1 / 22

Continuing Care

Continuing Care. Mary P. Martinasek, RRT Director of Clinical Education Hillsborough Community College. Homeostatic Thermoregulation. Defined as the maintenance of equality between: Heat dissipation and heat production Core body temp of 37 degrees C. Heat Production.

Mia_John
Download Presentation

Continuing Care

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Continuing Care Mary P. Martinasek, RRT Director of Clinical Education Hillsborough Community College

  2. Homeostatic Thermoregulation • Defined as the maintenance of equality between: • Heat dissipation and heat production • Core body temp of 37 degrees C

  3. Heat Production • Adult - can be produced by metabolic and physical activity (shivering) • Infant - has diminished shivering response and relies on metabolism of brown fat for heat production. • The breakdown of brown fat is called nonshivering thermogenesis

  4. Methods of Heat Loss • Radiant • Conductive • Convective (ambu bag air blowing on pt.) • Evaporative

  5. Goal of Thermoregulation • Maintain an environmental temperature such that the neonate’s core body temperature is maintained between 36.5 and 37.5 degrees C

  6. Thermoregulation • Incubator • Controlled environment (less convective heat loss) • Barrier to excessive handling • Quieter environment • Radiant Warmer (open bed) • Easier patient access (critical care) • Easier to attach probes and electrodes

  7. Fluid and Electrolyte Balance • Distribution of Body Water • 80% of total body weight of term infant • Decreases with aging • Distribution of Solutes • Fluid Deficit • Anterior fontanelles • Electrolyte Balance

  8. Extracellular Major Sodium Chloride Minor Potassium Calcium Magnesium Bicarbonate Protein Intracellular Major Potassium Magnesium Phosphate Minor Sodium Bicarbonate Distribution of Solutes

  9. Insensible Water Loss • IWL - water lost by evaporation from the skin and respiratory tract • Factors that increase insensible water loss • Premie • Respiratory distress • High environmental temperature • High body temperature • Break in skin • Radiant warmer • Phototherapy • Increased activity

  10. Neonatal Jaundice • Physiologic vs. Pathologic • Physiologic is common (25-50% of all newborns) • Pathologic • Caused by RH or ABO incompatibility • Bacterial or viral infections • Hemorrhaging in fetal body • IDM • Breast fed infants • Determined to be pathologic by certain criteria

  11. Exchange Transfusion • Used in an attempt to rid the neonatal body of factors causing hemolysis • Replaces about 87% of patient’s blood volume • Corrects severe anemia • Treats hemolytic disease by removing antibody-coated RBC • Removes excessive amounts of unconjugated bilirubin

  12. Necrotizing Enterocolitis (NEC) • Idiopathic disorder characterized by ischemia and necrosis of the intestine • Etiological Factors include: • Mucosal wall injury • Bacterial invasion into the damaged intestinal wall • Formula in the intestine

  13. Clinical Signs and Treatment • Guaiac-positive stools (presence of blood) • Poorly tolerated feedings • Abdominal distension • Bile residuals • Signs of sepsis (lethargy and increased O2 requirements) • Tx= avoid factors that lead to presence

More Related