Foundations of Neonatal Care Cardiac
Objectives Describe the anatomic and physiologic transition from fetal to neonatal circulation. List the diagnostic tests to be ordered for an infant with a cardiac condition. Describe three clinical presentations of cardiac conditions. Explain the nursing care required for an infant with a cardiac condition. Describe post–cardiac surgery nursing care. Identify nursing considerations for the administration of common cardiac medications.
Physiology
Embryology of Cardiac Conditions Cardiac tube develops; primitive heart structures form Atrial and ventricular septa form; endocardial cushions form the atrioventricular valves Great vessels including aorta and branches, septum, and semilunar valves form Weeks gestation 4 weeks 8 weeks Ventricular septal defect, atrial septal defect; endocardial cushion defect; stenosis, atresia, absence, or deformation of the tricuspid and mitral valves Truncus arteriosus, tetralogy of Fallot, pulmonary/aorta valve atresia or stenosis, transposition of great vessels Corrected transposition, dextrocardia Embryology of Cardiac Conditions
Fetal Circulation Reprinted with permission of greystone.net.
Neonatal Circulation Reprinted with permission of greystone.net.
Nutritional & Metabolic Foundations of Neonatal Care Nutritional & Metabolic
Objectives List the normal values for blood pH, carbon dioxide (CO2), and bicarbonate (HCO3) for interpreting blood gases. Write the formula for calculating total fluid intake. Explain the nursing considerations for oral and enteral feeding. Explain the nursing care for an infant with a fluid or electrolyte imbalance.
Physiology
Electrolyte Physiology Ca+ Ca+ Na+ Na+ Na+ Na+ K+ Mg+ Na+ Na+ Mg+ K+ K+ Ca+ Na+ K+ K+ K+ Na+ Na+ K+ K+ K+ Mg+ Inside cell Outside cell
Acid-Base Balance Acid-base regulation Acid-base imbalances Chemical buffering Respiratory system Kidneys Acid-base imbalances Acidosis pH <7.35 Alkalosis pH >7.45 Compensation Minimize pH changes
respiratory alkalosis Acid-Base Balance pH pCO2 / HCO3 Acid-base disorder Compensation low high pCO2 respiratory acidosis high HCO3 high low pCO2 respiratory alkalosis low HCO3 low low HCO3 metabolic acidosis low pCO2 high high HCO3 metabolic alkalosis high pCO2 pH 7.20 7.40 pH 7.60 Acidic Alkalotic