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PRETERM NEWBORN
• A neonate born before 38 weeks of gestation
• The primary concern relates to immaturity of
all body systems
CLINICAL FINDINGS
• respirations are irregular with periods of apnea
• body temp. is below normal
• poor suck and swallow reflexes
• diminished bowel sounds
• increased/decreased UO
• extremities are thin, with minimal creasing on soles and palms
• extends extremities & does not maintain flexion
• Lanugo present in wooly patches
• skin thin, with visible bld. vessels & minimal SQ fat pads
• skin may appear jaundiced
• testes undescended in boys
• labia narrow in girls
PRETERM NEWBORN
NURSING INTERVENTIONS
• Monitor V/S q2h
• Maintain cardiopulmonary functions
• Administer O2 & humidification as prescribed
• Monitor I&O and electrolyte balance
• Monitor daily weight
• Maintain in a warming device
• Position q 1-2 h and handle newborn carefully
•Provide newborn with appropriate stimulation, such as
touch
• Avoid exposure to infections
Best Procedure
• Resuscitation
• Suctioning
Intubations
CLINICAL FINDINGS
• Hypoglycemia
• Parchment-like skin (dry & cracked) without lanugo
• Fingernails long & extended over ends of fingers
• profuse scalp hair
• body is long & thin
• extremities show wasting of fat & muscle
• meconium-staining may be present on nails & umbilical
cord
POSTTERM NEWBORN
NURSING INTERVENTIONS
• Providenormal newborn care.
• Monitor for hypoglycemia.
• Maintain newborn’s temperature.
• Monitor I&O and electrolyte balance
• Monitor for meconium aspiration.
RH INCOMPATIBILTY
CLINICAL FINDINGS
• Excessive size and weight as a result of excess fat & glycogen in
tissues
• Edema or puffiness in the face & cheeks hypocalcemia,
hyperbilirubenemia
• Signs of hypoglycemia such as: twitching, difficulty in feeding,
lethargy, apnea, seizures, & cyanosis
• Hyperbilirubinemia
• Signs of respiratory distress such as: tachypnea, cyanosis,
retractions, grunting, & nasal flaring
NEWBORN OF DIABETIC
MOTHER
NURSING INTERVENTIONS
• Monitor for signs of respiratory distress.
• Monitor bilirubin and blood glucose levels.
• Monitor weight.
• Feed early with 10% glucose in water, breast milk,
or formula as prescribed.
• Administer IV glucose to treat hypoglycemia if
necessary and as prescribed.
• Monitor for edema.
• Monitor for tremors, seizures, apnea, and acidosis.
HYPOGLYCEMIA
• Abnormally low level of glucose in the blood (less than
30 mg/dl in the first 72 hours or below 40mg/dl after
thefirst 3 days of life
• Normal: 40-60 mg/dl
CLINICAL FINDINGS
• Increased RR
• Twitching, nervousness, or tremors
• Unstable temp.
• Cyanosis
HYPOGLYCEMIA
NURSING INTERVENTIONS
CLINICAL FINDINGS
FACIAL CHANGES
• Short palpebral fissures
• Hypoplastic philtrum
• Short upturned nose
• Flat midface
• Thin upper lip
• Low nasal bridge
FETAL ALCOHOL
SYNDROME
NURSING INTERVENTIONS
• Monitor for respiratory distress.
• Position newborn at the sides to facilitate drainage of secretions.
Diagnosis
a. Prenatal
1. Amniocentesis
2. Ultrasound
3. CT Scan
Treatment
a. Sac Closure in 48 hours
PREOP
• Prone or placed on their side with
support above and below the defect
• Sterile wet compress of saline,
antiseptic, or antibiotic gauze over
lesion
• Provide warmth
• Observe for seepage of clear fluid
(check for presence of glucose)
• Urine and feces must not touch the
lesion
• Measure HC
POST-OP
• Prone (7-14 days)
• Urine and feces must not touch the
incision area
• Feeding
• Observe for signs of increased ICP
• Turn to sides every 2 hours
• Provide normal stimulation
Nursing Care Spina Bifida