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MATERNAL FACTORS AFFECTING THE NEONATE 3. Infection a. Premature rupture of membrane b. Premature labor / birth c. Chorioamnionitis d. Recent maternal infection / illness e. Intrapartum / postpartum maternal fever (> 380 c) assess severity of apnea and quality of air entry Gasping! Ominous sign of impending cardiorespiratory arrest.
MATERNAL FACTORS AFFECTING THE NEONATE 3. Infection a. Premature rupture of membrane b. Premature labor / birth c. Chorioamnionitis d. Recent maternal infection / illness e. Intrapartum / postpartum maternal fever (> 380 c) assess severity of apnea and quality of air entry Gasping! Ominous sign of impending cardiorespiratory arrest.
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MATERNAL FACTORS AFFECTING THE NEONATE 3. Infection a. Premature rupture of membrane b. Premature labor / birth c. Chorioamnionitis d. Recent maternal infection / illness e. Intrapartum / postpartum maternal fever (> 380 c) assess severity of apnea and quality of air entry Gasping! Ominous sign of impending cardiorespiratory arrest.
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Attribution Non-Commercial (BY-NC)
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Descărcați ca PPT, PDF, TXT sau citiți online pe Scribd
1. Hypertension a. pre- eclampsia b. eclampsia 2. Bleeding a. abruptio placenta b. placenta previa
MATERNAL FACTORS AFFECTING THE NEONATE
3. Infection a. Premature rupture of membrane b. Premature labor/ birth c. Chorioamnionitis d. Recent maternal infection/ illness e. Intrapartum/ postpartum maternal fever (> 380 C) f. Rupture of membranes > 18 hours
EVALUATE RESPIRATORY DISTRESS
RESPIRATORY RATE Normal * 30 60 breaths per minute * breathing without difficulty * Auscultation clear breath sounds, equal air entry bilaterally
EVALUATE RESPIRATORY DISTRESS
Respiratory rate < 30 per minute * if labored, may be sign of exhaustion * assess severity of apnea and quality of air entry * Gasping ! Ominous sign of impending cardiorespiratory arrest
EVALUATE RESPIRATORY DISTRESS
Respiratory rate > 60 per minute * Evaluate ventilation & oxygenation * work of breathing * blood gas
EVALUATE RESPIRATORY DISTRESS
DIFFERENTIAL DIAGNOSIS Preterm: RDS Term: TTN Pneumonia DIAGNOSTICS CXR CBC w Pc
Blood CS Hgt
EVALUATE RESPIRATORY DISTRESS
Work of breathing or respiratory effort 1. Grunting attempt to increase intrathoracic pressure in response to collapse of alveoli * helps retain small volume of air in alveoli 2. Nasal flaring attempt to decrease airway resistance * sign of air hunger 3. Retractions
EVALUATE RESPIRATORY DISTRESS
3. Retractions a. Intercostal b. Substernal c. Subcostal d. Suprasternal : between ribs : under sternum : below rib cage : above sternum
EVALUATING FOR SHOCK
RESPIRATORY EFFORT * increased work of breathing * tachypnea * apnea * !!! Gasping * Arterial blood gas - Respiratory, Metabolic or mixed acidosis?
EVALUATING FOR SHOCK
PULSES * Strength of pulses a. weak evaluate for shock b. bounding consider PDA, large AV malformation, truncus arteriosus * compare brachial to femoral Brachial stronger than femoral consider coarctation or interrupted aortic arch
EVALUATING FOR SHOCK
PERIPHERAL PERFUSION 1. Capillary Refill Time (CRT) * Normal less than or equal to 3 secs * Compare upper to lower body 2. Cool skin
EVALUATING FOR SHOCK
COLOR 1. Cyanosis 2. Pale white - low hemoglobin 3. Mottled skin
EVALUATING FOR SHOCK
HEART RATE 1. NORMAL * 120 160 Beats per minute (bpm) * may range 80 200 2. Bradycardia * Heart rate < 100 bpm * hypoxemia, hypotension, acidosis depress conduction system * Rule out heart block 3. Tachycardia * sustained heart rate > 180 bpm * may indicate decrease cardiac output, CHF * Rule out arrythmias
NEONATAL INFECTION (SEPSIS)
CLINICAL SIGNS 1. Respiratory distress 2. Temperature instability 3. Feeding intolerance 4. Abnormal : a. skin perfusion b. heart rate c. blood pressure d. neurological status
NEONATAL INFECTION (SEPSIS)
PRE- TRANSPORT LAB EVALUATION Obtain the 4B s 1. Blood count 2. Blood culture 3. Blood sugar 4. Blood gas
: CBC w differential : obtain adequate amount : check early & be vigilant : respiratory distress suspected shock
WHEN TO CALL A DOCTOR
1. High risk pregnancy 2. Meconium stained amniotic fluid 3. Infant in respiratory distress 4. Infant who is not breathing or cyanotic 5. Infant with poor/ fair suck and activity