Topic 11: Neonatal Nursing Flashcards
How old are neonates?
usually less than 4 weeks
What are the differences in the physiological make up of neonates to adult animals?
- lower resting body temp
- inability to maintain body temp in extreme temps
- lower PCV
- Less efficient cardiac output
- poorer resp. ability, denser lungs
- poorer renal function, inability to concentrate urine
- low body fat stores
- poor bone mineralisation
- poor immune response
- poor vision/hearing/locomotion
What is the best method for checking a neonates health status over time?
weighing (weight)
-weight gain should be occuring
What is the most common cause of death in a new born?
Hypothermia
What does hypothermia cause in a neonate?
- suckling becomes weak
- intestines become hypomotile
- HR increases
- dropping of T
- intestinal stasis
- bacterial gas production
- lowered HR
- hypoglycaemia
- Cold/pale MM
How do we treat hypothermia in neonates?
Hypothermic patients should be re-warmed slowly (1-2 hours) using
a human neonatal incubator.
warmed wheat bags
hot water bottles insulated with towels
Heat lamps and electric heating pads are not recommended because of they can cause burns and overheating.
Monitor the environmental temperature and monitor the patient’s body temperature.
Turn the patient every 20 minutes while taking the temperature.
Once the patient has warmed and its suck reflex and intestinal motility have returned, supplemental feeding can be started.
What condition commonly occurs during birthing?
How should it be treated?
- Hypoxia
- Treat hypoxia with oxygen supplementation: oxygen tent, oxygen cage, nasal tube or face mask (short-term only)
- Measuring the oxygen saturation with a pulse oxymeter may give a false reading due to the animal’s poor circulation, so should not be relied upon.
How can a newborn be resuscitated?
- If the animal is unresponsive and not breathing, warm the newborn and stimulate it by rubbing its skin with a warm towel. This can often be enough to revive the animal and stimulate it to breathe.
- clear the airway, by applying gentle suction with a rubber bulb syringe to the nose and mouth. Do not swing the animal.
- If bradycardic and unresponsive, perform chest compressions with the thumb and forefinger at a rate of 1 to 2 compressions per second.
How do we determine if a neonate is dehydrated?
examine MM and eye for dryness -do not rely on skin turgor
How do we rehydrate a neonate?
- prewarmed Lactated ringers and 5% dextrose fluids can be given at a maintenance rate of approx 60-100 ml/kg per day, via:
- naso-gastric tube
- rectally
- SC
- IV
- IP
- IO
Why do neonates commonly get hypoglycaemia?
Clinical signs?
- Neonates can only maintain their glucose levels for a maximum of 24 hours without eating.
- After this, the blood glucose levels rapidly drop leading to symptoms of poor vision, incoordiation, muscle tremours, seizures, lethargy, collapse, death.
How do we treat hypoglycaemia in neonates?
Treatment is IV 10% Dextrose 1-2ml/ kg, or orally 10% dextrose via nasogastric tube 1-2ml/kg every 15 mins.
What is neonatal septicaemia?
- life-threatening bacterial infection. It can be caused by a number of common bacterial organisims including Staph, Strep, E Coli, Enterobacter, Clostridium and Salmonella.
How is neonatal septicaemia caused?
- bacteria can enter the body through the skin, the umbilicus, the respiratory tract, gastrointestinal tract or urinary tract.
- lack of colostrum, as well as hypothermia, hypoglycaemia, concurrent viral or parasite infection, and maternal mastitis/metritis will predispose the neonate to septicaemia.
What are the clinical signs of neonatal septicaemia?
- crying, restlessness, weakness, hypothermia, cyanosis, shock, and sudden death often without other symptoms.
- Bacteriology culture and sensitivity tests are performed and then appropriate antibiotic intravenous treatment is given.
