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DISEASE
OF THE NEWBORN
Wenna May S. Ramojal
INTRODUCTION
Hyaline
membrane
diseasealso
known
as
neonatalrespiratory distress syndrome,lung disease of
prematurity, orsurfactant deficiencyrefers to lung
pathology which results from insufficient production of
surfactant.
RDS almost always occurs in newborns born before
37 weeks of gestation. The more premature the baby
is, the greater is the chance of developing RDS. RDS is
more likely to occur in newborns of diabetic mothers.
OBJECTIVE
General objective:
To know more about Hyaline Membrane
Specific objective:
To know the Health History of Baby Boy L.
To identify the precipitating factors of his premature
delivery.
To understand the anatomy and physiology of the
disease.
To determine the laboratory result of Baby Boy L.
To study about the drugs given to the patient.
To discuss different nursing Care plans in relation to
DEFINITION OF
DIAGNOSIS
A respiratory disease of the newborn, especially the
premature infant, in which a membrane composed of
proteins and dead cells lines the alveoli (the tiny air
sacs in the lung), makinggas exchangedifficult or
impossible. The word "hyaline" comes from the Greek
word "hyalos" meaning "glass or transparent stone
such as crystal." The membrane in hyaline membrane
disease looks glassy.
Hyaline
membrane
is
now
commonly
calledrespiratory distress syndrome (RDS). It is caused
HISTORY
Baby Boy Ls mother used to have prenatal
every month in their Rural health unit and
shows good finding about the patient.
According to his mother, she didnt took any
drugs during conception just to assure that the
baby will be safe and will have no
abnormalities. Her mother was a plain house
wife and having light chores to do everyday
such us cooking foods for the family, sweeps
Maternal History:
Mother L is 19 years of age from Bukidnon. She is 5 th
among the 7 children. According to her, she was delivered
via NSVD and doesnt have any vaccination during their
time for they live in the farthest part of the province.
Shes currently living with his boyfriend at Magpet where
she have her conception with the patient. She eats well
especially vegetables.
It was December 10, 2014, Wednesday dawn when she
felt labor pain and noticed that there is spotting already and
there is water coming out from her. She was then rushed to
Cotabato Provincial Hospital for immediate treatment and
later on, she delivered a premature baby boy.
Paternal History:
Father L is 24 years of age from Bukidnon also. He is
3rd among the 4 children. According to him, there was
no incidence in their family that was delivered
prematurely. And during his time, his mother used to
go to manghihilot during conception.
He doesnt have any vices and dont used to drink
liquors too. He is currently works as a farmer.
PHYSICAL ASSESSMENT
General Health Survey/ Anthropometric Measurements
Flexed head and extremities
Head, 30cm; chest, 27cm; abdomen 23cm
Length head to heel, 44cm
Weight, 1.5 kgs
Vital Signs
Axillary temperature: 36.8C
Pulse, 140bpm
Respirations, 62cpm, irregular
Apgars
2 and 5
Integumentary
Bluish color of the skin and mucus membranes (cyanosis)
Head/Face
Positive molding but skull appears symmetrical
Fontanels soft and flat
Respiratory
Tachypnea (RR: 67)
Cardiovascular
Cyanotic
Apical pulse, 140 regular
Positive femoral pulses
Gastrointestinal
Positive Bowel sounds
Anus patent
Umbilical cord white with two arteries and 1 vein, intact with no discharges
Genitourinary
Voided
Genitalia
Pink and edematous
Musculoskeletal
10 fingers and 10 toes
No fractures or discolorations
ANATOMY AND
PHYSIOLOGY
The Respiratory System in Babies
What is respiration?
Respiration is the act of breathing in and out.
When you inhale, you take in oxygen. When
you exhale, you give off carbon dioxide.
The right lung has 3 lobes. The left lung has 2 lobes.
When you breathe, the air:
Enters the body through the nose or the mouth
Travels down the throat through the voice box (larynx)
and windpipe
Goes into the lungs through tubes called mainstem
bronchi:
One main stem bronchus leads to the right lung and one to
Breathing in babies
An important part of lung development in babies
is the production of surfactant. This is a substance
made by the cells in the small airways and
consists of phospholipids and protein. By about 35
weeks gestation, most babies have developed
enoughsurfactant. Surfactant is normally released
into the lung tissues where it helps lower surface
tension in the airways. This helps keep the lung
alveoli (air sacs) open. Premature babies may not
have enough surfactant in their lungs and may
have difficulty breathing.
PATHOPHYSIOLOGY
DIAGNOSTIC TEST
Hgt
Hct
Hmoglobi
n mass
newborns.
2/3 (low) A low hematocrit means the percentage of red blood cells is
203
DIAGNOSTIC TEST
WBC
14.9 x
Platelet
Neutrophils
10/g
162
0.51
Indicates infection.
Normal level.
Lower that normal level. The
lower your neutrophil count,
the more vulnerable you are
Lymphocyt
es
0.39
to infectious diseases.
Higher than normal level
DRUG STUDY
PROGNOSIS
CRITERIA
POOR
1. Duration of
illness
2. Onset of
illness
3.
Precipitating
Factors and
Predisposing
Factor
FAIR
GOOD JUSTIFICATION
PROGNOSIS
CRITERIA
POOR
4. Age
5. Environment
6. Family
support
7. Attitude and
willingness to
take
medications/
compliance to
treatment
regimen
FAIR
GOOD JUSTIFICATION
Indications:
Score:
1 Poor
2 Fair
3 Good
1x3=3
2x4=8
3x0=0
Total:
IDEAL:
11/7=1.57
Result = Poor