Care of preterm babies

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ptrterm baby...nursing care

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Care of preterm babies

  1. 1. CARE OF PRETERM BABIES PRESENTED BY AMRUTHA R 1STYR MSc nsg
  2. 2.  <2500GMS  TYPES  VLBW  ELBW
  3. 3.  PRETERMS  IUGR
  4. 4.  DEFINITION  A baby born before 37 completed weeks of gestation irrespective of birth weight.
  5. 5.  Maternal factors  socio economic factors  Pregnancy related factors  Medical conditions  Anatomic issues  Behavioral factors  Infections
  6. 6.  SMALL AND SCRAWNY  PROPORTIONALLY LARGE HEAD TO BODY  TRANSLUCENT SKIN  VISIBLE BLOOD VESSELS
  7. 7.  FINE LANUGO HAIR  SOFT PLIABLE EAR CARTILAGE  SOFT BONES  CLOSED EYES
  8. 8.  FEW SCROTAL RUGAE AND UNDECENDEDTESTIS  PROMINENT LABIA AND CLITTORIS  INACTIVE AND LISTLESS  EXTENDED EXTRIMITIES  PARTIALLY DEVELOPED REFLUX ACTIVITIES
  9. 9.  ABSENTWEAK OR INEFECTIVE SUCKING  INABILITY TO MAINTAIN BODY TEMPERATURE  LIMITED ABILITY TO EXCRETE SOLUTES IN URINE  INCREASED SUSCEPTIBILITYTO INFECTION  PLIABLE THORAX IMMATURE LUNG TISSUE
  10. 10.  IMMATURE REGULATORY CENTRE  MORE SUSCEPT IBLE TO HYPOGLYCEMIA AND HYPER BILIRUBINEMIA
  11. 11.  POOR CONTROL OF BODY TEMPERATURE  RESPIRATORY DIFFICULTY  SUSCEPTIBILITY TO INFECTION
  12. 12.  DIFFICULTIES WITH NUTRITION  IMMATURITY IN RENAL FUNCTION
  13. 13.  HYPOTHERMIA  BREATHING DIFFICULTY  APNOEA  RDS
  14. 14.  INTRA VENTRICULAR HAEMORRHAGE  FEEDING DIFFICULTIES  HYPOGLYCEMIA  METABOLIC ACIDOSIS
  15. 15.  HYPERBILIRUBINEMIA  ROP  FLUID AND ELECTROLYTE IMBALANCES  NECROTISING ENTEROCOLITIS
  16. 16.  ANEMIA  BPD  INFECTIONS
  17. 17.  INTELLECTUAL DISABILITIES  CEREBRAL PALSY  VISIONAND HEARING LOSS
  18. 18.  CARE AT BIRTH  APPROPRIATE PLACE OF CARE  THERMAL PROTECTION
  19. 19.  FLUIDS AND FEEDS  MONITORING AND EARLY DETECTION OF COMPLICATIONS  APPROPRIATE MANAGEMENT
  20. 20.  Elective intubation of extremely LBW babies (< 1000g) is practised in some centers to support breathing and for prophy lactic administration of exogenous surfactant.
  21. 21.  The baby should be promptly dried, kept effectively covered andWarm.  Vitamin K 0.5 mg should be given intramuscularly.
  22. 22.  ETTUBE  VENTILATOR  C PAP  02 SUPPLEMENTATION
  23. 23.  MUMMIFICATION  KMC  NESTING  DELAY BATH  WARMER
  24. 24.  <30– IV FLUIDS, NG ,KATORI, BREAST FEEDS  30—34 NG ,KATORI, BREAST FEEDS  >34 KATORI, BREAST FEEDS
  25. 25.  PROTEIN  10% of daily calories should be derived from proteins.  • Recommended allowance for LBW neonates is 3-4 gms/kg/day  BREAST FEEDING
  26. 26.  Carbohydrates  • Should provide 40% energy.  • Recommended allowance is 10-15 gms/kg/day.  Fats  • Should provide 50% of total energy.  • Recommended allowance is 5.4- 7.2 gms/kg/day
  27. 27.  • Recommendations are 2.5 to 3.5 meq/ kg/ day each.  • Mature Human milk contains 1.1 meq/100 kcal of sodium and premature milk contains 1.9 meq /100 kcal which is often insufficient forVLBW infants.
  28. 28.  VitaminA- An intake of 1500 IU/kg/day is recommended for preterms.  It may promote epithelial repair and minimize fibrosis in preterm  babies with CLD.  •Vitamin D-Vit. D at 400 IU/day maintains adequateVit D status and prevents Rickets.
  29. 29.  •Vitamin E-Vit. E is recommended for preterm infants in 6 to 12  IU/kg/day. One ml of Evion (E-Merck) contains 50 IU.  •Vitamin K-Vit K is required for hepatic synthesis of coagulation  factors II,VII, IX, & X. Administration at birth of 0.5 to 1.0 mg i.m.Vit K can prevent HDN.
  30. 30.  EBM  DONOR HUMAN MILK  FORMULA FEEDS
  31. 31.  NG/OGT  FREQUENCY  POSITIONING
  32. 32.  VITAMIN D  Ca and Ph  ZINC  IRON
  33. 33.  HAEMORRHAGE  WATERAND FLUID LOSS  RDS  HYPOGLYCEMIA
  34. 34.  INFECTION PREVENTION PROTOCOL  IMMUNISATION  5 CLEANS
  35. 35.  CLEAN HAND  CLEAN CORD  CLEAN CORD CLAMP  CLEAN SURFACE  CLEAN PROCEDURESN
  36. 36.  CORTICOSTEROIDS  SYNTHETIC SURFACTANT  VIT K  ANTIBIOTICS
  37. 37.  Vital signs  Activity and behaviour.  Color; Pink, pale, grey, blue, yellow.  Tissue perfusion  Fluids, electrolytes and ABG's.
  38. 38.  Tolerance of feeds;Vomiting, gastric residuals, abdominal girth.  Look for development of RDS, apneic attacks, sepsis, PDA, NEC, IVH  Weight gain
  39. 39.  Immunisation  Danger signs

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