The Neonate Flashcards
How do you recognise a sick neonate
- Poor feeding
- Dry nappies
- Not passed mec
- Jaundice
- Respiratory distress
- Temp lower than 36.5 - higher than 37.5
How is heat lost in the neonate?
Conduction - direct heat loss
Convection - through the air
Evaporation - heat loss when water evaporates from the skin
Radiation - electro magnetic waves from skin to surrounding surfaces
How can hypothermia be prevented?
Thermo-neutral environment
Skin to skin
Dress the baby
What is hypoglycaemia
Low blood sugars
Blood sugars should be maintained at >2.5mmol/l
Blood sugar levels drop immediately after delivery and are at the lowest approx 1 hour after birth
What are some risk factors for hypoglycaemia
Sepsis Hypothermia Prematurity IUGR SGA LGA Maternal diabetes
What are some of the symptoms of hypoglycaemia?
Jitteriness High pitched cry Unsettled Poor feeding Drowsiness Lethargy
How can hypoglycaemia be prevented?
Skin to skin
Early and regular feeding
Monitoring blood sugars
What is neonatal jaundice?
Jaundice is the yellow colouring of the skin causing a build up of bilirubin in the blood
Very high levels of jaundice can be neurotoxic, leading to death and long term disability
In most neonates this is part of normal transition to ex utero life but in some infants the rise is excessive and can be harmful.
What are the 2 types of jaundice?
Physiological
- usually occurs >24 hours age usually around day 3
- often doesn’t require treatment
- should resolve within 2 weeks
- not normally associated with underlying disease
Pathological
- usually presents within 24 hours
- persists beyond 2 weeks of age
- pale stools / dark urine
What are some common causes and risk factors of neonatal jaundice?
- Breastfeeding
- Previous sibling with jaundice requiring phototherapy
- Significant bruising
- East Asain ethnicity
- Prematurity
- Infection
What are the symptoms of jaundice?
Yellow tinge to the skin Lethargy Poor feeding Dark urine Pale stools Seizures Arching of the neck and back
How can jaundice be diagnosed?
Bilirubin screening
SBR levels
Visual check of the skin
How can jaundice be treated?
- Regular feeding
- Phototherapy
- Exchange transfusion
- Manage conditions
Why are preterm and sick neonates at particular risk of infection?
- Immature immune system
- Delayed feeding
- Immature skin which is easily damaged
- Exposure to maternal infection
- Invasive procedures
What are the different types of infections in the neonate?
- Congenital infection
- Early onset sepsis
- GBS
- E.coli
- MRSA
