NEONATAL SEPSIS Flashcards
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.
NEONATAL SEPSIS
Common causes of sepsis in children are bacterial infections, such as pneumonia, meningitis, urinary tract infections, and infections of the skin and soft tissues.
NEONATAL SEPSIS
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.
(a)1.4 cases per 1,000 live births
(b) 0.8 cases per 1,000 population.
(3) SUBJECTIVE DATA of NEONATAL SEPSIS
- Mother’s report of pain
- Mother’s report difficulty breathing
- Reports of s/s infection (burning with urination, frequent cough, green mucus, etc.)
Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, During Pregnancy
- Any fetal concerns during the pregnancy (e.g. growth problems or ultrasound scan abnormalities)?
- Any maternal illness during pregnancy (particularly infections)?
- Has the mother previously given birth to a baby who developed an invasive infection?
Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, Labor and Delivery
- What was the duration of membrane rupture?
- Did the mother develop a fever during labor?
- Were prophylactic antibiotics for GBS recommended and, if so, were they given?
Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, Birth
- What gestational age was the baby born at?
- What was the baby’s birth weight?
- What were the baby’s Apgar scores?
- Were any abnormalities noticed during the baby check?
Neonatal Sepsis. What questions should be asked for HEALTH HISTORY, Since birth
- Have there been any feeding problems?
- Has the baby passed urine and meconium?
- Has the baby received any interventions?
- Have the parents or nursing staff noticed any of the clinical features of sepsis?
(11) OBJECTIVE DATA of NEONATAL SEPSIS
- Body temperature changes
- Breathing problems
- Diarrhea,
- Low blood sugar
- Reduced movement
- Reduced sucking
- Seizures
- Slow heart rate,
- Swollen belly area
- Vomiting
- Yellowish skin and whites of the eyes (Jaundice)
Physical Assessment of NEONATAL SEPSIS
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
(4) Diagnostic and Laboratory Tests of NEONATAL SEPSIS
- CBC
- Blood culture
- Arterial blood gas (ABG)
- C-reactive protein (CRP)
Diagnostic and Laboratory Tests of NEONATAL SEPSIS:
used to identify the organism, and the susceptibility or resistance to specific antibiotics
Blood culture
Diagnostic and Laboratory Tests of NEONATAL SEPSIS:
is drawn to determine if acidosis or alkalosis is present and accurate oxygen saturation levels.
Arterial blood gas (ABG)
Diagnostic and Laboratory Tests of NEONATAL SEPSIS:
is a nonspecific indicator of inflammation.
C-reactive protein (CRP)
CRP responds within_____ hours of an inflammatory reaction; over____mg/dL is considered elevated.
6-8 hours
0.2mg/dL
NURSING DIAGNOSIS
PLANNING & IMPLEMENTATION CARE of NEONATAL SEPSIS
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
(13)NURSING INTERVENTIONS of NEONATAL SEPSIS
- Prompt lab draws
- Blood Cultures
- Appropriate administration of IV antibiotics
- Drawing the labs, then starting antibiotics as ordered is the nurse’s responsibility.
- The goal is to initiate broad-spectrum antibiotics within 1 hour of recognition of sepsis
- Optimize fluid-volume status
- Assess, monitor, and optimize cardiac output
- MAP should be monitored with an arterial line when administering vasopressors
- Lactic acid levels are elevated with decreased tissue perfusion – following lactic acid levels helps to determine if therapy is being successful
- Assess, monitor, and support oxygen status
- Prevent infection
- Assess, monitor, and manage body temp
- Communicate with and educate patient and loved one
PHARMACOLOGIC THERAPIES of NEONATAL SEPSIS
use of antibiotics to fight the infection
PHARMACOLOGIC THERAPIES:
(4) antibiotics of NEONATAL SEPSIS
- Ampicillin
- Gentamicin
- Cefotaxime
4.Vancomycin
SURGICAL INTERVENTIONS of NEONATAL SEPSIS (3)
- IV Cannula insertion
- UMBILICAL CATHETERS
- NASO - GASTRIC TUBING
SURGICAL INTERVENTIONS of NEONATAL SEPSIS: This is to administer the doctor’s prescribed medications, fluids or even blood products. Aseptic technique is always observed.
IV Cannula insertion
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.
UMBILICAL CATHETERS
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.
NASO - GASTRIC TUBING
NUTRITION SUPPORT IN NEONATAL SEPSIS
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.
(6) Complementary and Alternative Therapy of NEONATAL SEPSIS
- 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. - 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 - Exchange transfusions
- Fresh frozen plasma
- Granulocyte transfusions
- Recombinant colony-stimulating factors
