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PHARMACY PRACTICE II > NEONATAL SEPSIS > Flashcards

NEONATAL SEPSIS Flashcards

1
Q

Neonatal sepsis

A

signs and symptoms of infection with or without accompanying bacteremia in the first month of life

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2
Q

Systemic infections classified under neonatal sepsis

A

Septicemia
Meningitis
Arthritis
Osteomyelitis
UTIs
Pneumonia

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3
Q

Are superficial infections included in neonatal sepsis

A

NO

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4
Q

Contributing factors to newborn’s susceptibility to infections

A

Immature immune system
Immature skin and mucosal surfaces
Open portal of entry in umbilical cord

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5
Q

Neonatal sepsis mortality rate is higher among……

A

Low birth weight
Pre-term neonates

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5
Q

Risk of sepsis is higher in this population of neonates

A

Prematurity
Low birth weight
Neonate with underlying illness

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6
Q

Gold standard for diagnosis of sepsis

A

Growth of an organism from a sterile site

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7
Q

Danger signs for severe illness in newborns

A

Not feeding well
Convulsions
Fast breathing (60bpm or more)
Severe chest indrawing
Fever (37.5 or more)
Low body temperature (less than 35.5)
Movement only when stimulated or no movement at all

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8
Q

Recommendations on the danger signs

A

Presence of any one of the danger signs is predictive of severe illness
If 1 or more dangers signs, treat immediately
Begin treatment and refer if facility cannot support care of the infant

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9
Q

Classification of neonatal sepsis

A

Early onset neonatal sepsis
Late onset neonatal sepsis

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10
Q

Early onset Neonatal sepsis

A

Presents within 0-3 days of life
Associated with microbes from mother

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11
Q

Late onset Neonatal Sepsis

A

Present after 3 days of life
Associated with care giving environment

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12
Q

Onset of EOS is most rapid in which group of neonates

A

Premature neonates

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13
Q

Pneumonia is common in which type of neonatal sepsis

A

Early onset sepsis

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14
Q

When does 85% of cases of EOS occur

A

Within 24hours of birth

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15
Q

Common organisms associated with EOS

A

Group B streptococcus
E. coli
Coagulase-negative Staphylococcus

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16
Q

Risk factors for EOS

A

Premature birth or LBW
Maternal UTI
Maternal fever >38
Poor prenatal care
Poor maternal nutrition
PROM (<37 weeks)
Prolonged PROM
Prolonged rupture of membranes (18hrs or more)
Intraamniotic infection
Maternal colonisation with group B streptococci

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17
Q

PROM

A

Premature rupture of mebranes (rupture of featl membranes prior to onset of regular uterine contractions, 37 weeks or more)

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18
Q

Infections common in LOS

A

Meningitis
Bacteremia

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19
Q

Common organisms associated with LOS

A

Klebsiella
E coli
Coagulate negative staphylococcus
Staphylococcus aureus

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20
Q

Common organisms associated with both EOS and LOS

A

E. coli
Coagulase negative staphylococcus

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21
Q

Risk factors for LOS

A

Prematurity
Birth asphyxia, meconium staining, stress
Environmental exposure
Procedures (eg. lines, ET-tubes)
Breaks in skin and mucous membranes integrity

