PRESENTATION TOPIC

Infant Respiratory Distress Syndrome

GROUP MEMBERS

• AISHA NOOR
• SHAISTA JABEEN
OBJECTIVES

• At the end of this presentation the students will be able to:

• Define infant respiratory distress syndrome.
• Sign and symptoms of IRDS.
• Causes and treatment of IRDS.
• Nursing care plan for IRDS.
INFANT RESPIRATORY DISTRESS SYNDROM

• Infant respiratory distress or surfactant deficiency syndrome.

• previously called “Hyaline membrane disease” is a syndrome in premature infant caused
by developmental insufficiency of pulmonary surfactant.
PATHOPHYSIOLOGY

• Surfactant deficiency (decreased production and secretion) is the primary cause of RDS.
• Surfactant is a surface active material produced by type II alveolar cells.
• Prevent the alveoli from collapse.
• Surfactant deficiency results in atelectasis, ventilation perfusion mismatch and inadequate
gas exchange.
INCIDENCE

• The incidence of RDS is inversely proportional to gestation age.

• RDS accounts for 20% of all neonatal deaths.
• There are certain known risk factors, which increase incidence of RDS.
RISK FACTOR

• Prematurity (before 28 week of gestation).

• Infant of diabetic mother.
• Delivery by caesarian.
• History of prior affected infant.
• Impaired blood flow to the baby during delivery.
CLINICAL FINDING

• Tachypnea > 60/min

• Expiratory grunting
• Nasal flaring
• Cyanosis
• Chest wall retraction
INVESTIGATIONS

• Chest x-ray
• Septic screen
• ABGs
• ECG
MANAGEMENT

• Surfactant replacement therapy

• NCPAP (nasal continuous positive airway pressure)
• IPPV(intermittent positive airway pressure)
• Oxygen therapy
• Antibiotics
CASE PRESENTATION
PATIENT FINDINGS

Name : Zabiullah
PR No: 19-09-105679
Age : 3 weeks
DOA : 03 September,2019
Weight : 1700gm
Blood group: B +ive
Diagnosis : prematurity (32 weeks),LBW (1700gm),RDS,NNS
PRESENTING COMPLAINTS

• Prematurity
• Respiratory distress
• Grunting
• Oxygen dependency
• Feeding issue
MOTHER RISK FACTORS

Diabetic mother
Severe PIH
Caesarian
LAB RESULTS

• Echo = normal
• Chest x-ray = white patches
• Culture sensitivity = clear (no growth)
• CBC = (Thrombocytopenia)
• CRP = RAISED (5.4)
• (<0.5)
MEDICATIONS

• Gracil (25mg/ml)
• Claforan (0.25gm/2ml)
• Panadol
• 1/5th D/S (4.3% dextrose, 0.18% Nacl)
ASSESSMENT
HEAD TO TOE ASSESSMENT

• HEAD
• Head circumference = 32cm
• Anterior fontanel = diamond shape
• Posterior fontanel = triangular shape
• Face
• Eye and ear =symmetrical
• Nose = nasal flaring
• Mouth = no cleft lip / palate

• Neck = normal trachea, smooth clavicle

• Skin = dry
CHEST

• Chest circumference = 30cm

• Shape = Pectus excavatum
• Respiratory rate = >60
• Retractions
• Diaphragmatic breathing
• Use of accessory muscles
ABDOMEN

• No tender
• Not distended
• Umbilical cord dry at base

• GROIN
• Week femoral pulse
• Circumcised
REFLEXES

• Weak suck reflex

• Good grasping reflex
VITAL SIGNS

• Temperature =98.5 F (97.6-98.6F)

• Pulse = 140 b/min (120-140)
• Resp rate = 62 (40-60)
• Spo2 = 97%
• Intake output = normal
• FEED= MBF ( mother breast feed)
• No aspiration
Nursing care plan
ASSESSMENT

Objective data
 Tachypnea
 dyspnea
 Nasal flaring
 Chest wall retraction
NURSING DIAGNOSIS

• Ineffective breathing pattern r/t decreased lung compliance as evidence by dyspnea.

• GOAL:
• Patient will maintain an effective breathing pattern with normal rate and depth.
• Patient respiratory rate will remain within established limit.
• INTERVENTIONS;
• Assess respiratory rate and depth.
• Assess for the use of accessory muscles.
• Assess breath sounds.
• Observe for retractions and nasal flaring.
• Utilized pulse oximetry.
NURSING DIAGNOSIS

Imbalance nutrition less than body requirement r/t inability to suck.

• INTERVENTIONS;
• Evaluate total daily feed intake.
• Promote adequate timely fluid intake.
• Weight regularly..
N .DIAGNOSIS

• Impaired gas exchange r/t collapsed alveoli AEB tachycardia.

• INTERVENTIONS;
• Assess respirations, rate, pattern, depth and breathing efforts.
• Assess for changes in orientation and behavior.
• Use pulse oximetry to monitor oxygen saturation and pulse rate continuously.
THANK YOU