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Birth Related Stressors

Birth Related Stressors. Chapter 28. Asphyxia. Multiple systems effected Predisposing factors Nsg goals- oxygenation and warmth Initiation of resuscitation Check equipment Keep parents informed. Respiratory Distress Syndrome. Lack of surfactant Predisposing factors- prematurity

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Birth Related Stressors

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  1. Birth Related Stressors Chapter 28

  2. Asphyxia • Multiple systems effected • Predisposing factors • Nsg goals- oxygenation and warmth • Initiation of resuscitation • Check equipment • Keep parents informed

  3. Respiratory Distress Syndrome • Lack of surfactant • Predisposing factors- prematurity • Pulmonary vascular resistance increases • Respiratory acidosis • Metabolic acidosis • S/S- cyanosis, tachypnea, flaring, grunting, retracting

  4. Meconium Aspiration • Plugs alveoli • Allows are in not out • Evaluate tracing • Suction at perineum • Expect the unexpected

  5. Cold Stress • Effects- metabolic-cardiovascular-pulmonary system • Cause vasoconstriction • Assess for lethargy, apnea, hypoglycemia • Have warmer ready • Monitor temp- core vs. skin

  6. Hypoglycemia • Below 40mg/dl treat • Class A-C-Type I susceptible • S/S pallor-apnea-poor suck-cry • Reassess 30 min. after feeding • Too much glucose can cause rebound

  7. Jaundice • Cause- short life of RBCs-lack of intestinal bacteria-hydration • Need albumin to bind • Can be effected by drugs • Kernicterus- staining of basal ganglia

  8. Jaundice • Rh sensitization can cause erythroblastosis fetalis • Hydrops- sever anemia- organ failure • May deliver early • Physiologic vs. pathologic (Coombs) • Treat early

  9. Bililights • Assessment- lighting, palate, oral mucosa • Bililights helps to convert for excretion • Nsg- keep eyes covered, diaper, turn • Assess for dehydration

  10. Anemia- Polycythemia • Anemia- blood loss-hemolysis-decrease in RBCs • Decrease in bone marrow production • Check capillary refill • Polycythemia- increase in volume-Hct • Heal stick- look ruddy

  11. Newborn Infection • Can have rapid onset • Lack immunity • Premies • Assess labs • Look for subtle changes • Handwashing

  12. Parental Attachment • Must resolve grief before attaching • Facilitate bonding • Assess level of knowledge • Give positive feedback • Enroll in care • Prepare for discharge

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