Condition: Ophthalmia Neonatorum

Definition: Ophthalmia Neonatorum is an illness that causes acute inflammation of the eyes of a newborn during the
birth canal passage. Ophthalmia neonatorum is a conjunctivitis with discharge from the eyes that occurs
within the first 28 days of life.
Risk Factors/  Infections carried by the mother in the birth canal
Predisposing  HIV-positive mothers
Factors:  Infectious organisms are exposed to the newborn.
 Exposure of the infant to infectious organisms
 Premature rupture of membranes (PROM)
 Inadequacy of postnatal ocular prophylaxis
 Exposure to silver nitrate
 Ocular trauma during delivery
 Mechanical ventilation
 Prematurity
 Poor prenatal care
 Poor hygienic delivery conditions
Signs and  Lids
Symptoms: -oedema (may impede examination of ocular surfaces)
 Conjunctival features
-mucopurulent conjunctivitis – discharge may be profuse in C. trachomatis infection. Danger of
infection of clinician when prising open lids
-NB: in neonatal C. trachomatis infection there are no follicles as in adults, because of the neonate’s
lack of lymphoid tissue
-conjunctival oedema (‘chemosis’)
-conjunctival membrane in severe cases
 Corneal features
-cornea can be involved, especially in N. gonorrhoeae infection. This organism can pass through
intact corneal epithelium. Perforation may result
-signs usually bilateral; may be asymmetrical
  (Usually described by mother):
-redness
-discharge (may be profuse in gonococcal infection)
-swelling of lids (may be severe)
-symptoms usually bilateral
Management: Medical Management:
Medical &  Topical erythromycin ointment can be used as a supplementary treatment.
Surgical - This infection is treated for 14 days with oral erythromycin (50 mg/kg/d divided qid).
 Monitoring
- Observation on bacterial infection complication, chemical conjunctivitis normally disappears in 24-36
hours.
 In gonococcal conjunctivitis, normal saline irrigation helps to remove mucopurulent debris from the
lids and conjunctiva.
Nursing  Nurses should examine blood samples obtained from heel sticks, as well as vitamin K and
Interventions: prophylaxis for ophthalmia neonatorum, as practices that should be evaluated in order to improve
evidence-based treatment of babies on their first day of life.

 Practitioners should be aware of their limitations and, if necessary, seek additional counsel or send
the patient to another provider.

 GRADE: The strength of the suggestion and the level of evidence are always related to the
statement(s) immediately above.

 Educate the mother about her child's health and at the same time offer advice.

 Recommend HIV testing and counseling.

 Encourage them to come back in three days for a follow-up, or sooner if necessary.

Reference/s: Bondi, S. (2019, August 14). Ophthalmia neonatorum Bondi. Share and Discover Knowledge on
SlideShare. https://www.slideshare.net/sashabondi/ophthalmia-neonatorum-bondi
 Ophthalmia neonatorum. (n.d.). wikidoc. Retrieved April 19, 2022,
from https://www.wikidoc.org/index.php/Ophthalmia_neonatorum

Tesini, B. L. (2020, July 13). Neonatal conjunctivitis - Pediatrics - MSD manual professional edition. MSD
Manual Professional Edition. https://www.msdmanuals.com/professional/pediatrics/infections-in-
neonates/neonatal-conjunctivitis

Condition: Hepatitis B virus

Definition: The hepatitis B virus (HBV) is a small DNA virus with unusual features similar to
retroviruses. This virus affects the liver that leads on Hepatitis B which attacks and
injures the liver. Hepatitis B is transmitted through direct contact with infected blood or
certain bodily fluids.
Risk Factors/ Predisposing  Infants born to hepatitis B-positive mothers
Factors:  Individuals who inject drugs or exchange needles, syringes, and other drug-related
paraphernalia
 Hepatitis B patients' sex partners
 Men who engage in sex with other men
 People who live with a hepatitis B carrier
 Workers in the health-care and public-safety industries who are exposed to blood on
the job
 Dialysis patients
Signs and Symptoms:  Appetite loss
 Pain in the abdomen
 Skin and the whites of eyes are turning yellow (jaundice)
 Urine that is dark in color
 Fever
 Joint discomfort
 Vomiting and nausea
 Appetite loss
 Weakness and exhaustion
Management: Medical Management:
Medical & Surgical
  Blood tests
-Blood tests can detect signs of the hepatitis B virus in your body and tell your
doctor whether it's acute or chronic. A simple blood test can also determine if you're
immune to the condition.
 Liver ultrasound
-A special ultrasound called transient elastography can show the amount of liver
damage.
 Liver biopsy
-Your doctor might remove a small sample of your liver for testing (liver biopsy) to
check for liver damage. During this test, your doctor inserts a thin needle through
your skin and into your liver and removes a tissue sample for laboratory analysis.
 Screening healthy people for hepatitis B
-Doctors sometimes test certain healthy people for hepatitis B infection because the
virus can damage the liver before causing signs and symptoms.
Nursing Interventions:  Encourage patient to refrain from alcohol, and taking medication to relieve
symptoms.
 Assess level of understanding of the disease process, expectations and prognosis,
possible treatment options.
 Avoid making moral judgments regarding lifestyle.
 Highlight the significance of a follow-up physical check and laboratory test.
 Discuss restrictions on donating blood.
 Contract with patient regarding time for listening. Encourage discussion of
feelings/concerns.
Reference/s: Mayo Foundation for Medical Education and Research. (2020, September 4). Hepatitis
B. Mayo Clinic. Retrieved April 19, 2022, from https://www.mayoclinic.org/diseases-
conditions/hepatitis-b/diagnosis-treatment/drc-20366821

