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NEONATAL

NEONATAL

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Published by: Loggerz Arck on Mar 05, 2011
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02/01/2013

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CONCEPTS OF NEONATAL CARE

Reported by: Genevieve Manrique R.N.

or cardiopulmonary disorders) . jaundice. birth injuries. anomalies.INTRODUCTION A newborn should have a thorough evaluation performed within 24 hours of birth to identify any abnormality that would alter the normal newborn course or identify a medical condition that should be addressed (eg.

twitching . full range of motion.General Appearance of a Normal Newborn: ‡ Well-flexed. spontaneous movement Signs of potential distress or deviations from expected findings: ‡ Posture limp ‡ Asymmetry of movement ‡ Persistent tremor.

and delivery including screening tests and risk factors for sepsis. still births. In particular.HISTORY TAKING ‡ Review of this pregnancy. ‡ A review of maternal medications should be performed . ‡ Review of the mother's and father's medical and genetic history. maternal illnesses prior to and during pregnancy. and/or genetic or syndromic conditions. labor. ‡ Review of past pregnancies including a history of congenital anomalies.

ASSESSMENT ‡ HEART RATE 120-160 ‡ NORMAL RESPIRATIONS 30-60 ‡ NORMAL TEMPERATURE 97.8-99 ‡ NORMAL B/P 80/46 ‡ NORMAL HEAD CIRCUMFERENCE 13-14 IN ‡ CHEST CIRCUMFERENCE 30-33 CM 12-13 IN ‡ LENGTH 18-22 IN ‡ WEIGHT 2500-4000 GM 5-9 LBS .

DOES NOT BLANCH ‡ ‡ ‡ . FOUND NEVUS FLAMMEUS PORT WINE STAINRED/PURPLE. BLANCHES WITH PRESSURE. FOREHEAD ACROCYNOSIS PINK BODIES WITH BLUE EXTREMITIES ERYTHEMA TOXICUM NORMAL NEWBORN RASH BEEFY RED ON ABDOMEN MILLIA SMALL PIN HEAD SIZE PEARLY BALLS ON NOSE TELANGIECTATIC NEVI STORK BITE.ASSESSMENT ‡ ‡ ‡ ‡ VERNIX CASEOSA WHITE CHEESY SUBSTANCE FOUND ON SKIN LANUGO DOWNY FINE HAIR SEEN ON PINNA.

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extent of illness and environmental factors .Introduction Thermoregulation in the neonate is a critical physiological function that is strongly influenced by physical immaturity.

5 kg should be nursed within an enclosed incubator Use of Baby Therm .Peripheral temperature should be recorded hourly Use of Incubator .Any neonate less than 1.Babytherms provide heat by a combination of conduction (from below via a gel mattress) and radiation .GUIIDELINES Monitoring .

>1. who no longer requires close monitoring or intensive care and who can maintain a stable central temperature in 26-28°C room temperature. can be transferred to an open bassinette or small cot. .Use of Open Basinette .5 kg.A well neonate.

i.Signs of Cold Stress: ‡ central temperature < 36. > 2 seconds ‡ increased oxygen requirements ‡ metabolic acidosis ‡ tachycardia ‡ hypoglycaemia ‡ apnoeas ‡ bradycardia .e.5°C ‡ increase in core-toe gap > 2°C ‡ mottled & pale ‡ increased capillary refill time.

5kg in an incubator ‡ Use a baby-therm ‡ Increase the set temperature by 1°C every 15 minutes according to the neonate¶s response ‡ Take their temperature every 30 .60 minutes until warmed to an acceptable temperature .Intervention to Cold Stress: ‡ Place a neonate of < 1.

over exposure.g. wet bed. e. handling ‡ Promote a flexed position ‡ Ensure ventilator gases are adequately warmed to 37°C .‡ Identify & eliminate any environmental causes.

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Some babies will require special care and spend weeks or months hospitalized in a neonatal intensive care unit (NICU). . It is also known as preterm birth (or less than 37 weeks ² full term is about 40 weeks). Being born premature is also a serious health risk for a baby.Introduction Prematurity is a birth that is at least three weeks before a baby's due date. Prematurity is the leading cause of death among newborn babies.

The lungs. brain. gastrointestinal tract. and immune system are most often affected and pose the greatest risks for causing long-term problems and death .Common Problems of Prematurity Premature babies often have medical problems because their organs and body systems have not developed sufficiently.

8-3.000 gms (1.0011.2511. or NEC) General infection Survival to 120 days or hospital discharge Survival without any of these complications . by Birth Weight Birth Weight: 501750 gms (1.3 lbs) 30-32 22% 4% 1% 6% 3% 7% 96% 90% Complication: Gestational age (weeks) Respiratory distress syndrome Moderate bleeding in the brain (Grade 3) Severe bleeding in the brain (Grade 4) Chronic lung disease Inflammation or death of part of the GI tract (necrotizing enterocolitis.8 lbs) 28-30 36% 6% 3% 15% 6% 17% 94% 79% 1.2 lbs) 26-28 54% 9% 5% 33% 9% 30% 88% 59% 1.250 gms (2.Complications of Very Premature Babies.72.11.2-2.500 gms (2.7 lbs) 24-26 71% 12% 13% 47% 11% 44% 56% 36% 7511.

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