NEONATE: POSSIBLE COMPLICATIONS Flashcards
COLD STRESS
What is it?
How to Tx?
Neonates, particularly very low-birth-weight infants, are susceptible to environmental hypothermia; illness (eg, intracranial hemorrhage, sepsis) increases risk.
The optimal ambient temperature for neonates is that at which calorie expenditure needed to maintain normal body temperature is lowest, typically between 36.7° C and 37.3°
Rewarm neonates in an incubator or under a radiant warmer and treat any underlying conditions.
Prevent hypothermia by immediately drying and then swaddling the neonate.
Hypoglycemia
Occurs when?
S/S?
Frequently occurs in the first few hours of life.
What are the symptoms of hypoglycemia in the newborn?
Symptoms of hypoglycemia may not be obvious in newborn babies. The following are the most common symptoms of hypoglycemia. However, each baby may experience symptoms differently. Symptoms may include:
Jitteriness
Cyanosis (blue coloring)
Apnea (stopping breathing)
Hypothermia (low body temperature)
Poor body tone
Poor feeding
Lethargy
Seizures
Hypoglycemia: Risk Factors
Babies born to diabetic mothers may develop hypoglycemia after delivery when the source of glucose (via the umbilical cord) is gone and the baby’s insulin production metabolizes the existing glucose.
Small for gestational age or growth-restricted babies may have too few glycogen stores.
Premature babies, especially those with low birthweights, who often have limited glycogen stores (sugar stored in the liver) or an immature liver function.
Babies born under significant stress.
Babies who experience temperature instability (for instance, get cold) or when mothers were treated with certain drugs (for instance, terbutaline)
Infants of diabetic mothers
Babies who are large for their gestational age. This is associated with gestational diabetes, but also with forms of congenital hyperinsulinism
Hypoglycemia: s/s
Jitteriness
Cyanosis (blue coloring)
Apnea (stopping breathing)
Hypothermia (low body temperature)
Poor body tone
Poor feeding
Lethargy
Seizures
Hypoglycemia glucose level
Hypoglycemia is a condition in which the amount of blood glucose (sugar) in the blood is lower than normal (under 50 mg/dL).
Cold stress core is =<35c
Increase brown fat metabolism
Fat metabolism can lead to ketones in blood and predisposing to acidosis.
Cold stress rewarm infant slowly to avoid (2)
Hypotension
Apnea
Chronic hypothermia could be indicative of?
Early signs of sepsis
Sepsis
Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail.
If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death.
Anyone can develop sepsis, but it’s most common and most dangerous in older adults or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival.
Beta-hemolytic streptococcal vaginosis is most common cause of
neonatal sepsis and meningitis get crevice culture before delivery
Expiratory grunting and inspiratory nasal flaring are indicative of
Respiratory Distress
Crackles and wheezing are symptoms of…?
fluid or infection of the lungs
Cold stress: Nursing Actions
Monitor for s/s cyanotic trunk, depressed respirations
Warm slowly over a 2-4 hr period
Correct hypoxia by adm oxygen
Correct acidosis and hypoglycemia
Hypoglycemia
Nursing Actions:
1) Monitor for S/S Jitteriness Cyanosis (blue coloring) Apnea (stopping breathing) Hypothermia (low body temperature) Poor body tone Poor feeding Lethargy Seizures Glucose level less than 40 mg/dL by heel stick
2) Give formula immediately or BF
Hemorrhage due to improper cord care or placement of clamp: Nursing Actions
1) Ensure that the clamp is tight. No seepage of blood if so replace with another clamp
2) Notify HCP if bleeding continues
