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NORMAL FINDINGS:
- Temp: between 36.5°C (97.7°F) and 37.5°C (99.5°F)
- NB does not shiver/sweat
-acrocyanosis (immediately after birth)
ABNORMAL FINDINGS:
- Cool to the touch
-Cyanosis
- Nursing interventions: promote skin to skin, warmed blankets/radiant
warmer, use of clothes/hats, dry quickly after birth & baths, expose as little
as possible when assessing & delay first bath until temp is stable
WHO HAND HYGEINE
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, outlines that you should be washing hands w/ soap & water when visibly
soiled & using an alcohol based hand rub when hands are not visibly soiled,
keeping sleeves above elbows when washing, removing rings & bracelets
prior to hand washing, cleaning stethoscope before & after each use, wash
hands prior to and after each contact with infant (regardless of glove use),
wear gloves when in contact w/ mucous membranes/blood products/body
fluids/wounds, keep nails short & do not wear artificial nails.
NB SCREENING
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-collected via heel stick within 24 hrs- 7 days of life & can detect disorders
before infant is symptomatic
-hearing screening is also done before discharge
SEPSIS
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, - critical condition in which the body's immune response to an infection
causes systemic inflammation and damage to body tissues.
- definitive diagnosis must be done via blood culture (obtain before
antibiotic administration)
-s/sx: can be non-specific and subtle, Ø includes respiratory distress,
lethargy (late sign), irritability (late), hypotonia, feeding intolerance, V/D,
glucose instability, cardiovascular changes (bradycardia & hypotension are
late signs), poor perfusion (pallor is a late sign), jaundice, temp instability,
oliguria (late), metabolic acidosis, thrombocytopenia & neutropenia
-Antibiotics are the primary treatment for sepsis. Another critical
intervention is IV fluid resuscitation with isotonic saline to ensure adequate
perfusion, accompanied by regular evaluation of both fluid and electrolyte
balance.
-hand hygeine is the best way to prevent infection
GASTROSCHISIS
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-abdominal wall defect at the level of the umbilicus where the
intestines/bowel are outside of the abdomen with no covering
-Complications are generally related to surgery, sepsis, malnutrition,
adhesions, and short-bowel syndrome
- Delivery room procedures are similar to those for infants with
omphalocele.
MECHANISMS OF HEAT LOSS
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, CONVECTION: heat transfer from the newborn to the surrounding air
(keep ambient temp up & avoid drafts from windows/vents)
EVAPORATION: heat loss due to liquid evaporation (dry neonates after
birth, bathe in warm environment & stabilize temp before bathing)
CONDUCTION: heat transfer from newborn to another object via direct
touch (skin to skin & place infant on prewarm surfaces)
RADIATION: heat transfer from the newborn to nearby surfaces (keep NB
away from windows)
FETAL GROWTH RESTRICTION
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-a potential result of post term pregnancy, can happen due to insufficiency
of an aging placenta, with the result of an infant who is small for gestational
age (SGA)
- glucose screening indicated due to increased risk of hypoglycemia
- increased risks of polycythemia & hypocalcemia
- FGA is worsened by uterine contraction (worsens placental insufficiency)
and can lead to hypoxia, which can lead to metabolic acidosis.
-Thermoregulation by use of a skin-to-skin contact, an isolette, or a radiant
warmer is critical to avoiding cold stress, which can exacerbate problems
related to perinatal asphyxia.
CAFFEINE CITRATE
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