New Pre Maturity Student

8/6/2019 New Pre Maturity Student

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Prematurity

Lifespan III


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Ineffective Thermo Regulation

The state in which the individuals

temperature fluctuates between

hypothermia and hyperthermia


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Prematurity Defined

Born before end of 37th week

Typically a lower birth weight

Now consists of about 13-15% of alldeliveries


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Causes of Prematurity

The biggest is unknown reasons

Medical conditions with mom such as PIH,

Infection, DM, Heart Disease, incompetentcervix, defect in uterus, STDs, drugs,

alcohol, cigarette smoking, etc.


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Prenatal Tests for Maturity

Amniocentisis

L/S Ratio: estimates pulmonary maturity

a ratio used to determine fetal pulmonarymaturity, found by testing the amniotic fluid;

when the lungs are mature, lecithin exceeds

sphingomyelin by 2 to 1.


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Physical Signs of Prematurity

Basis for Gestational Age

Body hair (lanugo)

Abnormal breathing patterns (shallow,

irregular pauses in breathing called apnea)

Enlarged clitoris (female infant)

Problems breathing due to immature lungs(neonatal respiratory distress syndrome) orpneumonia

Lower muscle tone and less activity thanfull-term infants


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Ballard Score

6 neuromuscular signs

6 external physical signs

Age assessable from 20-44 weeks


8/24

Review of A&P-Thermoregulation

Thermoregulation

Evaporation:

Convection:

Conduction:


9/24

Body Surface Factors

Cold Stress-

Posture-

Brown Fat Stores-


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Consequences of Cold Stress

o metabolic consumption of calories

o oxygen consumption p hypoxia

o glucose consumption p hypoglycemia Fatty acid release p hyperbilirubinemia

andq bilirubin levels

Interference with clotting factorso risk of bleeding


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Heat Production

Constriction of blood vessels in the skin

Increase metabolic rate

Restlessness and hyperactivity

Non-shivering thermogenesis-


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How can we prevent heat loss?


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More Nursing Management for

Premies!

Remember they are only as old as their

due date!

Remember this is scary-so lots of TLC

Skin-to-skin (AMAZING)


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Respiratory Distress Syndrome


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Pathophysiology Of RDS

Deficiency in surfactant activity = high

pulmonary resistance


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S&S of RDS

Occurs within 2 hours after birth (usuallynoticed during initial assessment)

Expiratory grunt or sigh


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Treatment

Supportive

Provide oxygen-warm and moistened

CPAP

ECMO


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Risk Factors for RDS

A brother or sister who had RDS

Diabetes in the mother

Cesarean delivery

Delivery complications that lead to

acidosis in the newborn at birth

Multiple pregnancy (twins or more) Rapid labor


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Complications

Air or gas may build up in:

The space surrounding the lungs (pneumothorax)

The space in the chest between two lungs

(pneumomediastinum) The area between the heart and the thin sac that

surrounds the heart (pneumopericardium)

ROP

BPD

And more


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Retinopathy of Prematurity


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Risk Factors For ROP

In addition to prematurity, other risks

factors may include:

Brief stop in breathing (apnea)

Heart disease

High carbon dioxide (CO2) in the blood

Infection


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Stages of ROP

There are 5 stages of ROP.

Stage I: There is mildly abnormal blood vessel

growth.

Stage II: Blood vessel growth is moderately

abnormal.

Stage III: Blood vessel growth is severely

abnormal.

Stage IV: Blood vessel growth is severely

abnormal and there is a partially detached

retina.

Stage V: There is a total retinal detachment.


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S&S of ROP

Symptoms of severe ROP include:

Abnormal eye movements

Crossed eyes

Severe nearsightedness

White-looking pupils (leukocoria)


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Treatment of ROP

Early intervention has the best outcomes

Cryotherapy

Laser Therapy

Surgery if detachment

Documents

New Pre Maturity Student