This document discusses fluid calculation and homeostasis in neonates. It notes that water and electrolyte balance is vital but different in neonates compared to older children and adults due to rapid developmental changes. It outlines the physiology of total body water, intracellular water, and extracellular water. It also discusses changes that occur at birth and how to assess hydration status in neonates through monitoring things like urine output, weight, physical exam findings and lab tests. Maintaining appropriate fluid and electrolyte balance is important for health in preterm infants.
Defines Exchange Transfusion, the Aims, and indications of Exchange Transfusion. Articles required, choice of donor, the procedure of exchange transfusion. Post transfusion care and the complications that can occur due to exchange transfusion. The Ppt also describes the special considerations during the procedure.
neonatal hypothermia is a very emergency condition. if we identify this in early stage we can save the life of neonate. all should know about the maintaining the temperature if the neonate is in our home.
Defines Exchange Transfusion, the Aims, and indications of Exchange Transfusion. Articles required, choice of donor, the procedure of exchange transfusion. Post transfusion care and the complications that can occur due to exchange transfusion. The Ppt also describes the special considerations during the procedure.
neonatal hypothermia is a very emergency condition. if we identify this in early stage we can save the life of neonate. all should know about the maintaining the temperature if the neonate is in our home.
Hyperbilirubinemia didactics at Neonatal Intensive Care Unit
Source: Nelson's Textbook of Pediatrics 19th edition
Most pictures were taken from Google images
Presentation on NRP (Neonatal Resuscitation Program)Moninder Kaur
NRP is neonatal resuscitation program. Approximately 10% of newborns require some assistance to begin breathing at birth. Less than 1% require extensive resuscitative measures. Although the majority of newly born infants do not require intervention to make the transition from intrauterine to extra-uterine life, because of the large total number of births, a sizable number will require some degree of resuscitation.
This slides contain detailed description of radiant warmer used in hospital setting, various modes , alarms, do's and don't of radiant warmer and nursing care management for the baby under radiant warmer
Hyperbilirubinemia didactics at Neonatal Intensive Care Unit
Source: Nelson's Textbook of Pediatrics 19th edition
Most pictures were taken from Google images
Presentation on NRP (Neonatal Resuscitation Program)Moninder Kaur
NRP is neonatal resuscitation program. Approximately 10% of newborns require some assistance to begin breathing at birth. Less than 1% require extensive resuscitative measures. Although the majority of newly born infants do not require intervention to make the transition from intrauterine to extra-uterine life, because of the large total number of births, a sizable number will require some degree of resuscitation.
This slides contain detailed description of radiant warmer used in hospital setting, various modes , alarms, do's and don't of radiant warmer and nursing care management for the baby under radiant warmer
Dehydration in Children and Fluid Management (with discussion on Unani Manage...Dr. Nazia
This Presentation discusses pediatric daily fluid requirements, body water balance, dehydration and its management.
Additionally, it gives an insight to Unani management of dehydration.
Medical Students/Healthcare Professionals belonging to either Modern System of Medicine (allopathy) or Indian System of Medicine may find this presentation helpful.
Content credit to rightful owner (wherever applicable).
Slides belong to this Author.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
2. Introduction
Water and electrolytes are vital components of the
body at any age. The laws that regulate fluid and
electrolyte balance in the newborn are the same as
those that control this process in children and adults
the newborn’s body water distribution is both
quantitatively and qualitatively different
Furthermore, rapid changes occur at the time of
birth, and sick newborns pose additional challenges.
Consequently, water and electrolyte homeostasis is
of vital importance and special care is required to
maintain an appropriate balance, especially in very-
low-birth-weight (VLBW) infants.
3. Water
Physiology.
Water is the main component of the human body. It
is distributed both inside and outside the cells:
Therefore a practical simplification is to classify total
body water (TBW) as,
intracellular water (ICW) and
extracellularwater (ECW).
ICW is the total amount of water in all the body’s
cells.
ECW is the total amount of water outside the cells; it
comprises the water in the interstitial space and in
the intravascular space (plasma).
4. In each compartment, a main solute acts to keep water
in the compartment:
The volume of the intracellular compartment is
maintained mainly by potassium salts and is
regulated by the Na-K cellular pump.
The volume of the extracellular compartment is
maintained mainly by sodium salts and is regulated
by the kidneys.
In the extracellular space, the volume of the
intravascular compartment is maintained main
8. Postnatal Adaptation
Fluid management is easier if one remembers a few
simpleprinciples:
(1) to separate water from sodium requirements;
(2) to keep maintenance fluids separate from fluids
given to correct electrolyte abnormalities;
(3) to recognize the pattern of neonatal diuresis.
Monitoring a newborn’s urine output(UOP) can help
to individualize fluid requirements
9.