Condition: HIV infection

Definition: Human immunodeficiency virus (HIV) is a virus that attacks the body's immune
system. If HIV is not treated, AIDS can develop (acquired immunodeficiency

other hand, may be controlled with proper medical treatment.
Risk Factors/ Predisposing
Factors:
syndrome). HIV infected people are infected for the remainder of their life. HIV, on the
 Sustaining needle stick injuries, particularly among health care employees
 Having unprotected anal or vaginal intercourse
 Exchanging contaminated needles, syringes, and other injecting equipment, as
well as drug solutions, when injecting drugs
 Becoming a victim of a needle stick injury, especially among health-care workers
 Having another sexually transmitted infection (sti) such as syphilis, herpes,
chlamydia, gonorrhoea, or bacterial vaginosis
 Receiving potentially life-threatening injections, blood transfusions, and tissue
transplants, as well as medical treatments that require sterile cutting or piercing.

Signs and Symptoms:  Fever

 Cough
 Headache
 Night sweats
 Muscle aches and joint pain
 Rash
 Sore throat and painful mouth sores
 Swollen lymph glands, mainly on the neck
 Diarrhea
 Weight loss
Management: Medical Management:
Medical & Surgical  Antiretroviral therapy (ART)
-Antiretroviral medications work by blocking the virus from multiplying in the body
and it requires taking an HIV drug cocktail on a daily basis (known as an HIV
treatment regimen)
Nursing Interventions:  A diet history is obtained and factors that may affect oral intake.
 Evaluate the patient's knowledge of the disease and its transmission routes.
 Determine the state of fluid and electrolyte balance by assessing for the turgor and
dryness of the skin and mucous membranes.
 Assess for the signs of a respiratory problem such as cough, chest pain, shortness
 of breath and etc.
 Look for signs of breakdown, ulceration, or infection through daily skin and mucous
membrane examinations.
Reference/s: Belleza, M. (2021, February 20). HIV and AIDS nursing care management and study
guide. Nurseslabs. https://nurseslabs.com/hiv-aids/

Mayo Clinic - Mayo Clinic. (2020, February 13). HIV/AIDS - Diagnosis and treatment -
Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hiv-aids/diagnosis-
treatment/drc-20373531

WHO | World Health Organization. (2021, June 9). Hiv/Aids. https://www.who.int/news-

room/fact-sheets/detail/hiv-aids
https://nurseslabs.com/hiv-aids/

Condition: Infant of a drug dependent mother

Definition: An infant born to a person with a substance use disorder is at risk for withdrawal,
commonly referred to as neonatal abstinence syndrome (NAS). A drug-addicted
mother's child may have a variety of short- and long-term health issues. It can lead to
breastfeeding difficulties, sluggish weight gain, and admission to the newborn intensive
care unit. Furthermore, this circumstance may have an impact on an infant's brain
development, leading to difficulties managing their thoughts or behaviors, as well as
emotional and mental health disorders such as rage and difficulty controlling emotions.
Risk Factors/ Predisposing  Pregnant women who use drugs, smoke, or drink alcohol, and;
Factors:  Women who use drugs also may be less likely to get prenatal care.
Signs and Symptoms:  Fever
 Stuffy nose, sneezing
 Irritability
 Trouble sleeping
 Quick breathing
 Weight gain is delayed due to poor eating.
 Excessive sucking
 Diarrhea, vomiting
  Hyperactive reflexes, increased muscle tone
 Excessive and/or high-pitched crying
 Blotchy skin
 Sweating
 Stuffy nose, sneezing
Management: Medical Management:
Medical & Surgical  Medicines that used for severe withdrawal include morphine, methadone and
buprenorphine.
 Getting fluids through a needle into a vein (also called intravenous or IV) to prevent
the baby from getting dehydrated. Babies with NAS can get dehydrated from having
diarrhea or throwing up a lot.
 Being fed higher-calorie baby formula.
-Some babies with NAS need extra calories to help them grow because they have
trouble feeding or slow growth.
 The NAS system is a scoring system that is used in the United States. The baby's
provider uses points to rate how bad the baby's withdrawal is with this method. Its
findings determine the type of treatment the baby need.
 Urine and meconium test
-The baby's first bowel movement is meconium, and these tests are used to check for
drugs.
Nursing Interventions:  Room in the baby.
 Emphasize the baby skin-to-skin care (also called kangaroo care). This is when the
baby put on the mother's bare chest and dressed only in a diaper.
 Dim the lights and keep the baby's room quiet.
 After the kid is born, she checks on him frequently in the NICU to make sure he's
doing well and showing fewer and fewer withdrawal symptoms.
Reference/s: Drug addicted babies: Long term effects of babies born addicted. Laguna Treatment
Hospital. (2020, December 5). Retrieved April 19, 2022, from
https://lagunatreatment.com/support-for-women/newborn-health-effect/

