1.

Predisposing - those that put a child at risk of developing a problem (in this case, high anticipatory
distress). These may include genetics, life events, or temperament

Premature birth (33-34 weeks)

Cord coils
No pre-natal checkup

2. Precipitating - refer to a specific event or trigger to the onset of the current problem
Low birth weight
Severe birth
Asphysia
PROM

3. Signs and symptoms

Low body temperature

Management:
1. Passive rewarming
2. Blood rewarming
3. IV fluid
4. Oxygen therapy/intubation and mechanical ventilation
5. Irrigation
6. Provide barrier to heat loss, as well as active rewarming for newborns

Diagnosis
1. Temp test (Thermometer)

Nasal flaring

Diagnostic
1. arterial blood gas (ABG)
- to measure how much oxygen and carbon dioxide are in your blood (usually done in a hospital setting)
2. complete blood count (CBC)
-to check for signs of infection
3. electrocardiogram (EKG)
-to assess how well your heart is working
4. pulse oximetry
-to check the oxygen level in your blood
5. chest X-rays
-to look for signs of infection or damage

Management
1.
Sternal and subcostal retractions
Tachypnea (more than 60 respirations per minute)
 Cyanotic mucous membranes

4. Diagnostic/Evaluation Tool

Chest X-rays of the lungs. = characteristic of atelectasis

Arterial Blood gas tests. = hypoxia or decreased level of O2; reveals respiratory acidosis; hypercapnia
or increased level of CO2

Disease process (if treated)

Fetal lung immaturity = pulmonary surfactant deficiency = atelectasis (the alveoli collapses or close) =
reduced or absent gas exchange = hypoxia

Neonate breathe easily and comfortably

Less oxygen needed

Management
Arterial catheterization.
touch times" with mother
Place in an incubator.
Warm, humidified oxygen.

1. mechanical ventilation
2. surfactant
3. ambroxol hydrochloride
4. nitric oxide

Administer oxygen at the lowest concentration indicated and prescribed respiratory medications

1. Medical
 Surfactant administration (administered directly into the trachea. o Continuous monitoring of
ABG, HR, RR, signs.
 Oxygen administration
 Ventilation

2. Pharmacological
antibiotic (penicillin or ampicillin)
aminoglycoside (gentamicin or kanamycin)

Pancuronium (IV)
Liquid ventilation (perfluorocarbons)
 3. Nursing
 Keep infant warm
 Hydration and nutrition (IV)

Prognosis
Prognosis with treatment is excellent; mortality is < 10%. With adequate ventilatory support
alone, surfactant production eventually begins, and once production begins, RDS resolves
within 4 or 5 days. However, in the meantime, severe hypoxemia can result in multiple organ
failure and death.

Disease process (if not treated)

Deficient surfactant -> hypoinflation of lungs -> poor perfusion -> impaired gas exchange -> tissue
hypoxia -> increase production of lactic acid -> lactic acid + increasing carbon dioxide level – acidosis

As the baby's lung function gets worse, the baby takes in less oxygen. More carbon dioxide builds up in
the blood. This can lead to increased acid in the blood (acidosis). This condition can affect other body
organs. Without treatment, the baby becomes exhausted trying to breathe and over time gives up. A
ventilator must do the work of breathing instead.

can lead to BDP

-acute respiratory failure
-death

may lead to severe acidosis

The lack of oxygen can damage the baby's brain and other organs if not treated promptly.
May change over time to become bronchopulmonary dysplasia, or BPD.

Prognosis