High-Risk-Newborn幻灯片.pptVIP

Meconium Aspiration Symptoms Cyanosis Rapid breathing Labored breathing Apnea X-ray patches or streaks of meconium trapped air Meconium Aspiration Nursing Management Assess for risk factors prior to delivery Suction at delivery prior to newborn crying Supplemental O2 Mechanical ventilation Antibiotic therapy Hyperbilirubinemia Excess of bilirubin in the blood-elevated bilirubin level 5mg/dl Heme from erythrocytes break down forms unconjugated bilirubin Jaundice Physiologic Pathologic Hyperbilirubinemia Causes Drugs/Medical conditions disrupt conjugation and albumin binding sites Decreased hepatic function Increased erythrocyte production Enzymes in breast milk Hyperbilirubinemia Physiologic Develops in 3-4 days after term birth Develops3-5 days after preterm birth Term birth resolves 7 days Preterm birth resolves 9-10 days Unconjugated bilirubin level 12mg/100 ml Hyperbilirubinemia Pathologic Develop after first day Persists beyond 7 days Bilirubin 12.9mg/100 term Bilirubin 15mg/100 preterm Increases 5mg/100ml in 24hrs Hyperbilirubinemia Nursing Management Phototherapy Increase feeding to q 2-3 hrs Phenylketonuria PKU Inability to metabolize phenylalanine- amino acid found in protein Affect brain and CNS development Interferes with the production of melanin, epinephrine thyroxine Both parents must pass the gene on Phenylketonuria PKU Symptoms Seizures Irritability Tremors Jerking movements arms legs Hyperactivity Unusual hand posturing Phenylketonuria PKU Diagnosed with PKU screening prior to discharge from hospital Hemolytic Disorders Hemolytic disease occurs when blood groups of mother and newborn are different Antibodies are present or formed in response to antigen from fetal blood crossing placenta and entering maternal circulation Hemolytic Disorders Maternal antibodies of IgG class cross placenta, causing hemolysis of fetal RBCs Fetal anemia Neonatal jaundice Hyperbilirubinemia Hemolytic Disorders Rh incompatibility (isoimmunization)