Neonatal abstinence syndrome (NAS). Home. (n.d.). Retrieved April 19, 2022, from
https://www.marchofdimes.org/complications/neonatal-abstinence-syndrome-(nas).aspx
Conditio Infant with fetal alcohol exposure
n:
Definitio Babies born to mothers who consumed alcohol while pregnant may have
n: birth abnormalities and developmental problems. Fetal alcohol spectrum
disorders (FASDs) are a collection of abnormalities that can occur when
newborns are exposed to alcohol. A wide range of physical, behavioral,
and learning issues are among them.
Risk  Any drinking during pregnancy raises the chance of fetal alcohol
Factors/ syndrome, but the risk to the fetus is greatest if the pregnant woman
Predisp drinks in the second part of her first trimester.
osing
Factors:
Signs The severity of this disease differs. As a result, this disorder may arise in a
and variety of manners, including physical defects, intellectual or cognitive
Sympto deficits, and difficulties functioning and coping with daily life.
ms:
Physical defects:
 Distinctive facial features, including small eyes, an exceptionally thin
upper lip, a short, upturned nose, and a smooth skin surface between
the nose and upper lip
 Deformities of joints, limbs and fingers
 Slow physical growth before and after birth
 Vision difficulties or hearing problems
 Small head circumference and brain size

Brain and central nervous system problems:

 Poor coordination or balance
 Intellectual disability, learning disorders and delayed development
 Poor memory
 Trouble with attention and with processing information
 Difficulty with reasoning and problem-solving
  Difficulty identifying consequences of choices
 Poor judgment skills
 Jitteriness or hyperactivity
 Rapidly changing moods

Issues of social and behavioral nature:

 Time management is a problem.
 Planning or achieving a goal is difficult.
 Having difficulty getting along with others
 Social skills deficits
 Having trouble staying on task
 Problems with impulse control and behavior
 Change is difficult to adapt to, and transitioning from one work to
another is difficult.
Manage There is no way to identify if a child has fetal alcohol syndrome using a lab
ment: test. However, screening the mother to see if she was exposed to alcohol
while pregnant could reveal the presence of the condition.
Medical
& Medical Management:
Surgical  Therapy can aid in the treatment of behavioral and educational issues.
 Parents might also receive training in order to assist their children.
 There are no drugs available to treat fetal alcohol syndrome. Certain
medications, on the other hand, can help with symptoms such as
hyperactivity, inability to focus, and anxiety. The following drugs are
among them:
-Antidepressants are used to treat mood disorders, insomnia, irritability,
violence, and academic difficulties.
-Anti-anxiety medications.
-Stimulants are used to treat difficulties like hyperactivity, inability to
concentrate, and poor impulse control.
-Neuroleptics are medications that are used to treat behavioral issues
such as aggression and anxiety.
  Complementary therapy may be beneficial in some cases. They are as
follows:
-Massage
-Acupuncture
-Exercise
-Yoga
 Treatment for a mother who is addicted to alcohol is also
recommended.
-This can help the mother develop parenting strategies to aid their fetal
alcohol syndrome-affected child.

Nursing  Conduct a thorough examination of all systems, including heart and

Intervent lung auscultation.
ions:  Measure the circumference of the infant's head and abdomen.
 Parents and caregivers should be educated and counseled.
 Obtain the patient's mother's pregnancy history.
-Determine how much and how often alcohol was consumed during
pregnancy.
-The severity of symptoms can be determined by the amount of time
spent in the environment.
-During pregnancy, no amount of alcohol is considered safe.
 Examine the infant for signs of withdrawal, such as:
-yell with a high pitch
-Arching of the spine (of the back)
-Apnea / bradypnea is a condition in which breathing is slow or delayed.
-Heartbeat that is slow or irregular
Referen Mayo Foundation for Medical Education and Research. (2018, January
ce/s: 10). Fetal alcohol syndrome. Mayo Clinic. Retrieved April 20, 2022, from
https://www.mayoclinic.org/diseases-conditions/fetal-alcohol-syndrome/
symptoms-causes/syc-20352901

WebMD. (n.d.). Fetal alcohol syndrome: Symptoms, causes, treatments.

WebMD. Retrieved April 20, 2022, from
https://www.webmd.com/baby/fetal-alcohol-syndrome#:~:text=To
%20diagnose%20fetal%20alcohol%20syndrome,and%20if%20so%2C
%20how%20much.

Nursing care plan for Fetal Alcohol Syndrome (FAS). NURSING.com.

(2022, February 23). Retrieved April 20, 2022, from
https://nursing.com/lesson/nursing-care-plan-for-fetal-alcohol-syndrome-
fas/