10. Appropriate administration of fluid is important,
because both excessive fluid restriction and fluid
overload lead to clinical consequences.
Excessive fluid restriction may lead to dehydration,
hyperosmolality, hypoglycemia, and
hyperbilirubinemia.
In preterm infants, high volumes of parenteral fluids
have been associated with a higher incidence of
PDA, BPD, and necrotizing enterocolitis.
11. It is important to realize that the occurrence of BPD
has been correlated with fluid volume administered
during the first 4 days of life.
Maintaining the fluid and electrolyte balance,
therefore, is extremely important in preterm infants.
Close monitoring of clinical hydration, body weight,
UOP, and the serum sodium concentration should
allow the best possible decisions on fluid
administration
12. Assessment and Evaluation in Fluid and
Electrolyte Therapy
The estimation of a patient’s fluid and nutritional
needs depends on the infant’s age and weight and
the disease process involved
Fluid needs can be calculated using body weight,
body surface area, or caloric expenditure
Caloric expenditure is an easy method in which the
infant’s caloric needs are calculated, and fluid and
electrolyte requirements are related to it.
13. To begin these calculations, it must be
remembered that 1 kcal is the amount of heat
needed to raise 1 L of water 1°C.
Caloric expenditures up to 10 kg = 100 cal/kg/24
hr.
For example, a 1,700-g infant would expend 170
calories in 24 hours, whereas a 460-g infant would
expend 46 calories in 24 hours.
This can be expressed as
Energy intake=
energy stored + Energy expended
+ Energy excreted
14. Caloric expenditures can be modified by an increase
or decrease in body temperature and by specific
disease states.
Caloric expenditure can be used to determine water
needs, because for every 100 calories metabolized,
100 mL of fluid is needed
Water needs are determined by calculating IWL from
the skin and pulmonary system and actual losses
from the urine, stool, and sweat
15.
16. Fluids usually are calculated on a daily basis, taking
into consideration past losses, projected losses, and
maintenance requirements.
Electrolyte requirements usually are calculated on
the basis of 100 calories metabolized:
Sodium: 2 to 3 mEq/100 cal/24 hr (2–3 mEq/kg/d)
Potassium: 1 to 2 mEq/100 cal/24 hr (1–2 mEq/kg/d)
Standard IV solutions containing a predetermined
amount of sodium are routinely used in neonatal
intensive care units (e.g., 5% dextrose in 0.45%
NaCl) with potassium chloride and other electrolytes
or minerals added as indicated
17. Caloric requirements cannot be met solely by the IV
solutions commonly used in NICUs (i.e., 5% or 10%
dextrose).
These solutions are relatively low in calories, as
there are only 4 calories per gram of
glucosecarbohydrate).
The number of calories in IV solutions is calculated
on a percent solution and based on grams per 100
mL. Therefore 5% dextrose in water (D5W) contains
5 g of dextrose per 100 mL of fluid, 10% dextrose in
water (D10W) contains 10 g/100 ml, and so on. To
carry this calculation further, D5W and D10W IV
solutions contain 20 and 40 calories, respectively
(D5W = 5 g/100 mL at 4 cal/g = 20 cal).
18. An essential test of the infant’s response to IV
glucose therapy can easily be done at the bedside
with a urine dipstick and a few drops of urine
Determination of the specific gravity is another
essential bedside test that requires only a few drops
of urine. The specific gravity, which normally is
between 1.008 and 1.012, is an early indicator of
hydration status.
Fluid intake and output should be strictly monitored
to ensure adequate hydration
19. UOP is monitored and calculated hourly over a 24-
hour period. It should be no less than 1 mL/kg/hr/d.
For example, for a 2-kg infant:
UOP = 240 mL/24 hr = 10 mL/2 kg = 5 mL/kg/hr
Weight is an important indicator of overall fluid
status. Infants are usually weighed daily
20. The physical examination can reveal changes in the
infant’s fluid status and should be used in
conjunction with laboratory data to plan interventions
in fluid and electrolyte therapy.
Color: Pink and well perfused, rather than pale and
mottled (indicates dehydration)
Skin turgor: Good turgor, rather than “tenting”
(indicates dehydration) or edematous and shiny
(indicates fluid overload)
Activity: Active with good tone, rather than lethargic
and hypotonic (indicates dehydration or
overhydration)
Mucous membranes: Pink and moist, rather than
dry and gray (indicates dehydration)
21. Fontanelles: Soft and flat, rather than depressed
(indicates dehydration) or tense and full (may
indicate overhydration)
Vital signs: Heart rate, rhythm, blood pressure and
temperature within normal range for gestational age
UOP: Normal (e.g., ~1 cc/kg/hr), rather than
excessive (indicates overhydration), diminished, or
absent (indicating dehydration)