INTRODUCTION

Researchers conducted a study about a pediatric patient who is diagnosed with neonatal sepsis.
Sepsis or septicemia refers to a generalized bacterial infection in the bloodstream. Neonates are
highly susceptible to infection as a result of diminished specific (humoral) and nonspecific
(inflammatory) immunity. Because of infant's poor response to pathogenic agents, there is
usually no local inflammatory reaction at the portal of entry to signal an infection.

This patient was delivered full term yet the mother had her BOW ruptured right before she was
admitted at the delivery room. She had to undergo emergency CS to assist in the cervical
dilation. Sepsis in the neonatal period can be acquired prenatally across the placenta from the
maternal bloodstream or during labor from ingestion or aspiration of infected amniotic fluid.
Also, prolonged ruptured of the membranes always presents a risk for this type from maternal-
fetal transfer of pathogenic organisms. The baby had seizure while having amniotic vomit right
after birth. This said symptoms was caused by the prolonged ruptured of the BOW or the "bag of
water" of the mother who was not admitted prior to the delivery of the baby.

Early sepsis (less than 3 days) is acquired in the perinatal period; the infection can occur from
direct contact with organisms from the maternal gastrointestinal and genitourinary tracts. The
most common infecting organisms are group B streptococcus (GBS) and Escherichia coli, which
may be present in the vagina. GBS has emerged as an extremely virulent organism in Neonates,
with a high (50%) death rate in affected infants. Because sepsis is so easily confused with other
neonatal disorders, the definitive diagnosis is established by laboratory and radiographic
examination through cultures of blood, urine, and cerebrospinal fluid. Blood studies may show
signs of anemia, leukocytosis, or leukopenia.

Nursery procedures aimed at minimizing the risk of nocosomial infections include the practice of
good handwashing techniques, appropriate isolation precautions where indicated, and the
adoption of the recommended standards for spacing of infant beds. In addition to the institution
of vigorous therapeutic measures, early recognition and diagnosis are essential to increase the
infant's chance for survival and reduce the likelihood of permanent neurological damage.
Antibiotic is initiated before laboratory results are available for confirmation and identification
of the exact organism. Treatment consists of circulatory support, respiratory support, aggressive
administration of antibiotics, and immunotherapy. Antibiotic therapy is continued for 7-10 days
if cultures are positive, discontinued in 3 days if cultures are negative and the infant is
asymptomatic, and most often administered via IV infusion.
The trend in antenatal diagnosis of maternal GBS and subsequent maternal and neonatal
treatment with antibiotic therapy has decreased the incidence of early onset GBS disease by 70%
(0.5 cases per 1000 live births in 1999), although rates of late onset perinatal GBS disease
remained constant according to Centers for Disease Control and Prevention, 2002.

Nursing care of the infant with sepsis involves observation and assessment as outlined for any
high risk infant. It is usually the nurse who observes and assesses infants and identifies that
"something is wrong" with them. Knowledge of the side effects of the specific antibiotic and
proper regulation and administration of the drug are vital.
 OBJECTIVES

GENERAL

At the end of the study, the researchers will be able to improve not only the knowledge in the
pathophysiologic and clinical manifestations but also how to give necessary interventions
indicated for the patient. By this, we will be able to speed our knowledge, skills and attitude in
giving appropriate nursing care for the patients. Through systematic research and interview, we
can acquire more concrete and necessary information about the Neonatal Sepsis.

SPECIFIC

1. To establish good rapport with the client and his significant others to achieve good
working relationship for the success of this case study.
2. To present reasonable introduction that will give an overview of the disease and can be
an eye-opener of information for the readers.
3. To conduct a thorough physical assessment of the patient with the help of the parents to
note other problems of the patient to be managed.
4. To discuss the anatomy and physiology of the affected system to have a background
regarding the organ affected by the disease.
5. To provide necessary nursing care plans to prioritize the immediate problem of the
patient.