DR. MARYAM VEYSIZADEDR. MARYAM VEYSIZADE

ASSISTED PROFESSORASSISTED PROFESSOR

TEHRAN UNIVERSITY OF MEDICAL TEHRAN UNIVERSITY OF MEDICAL SCIENCESSCIENCES

SICK SICK NEONATENEONATE

GeneralGeneral::

•The neonatal at birth represent the culmination The neonatal at birth represent the culmination of genetic , antepartal, and intrapartal factors of genetic , antepartal, and intrapartal factors

that affect its immediate activity future wellthat affect its immediate activity future well-.-.

beingbeingMany neonates ,when born, have already been Many neonates ,when born, have already been introduced to in utero insults and birth trauma, introduced to in utero insults and birth trauma, which severly jeoparadized their future welfarewhich severly jeoparadized their future welfare..

Their survival and perhaps their quality of life, is Their survival and perhaps their quality of life, is entrusted to the knowledge, and expertise of the entrusted to the knowledge, and expertise of the health care teamhealth care team..

ContdContd;;

The practical nurse performs a vital role in caring The practical nurse performs a vital role in caring for the sick neonate. Constant attention must be for the sick neonate. Constant attention must be directed to the accurate observation of the directed to the accurate observation of the neonate so that significant changes may be neonate so that significant changes may be reported immediatelyreported immediately..

This season will consist of twelve problem of the This season will consist of twelve problem of the neonateneonate..

Weight related gestational ageWeight related gestational age::SGASGA::

CharacteristicCharacteristic::

Chromosomalproblem,smoking,preeclampsiaChromosomalproblem,smoking,preeclampsia,,

eclampsia, insufficiency prenatal care, eclampsia, insufficiency prenatal care, GlcGlc ,hypothermia,polycythemia↓,hypothermia,polycythemia↓

,,congenital anomalycongenital anomaly..

Nursing care:Nursing care:monitoring blood glucose,observe monitoring blood glucose,observe sign of respiratory distress, monitor input and sign of respiratory distress, monitor input and output, daily weight, lab test based on local output, daily weight, lab test based on local policy,support the parents by listening to their policy,support the parents by listening to their concerns and answering questionconcerns and answering question..

ContdContdLGALGA::

CharacteristicCharacteristicSpecial attention toSpecial attention to hypoglysemia,hypocalcemia,polycythemia,hyper hypoglysemia,hypocalcemia,polycythemia,hyper blbemia,RDS,congenital anomalyblbemia,RDS,congenital anomaly,,

Nursing considerationNursing consideration::

Monitoring vital sign and temprature, level of Monitoring vital sign and temprature, level of glucose,calcium,bilirubin,hematocrit,prevent glucose,calcium,bilirubin,hematocrit,prevent infectioninfection..

ContdContd

Premature infantPremature infantCharacteristics:skin,finger nail, reflexes, state of Characteristics:skin,finger nail, reflexes, state of placental insufficiency,pulmonary placental insufficiency,pulmonary hemorrhage,pneumonia,pneumothoraxhemorrhage,pneumonia,pneumothorax..

Nursing considerationNursing consideration::

Monitoring intake and output, observe of Monitoring intake and output, observe of respiratory distress, stable termoregulation, respiratory distress, stable termoregulation, support the parentssupport the parents..

JaundiceJaundice

Pathologic or physiologicPathologic or physiologic::

Nursing careNursing care::Consideration of lethargy, poor feeding, dark stool, Consideration of lethargy, poor feeding, dark stool, highpitch cry, seizure, neurologic damage. highpitch cry, seizure, neurologic damage. monitoring of skin turgor, daily weight, eye monitoring of skin turgor, daily weight, eye problem, termoregulationproblem, termoregulation,,

Intracranial hemorrhageIntracranial hemorrhage

CharacteristicCharacteristic::

Cold, pale, clammy skin. bulging or tense Cold, pale, clammy skin. bulging or tense fontanel, unequal pupils, diminishing moro fontanel, unequal pupils, diminishing moro reflexes,opistotonus,siezurereflexes,opistotonus,siezure,,

Nursing considerationNursing considerationQuiet space, avoid stimulation, monitor Quiet space, avoid stimulation, monitor respiratory function, feed as tolerated, respiratory function, feed as tolerated, control of bleedingcontrol of bleeding

TE TE fistulafistulaType of anomaly, VACTREL syndromType of anomaly, VACTREL syndrom,,

Nursing considerationNursing considerationPattern of feeding and respiration, stomach Pattern of feeding and respiration, stomach distention, chemical pneumonitis, distention, chemical pneumonitis, recurrent fistula, esophageal stricture, recurrent fistula, esophageal stricture, recurrent pneumonitis, failure to thrive, recurrent pneumonitis, failure to thrive, decreased esophageal motilitydecreased esophageal motility..

Pulmonary physiology, control intake and Pulmonary physiology, control intake and input, supportive care of gastrostomy tube input, supportive care of gastrostomy tube feedingfeeding

Down syndromDown syndrom

Sign and symptomSign and symptomNursing considerationNursing considerationFeeding monitoring, complication Feeding monitoring, complication monitoring, developmental stimulation, monitoring, developmental stimulation, Encourage prenatal participation in the Encourage prenatal participation in the infants careinfants care..

Erythroblastosis fetalisErythroblastosis fetalis

Characteristic: jaundice, edema, ptechiaCharacteristic: jaundice, edema, ptechia,,

respiratory problem, neurologic unresponsivenessrespiratory problem, neurologic unresponsivenessNursing considerationNursing considerationTermoregulation, resussitative equipment, Termoregulation, resussitative equipment, monitoring of transfusion complicationmonitoring of transfusion complication,,

Respiratory distress syndromRespiratory distress syndrom

Sign and symptomsSign and symptoms,,

Nursing considerationNursing considerationMonitoring of pulmonary function, infection, Monitoring of pulmonary function, infection, circulation, thrombosiscirculation, thrombosis,,

Infant of addicted motherInfant of addicted mother

Etiology, Degree of withdrawal symptoms, Etiology, Degree of withdrawal symptoms, onset of symptoms, sign of withdrawalonset of symptoms, sign of withdrawal,,

Nursing considerationNursing consideration::

Be familiar with withdrawal syndrome, Be familiar with withdrawal syndrome, checking abstinense syndrome, maintain checking abstinense syndrome, maintain fluid/caloric requirementfluid/caloric requirement..

OthersOthers

Monitoring ofMonitoring of : :

Fever, Breathing difficulties, Diarrhea, Fever, Breathing difficulties, Diarrhea, Vomiting, Excessive sleepiness, Vomiting, Excessive sleepiness, Floppiness, Jitterinous, Rash, Eye or Ear Floppiness, Jitterinous, Rash, Eye or Ear troubletrouble..