.

Peri/Intraventricular Hemorrhage (PVH)(IVH) Etiology Incidence: S/S Diagnosis Management Prof. Carole A. Devine RN.MSN.

Necrotizing Entercolitis Etiology/Incidence S/S Diagnosis Management Prof. Carole A. Devine RN.MSN.

Retinopathy of Prematurity (ROP) Definition/Etiology: S/S: Management: Prevention: L/T. Consequences Prof. Carole A. Devine RN.MSN.

Prof. Carole A. Devine RN.MSN. Post Term Infant Definition: Gestational age > than 42 weeks Factors assoc. with Post Term: Aging Placenta Oligohydramnios CPD (Cephalopelvic Disproportion) MAS Factors Cont. Hypoglycemia Polycythemia Thermoregulation Appearance Therapeutic Management Prof. Carole A. Devine RN.MSN.

Infant of a Diabetic Mother Appearance: Etiology: Complications: Management: Prof. Carole A. Devine RN.MSN.

Prenatal Drug Exposure Risk Factors: Effect on Fetus/Newborn: Neonatal Abstinence Syndrome Management/Nursing Care Alcohol Heroin Cocaine PCP Marijuana Caffeine Nicotine Prof. Carole A. Devine RN.MSN.

Torch Infections That Effect The Fetus/Newborn S/S; Nursing Dx.; Management (see handout) T=Toxoplasmosis O=Other: Gonorrhea Syphilis Varicella Hepatitis B Virus HIV R= Rubella C=Cytomegalovirus (CMV) H=Herpes Simplex Virus (HSV) Prof. Carole A. Devine RN.MSN.

Parenting Issues with a High Risk Newborn NSG.DX. High Risk for Altered Parenting R/T Impaired Parent/Infant Bonding Promote Bonding Emotional support Fetal Demise Nursing Responsibilities Care of Infant Care of Family Prof. Carole A. Devine RN.MSN.

THE END Of THE STORY ! ! For Now…… Prof. Carole A. Devine RN.MSN.