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High risk related to Dysmaturit

الكلية كلية التمريض     القسم قسم التخصصات التمريضية     المرحلة 3
أستاذ المادة عبد المهدي عبد الرضا حسن الشحماني       07/11/2018 05:18:25
HHigh risk related to Dysmaturity ? Preterm Infants ? Post term infants ? Preterm Infants: ? Infants born before completion of 37 weeks of gestation are considered preterm or premature regardless of birth weight. ? These newborns are the largest number to be admitted to the NICU.(neonatal intensive care unit)
? They have high incidence for complications and to have congenital defects ? Incidence ? Majority of cases the cause is unknown ? It is common in: a. In low socioeconomic classes b. Multiple pregnancies c. Interrupted pregnancy due to placental accidents d. Hypertension relater to pregnancy ?



The premature has to adjust to extra uterine life with his immature systems that leads to problems since his systems are not physiologically ready. ? Diagnostic evaluation: ? On inspection: Very small with little subcutaneous fat ? Large head in proportion to body ? Inactive and relaxed attitude ? Clinical manifestations of prematurity: 1. Very small, scrawny appearance 2. Skin: Red-Pink with visible veins 3. Fine, feathery hair, Lanugo on back and face 4. Little or no evidence of subcutaneous fat 5. Head is relatively large to body
6. Lies in a relaxed attitude 7. Limbs extended 8. Ear cartilage poorly developed 9. Few fine wrinkles on palms and soles 10. Clitoris prominent in females 11. Scrotum undeveloped and non pendulous with minimal rugae and undescended testes 12. Lax, easily manipulated joints 13. Absent, weak or ineffectual reflexes 14. Other neurological signs are absent or diminished 15. Unable to maintain body temperature
16. Diluted urine 17. Pliable thorax 18. Periodic breathing hypoventilation 19. Frequent episodes of apnea ? Therapeutic Management: ? When a preterm delivery is expected the NICU is alerted and the team of neonatal specialists are present at the time of delivery ? Resuscitation is done if needed in the lobar room the n infant is transferred to NICU in an incubator
? Measurements taken and vitamin K is given ? Cont. Management ? Respiratory support: Apnea mattress – Incubator – O2 monitoring ? Temperature regulation: Incubator, and monitoring of temperature, Humidity as recommended ? Cont. Management ? Complications such as hypoglycemia and hypocalcaemia are frequent in the premature infant and are managed according to specific conditions and monitored frequently
? Respiratory distress syndrome is very common and required respiratory support ? Post term infants ? Infant born after 42 weeks of gestation ? Incidence:12% of births ? Cause: Unknown ? Post mature (posterm) delivery is much less common than premature (preterm) delivery. The reason for a pregnancy to continue beyond term is usually unknown
? The placenta becomes less able to provide adequate nutrients to the fetus. ? To compensate, the fetus begins to use its own fat and carbohydrates to provide energy. ? As a result, its growth rate slows ? Its weight may decrease. ? If the placenta shrinks sufficiently, it may not provide adequate oxygen to the fetus, particularly during labor. A lack of adequate oxygen may result in fetal distress ? May result in injury to the fetal brain and other organs. ? Fetal distress may cause the fetus to pass stools (meconium) into the amniotic fluid. The fetus
inhale the meconium-containing amniotic fluid into the lungs during birth. ? As a result, the newborn may have difficulty breathing after delivery (meconium aspiration syndrome). ? Symptoms ? A post mature newborn has dry, peeling, loose skin ? May appear emaciated, especially if the function of the placenta was severely reduced. ? The newborn often appears alert.
? The skin and nail beds may be stained green if meconium was present in the amniotic fluid. ? A post mature newborn is prone to developing low blood sugar levels (hypoglycemia) after delivery, especially if oxygen levels were low during labor. ? Treatment ? The post mature newborn who experienced low oxygen levels and fetal distress may need resuscitation at birth. ? If meconium has been breathed into the lungs, a ventilator may be needed. ? Intravenous glucose solutions or frequent breast milk or formula
feedings are given to prevent hypoglycemia. ? If these problems do not occur, the major goal is to provide good nutrition so that the newborn can catch up to the weight that is appropriate for him. ? H Hi ig gh h r ri is sk k r re el la at te ed d t to o
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المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .