NEONATAL SEPSIS

Question 1

is a serious medical condition that occurs when the body’s immune system overreacts to an infection, causing inflammation and damage to organs and tissues.

Answer 1

NEONATAL SEPSIS

Question 2

Common causes of sepsis in children are bacterial infections, such as pneumonia, meningitis, urinary tract infections, and infections of the skin and soft tissues.

Answer 2

NEONATAL SEPSIS

Question 3

According to a study published in the New England Journal of Medicine in 2005, the incidence of severe sepsis in children under the age of 1 was (a)____cases per_____ live births, while the incidence in children
between the ages of 1 and 17 was (b)___ cases per ______ population.

Answer 3

(a)1.4 cases per 1,000 live births
(b) 0.8 cases per 1,000 population.

Question 4

(3) SUBJECTIVE DATA of NEONATAL SEPSIS

Answer 4

1. Mother’s report of pain
2. Mother’s report difficulty breathing
3. Reports of s/s infection (burning with urination, frequent cough, green mucus, etc.)

Question 5

Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, During Pregnancy

Answer 5

1. Any fetal concerns during the pregnancy (e.g. growth problems or ultrasound scan abnormalities)?
2. Any maternal illness during pregnancy (particularly infections)?
3. Has the mother previously given birth to a baby who developed an invasive infection?

Question 6

Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, Labor and Delivery

Answer 6

1. What was the duration of membrane rupture?
2. Did the mother develop a fever during labor?
3. Were prophylactic antibiotics for GBS recommended and, if so, were they given?

Question 7

Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, Birth

Answer 7

1. What gestational age was the baby born at?
2. What was the baby’s birth weight?
3. What were the baby’s Apgar scores?
4. Were any abnormalities noticed during the baby check?

Question 8

Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, Since birth

Answer 8

1. Have there been any feeding problems?
2. Has the baby passed urine and meconium?
3. Has the baby received any interventions?
4. Have the parents or nursing staff noticed any of the clinical features of sepsis?

Question 9

(11) OBJECTIVE DATA of NEONATAL SEPSIS

Answer 9

1. Body temperature changes
2. Breathing problems
3. Diarrhea,
4. Low blood sugar
5. Reduced movement
6. Reduced sucking
7. Seizures
8. Slow heart rate,
9. Swollen belly area
10. Vomiting
11. Yellowish skin and whites of the eyes (Jaundice)

Question 10

Physical Assessment of NEONATAL SEPSIS

Answer 10

Lethargy Poor cry
Body temperature change Not arousable, comatose
Tachypnea Abdominal distension
Tachycardia Diarrhea
Tachycardia Vomiting
Pallor Hypothermia
Jaundice Poor perfusion
Refusal to suckle Sclerema
Poor cry Poor weight gain
Not arousable, comatose Shock
Bleeding Seizures
Renal Failure Blank look
Cyanosis High pitched
Chest Retractions Excessive Crying
Grunt Neck Retraction
Apnea/Gasping Bulging Fontanelle
Fever

Question 11

(4) Diagnostic and Laboratory Tests of NEONATAL SEPSIS

Answer 11

1. CBC
2. Blood culture
3. Arterial blood gas (ABG)
4. C-reactive protein (CRP)

Question 12

Diagnostic and Laboratory Tests of NEONATAL SEPSIS:
used to identify the organism, and the susceptibility or resistance to specific antibiotics

Answer 12

Blood culture

Question 13

Diagnostic and Laboratory Tests of NEONATAL SEPSIS:
is drawn to determine if acidosis or alkalosis is present and accurate oxygen saturation levels.

Answer 13

Arterial blood gas (ABG)

Question 14

Diagnostic and Laboratory Tests of NEONATAL SEPSIS:
is a nonspecific indicator of inflammation.

Answer 14

C-reactive protein (CRP)

Question 15

CRP responds within_____ hours of an inflammatory reaction; over____mg/dL is considered elevated.

Answer 15

6-8 hours
0.2mg/dL

Question 16

NURSING DIAGNOSIS
PLANNING & IMPLEMENTATION CARE of NEONATAL SEPSIS

Answer 16

Lessening the immune response, prevention of cellular death, resolution of infection, minimizing damage from cellular oxygen deprivation and lactic acid build-up, maximizing cardiac output, and resolution of the condition

Question 17

(13)NURSING INTERVENTIONS of NEONATAL SEPSIS

Answer 17

1. Prompt lab draws
2. Blood Cultures
3. Appropriate administration of IV antibiotics
4. Drawing the labs, then starting antibiotics as ordered is the nurse’s responsibility.
5. The goal is to initiate broad-spectrum antibiotics within 1 hour of recognition of sepsis
6. Optimize fluid-volume status
7. Assess, monitor, and optimize cardiac output
8. MAP should be monitored with an arterial line when administering vasopressors
9. Lactic acid levels are elevated with decreased tissue perfusion – following lactic acid levels helps to determine if therapy is being successful
10. Assess, monitor, and support oxygen status
11. Prevent infection
12. Assess, monitor, and manage body temp
13. Communicate with and educate patient and loved one

Question 18

PHARMACOLOGIC THERAPIES of NEONATAL SEPSIS

Answer 18

use of antibiotics to fight the infection

Question 19

PHARMACOLOGIC THERAPIES:
(4) antibiotics of NEONATAL SEPSIS

Answer 19

1. Ampicillin
2. Gentamicin
3. Cefotaxime
   4.Vancomycin

Question 20

SURGICAL INTERVENTIONS of NEONATAL SEPSIS (3)

Answer 20

1. IV Cannula insertion
2. UMBILICAL CATHETERS
3. NASO - GASTRIC TUBING

Question 21

SURGICAL INTERVENTIONS of NEONATAL SEPSIS: This is to administer the doctor’s prescribed medications, fluids or even blood products. Aseptic technique is always observed.

Answer 21

IV Cannula insertion

Question 22

SURGICAL INTERVENTIONS of NEONATAL SEPSIS: Since an infant is high-risk and is closely observed in the NICU, this provides safe vascular access immediately after birth. Through the UVC, this may be used for intravenous administration of parenteral nutrition and drugs, for blood sampling and blood transfusion.

Answer 22

UMBILICAL CATHETERS

Question 23

SURGICAL INTERVENTIONS of NEONATAL SEPSIS: This enables them to drain gastric contents, decompress the stomach, obtain a specimen of the gastric contents, or introduce a passage into the GI tract of the neonate.

Answer 23

NASO - GASTRIC TUBING

Question 24

NUTRITION SUPPORT IN NEONATAL SEPSIS

Answer 24

minimizing nutrient loss and stimulating the
maturation of the gastrointestinal tract. The use of breast milk and early enteral nutrition is important for reducing the risk of infections.

Question 25

(6) Complementary and Alternative Therapy of NEONATAL SEPSIS

Answer 25

1. Aside from the pharmacological therapies, such
   as:
   a. Intravenous (IV) fluids.
   b. IV antibiotics to fight bacterial infections.
   c. Antiviral medication to fight viral infections.
   d. Heart and/or blood pressure medications.
2. An extra oxygen and supportive therapy is
   needed
   General supportive measures, including:
   a. respiratory management
   b. hemodynamic management
   Note: These two are combined with antibiotic
3. Exchange transfusions
4. Fresh frozen plasma
5. Granulocyte transfusions
6. Recombinant colony-stimulating factors