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22
Q

Conditions that cause breaks in skin and mucous membranes in neonates

A

Omphalocoele
Meningomylocoele

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23
Q

What percentage of newborn deaths in Ghana is due to neonatal sepsis

24
Maternal risk factors associated with neonatal sepsis in Ghana
Parity Mode of delivery Bleeding disorder PROM
25
Neonatal risk factors associated with neonatal sepsis in Ghana
APGAR score in the first and fifth minute Need for resuscitation at birth Duration of stay in the facility Neonatal age on admission
26
Most common adverse event in health facilities
Hospital acquired infections
27
Signs of local infection
Many or severe skin pustules Umbilical redness extending to peri-umbilical skin Umbilicus draining pus Bulging fontanelle Painfull joints, joint swelling, reduced movement, irritability if these parts are handled Eye discharge Abscess
28
Investigations for sepsis
FBC, RBS, BUE, Blood culture Urine culture Swab of any leasion or discharge area for C&S CSF biochemistry and C&S X-ray Blood gases Serum bilirubin Oxygen saturation
29
Managing abdominal distention in neonates
NIL orally, Gastric aspiration 2 hourly until no distension
30
Supportive treatment for SEPSIS
Ensure ABC IV fluids as required Maintain temperature O2 as required Manage seizure Introduce feeding asap Manage metabolic problems Manage abdominal distension
31
If sepsis is not improved in -------- hours, refer to higher center
12 hours for neonatal sepsis 48 hours for cord sepsis
32
Treatment for neonatal sepsis
IV/IM Ampicillin + IV/IM Gentamycin or IV/IM Ampicillin + IV Cefotaxime
33
Treatment for cord sepsis
IV/IM Flucloxacillin + IV/IM Gentamycin
34
Treatmment for sepsis when meningitis is suspected or proven
IV Ampicillin + IV Gentamycin
35
Diagnosis of meningitis
WBC in the CSF 20/mm3 or more for babies<7days or 10/mm3 or more for babies 7days old or more Culture or Gram stain of CSF is positive
36
Duration for treatment of sepsis with meningitis
If baby's condition improve after 48 hours Continue for 14 to 21 days or for 7 days after signs of improvement are first noticed
37
Dose of ampicillin for sepsis
50mg/kg/dose 12 hourly for <7days 50mg/kg/dose 8hourly for 7 days old or more
38
Dose of ampicillin for meningitis
100mg/kg/dose 12 hourly for babies < 7 days 100mg/kg/dose 8 hourly for babies more or equal to 7 days old
39
Dose for flucloxacillin for cord sepsis
50mg/kg/dose 8 hourly
40
Dose of Gentamicin for both sepsis and meningitis
<2Kg- 4mg/kg once daily 2Kg or more- 5mg/kg once daily
41
Dose of Cefotaxime for sepsis
<7days- 50mg/kg/dose 12 hourly 7 days or more- 50mg/kg/dose 8 hourly
42
Cefotaxime for meningitis
50mg/kg/dose 8hourly for <7days old 6hourly for 7 days old or more
43
Chain of infection
Infectious agent Reservoir host Portal of exit Route of transmission Portal of entry Susceptible host
44
Route of transmission of infections
Air Ingestion Direct or indirect contact
45
What is IPC
Procedures and practices used to reduce the risk of spreading infections esp in healthcare facilities
46
What are standard precautions
Basic level infection control precautions which are to used as a minimum in the care of all patients
47
12 components of standard precautions
1.Proper hand hygiene 2. Appropriate use of PPE 3. Patient placement and transportation 4. Effective processing of used patient care equipment 5. Proper environment cleaning and disinfection 6. Appropriate sharps management 7. Proper healthcare waste management 8. Safe injection practices 9. Occupational health and bloodborne pathogens 10. Appropriate handling of textiles, line and laundry 11. Proper management of clinical specimen 12. Respiratory hygiene/Cough etiquette
48
Transmission Based Precautions
Used when the route of transmission cannot be completely interrupted using standard procedures
49
When is transmission based precaution used
1. Patients in isolation 2. Outbreaks of highly infectious diseases 3. Infections of epidemiological importance
50
Categories of TBP
1. Contact precautions 2. Droplet precautions 3. Airborne precautions
51
Contact precautions
Gloves and Gown
52
When is contact precautions employed
Pemphigus neonatarium Cholera Scabies Herpes simplex
53
Face shield and Face mask
Droplet precautions
54
Droplet precautions are employed in
Whooping cough Meningitis Influenza
55
Airborne precautions
N95 Mask
56
Airborne precautions are employed in
Tuberculosis Measles Chicken pox
57
The five cleans
Clean hands Clean surfaces and linen Clean and dry cord Clean cut and tie Sterile instruments
58
Preventive elements of essential newborn care
1.Early and exclusive breastfeeding 2.Cord care 3. General hygiene 4. Thermal care

PHARMACY PRACTICE II (17 decks)

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