child health nursing topic respiratory distress syndrome

1. RESPIRATORY DISTRESS
SYNDROME
PRESENTED BY:
PRERNA
(B.SC. NURSING 3RD YEAR)

2. OBJECTIVES
 Introduction of RDS
 Definition of RDS
 Enlist the causes of RDS
 To elaborate the pathophysiology
 To enlist the sign & symptoms
 To discuss the diagnostic evaluation
 Describe the management of RDS
 Health education
 Conclusion
 Bibliography

3. INTRODUCTION
 Respiratory distress syndrome (RDS) occurs in babies born
early (premature) whose lungs are not fully developed.
 Also known as neonatal respiratory distress syndrome.
 The earlier the infant is born, the more likely it is for them to
have RDS and need extra oxygen and help breathing.

4.  INCIDENCE
 The incidence of RDS is inversely related to
gestational age.It occurs in 98% of preterm infants
betewee n 22 and 24 weeks gestation but only 25 %
of those with bright weight between 1.25 – 1.5 kg.

5. DEFINITION
 Neonatal respiratory distress syndrome (NRDS) is more
common in premature babies born six weeks or more before
their due dates. It usually develops within the first 24 hours
after birth.
 It is a syndrome of premature neonates that is characterized
by progressive and usually fetal respiratory failure resulting
from atelectasis and immature lungs.

6. CAUSES
1. Predisposing factors
 Prematurity
 Asphyxia
 Hypothermia
 Maternal anaemia
 Pre eclempsia
 Maternal diabetes

7. CONT….
2. Pulmonary risk factors
 Pneumonia
 Pneumothorax
 Congenital malformation
 Upper respiratory obstruction

8. CONT….
3. Non-pulmonary risk factors
 Sepsis
 Cardiac defect
 Exposure to cold
 Hypoglycemia
 Metabolic acidosis

9. PATHOPHYSIOLOGY

10.  https://youtu.be/oX3CZnrLxbQ

11. SYMPTOMS
 Fast breathing very soon after birth
 Grunting “ugh” sound with each breath.
 Widening (flaring) of the nostrils with each breath
 Chest retractions – skin over the breastbone and ribs pulls in
during breathing

12. CONT….
 Cyanosis or pallor
 Apnea
 Mottling

14. DIAGNOSTIC TEST
 History collection
 Physical examination
 Chest X-ray : ground glass appearance
 ABG
 Pulse oxymetry
 Spirometry
 Downe’s score

15. X-ray

16. Down score

17. Spirometry

18. ABG test

19. MANAGEMENT
 Mediacal management:
1. Neonatal suspected to RDS need to be treated in NICU
2. Administer IV fluids & oxygen start oxygen therapy depends
on the condition.
3. Maintain oxygen saturation between 90-95%
4. Administration of exogenous surfectant through ET tube
directly into trachea.

20. CONT….
 Medicine
1. Antibiotics, aminoglycosides, ampicillin,
Amoxicillin, Procaine penicillin usually given for
7-10 days.
2. Muscle relaxants : pancuronium
3. Antacids: sodium bicarbonate, sodium citrate

21. SURFACTANT THERAPY
 Surfectant is isurfactant in all neonates with RDS.
 Adequate oxygenation, ventilation and monitoring should be
started before administration surfectant.
 Dose 100mg/kg body weight 2-4 divided doses as 6-12
hours apart.
 Depending upon the baby’s condition repeated dose of
surfectant need to be administered.

22. NURSING MANAGEMENT
1. Maintain adequate hydration and electrolyte status.
2. Administer antibiotics to reduce the infections.
3. Maintain acid base balance.
4. Fluid and electrolyte management: Electrolyte balance,
fluids, calcium and glucose homeostasis are all equally
important
5. IV line for fluid/hydration, nutrition and medication.
6. Maintain saturation level.

23. HEALTH EDUCATION
 To prevent premature birth can help prevent neonatal RDS.
 Good prenatal care and regular checkups beginning as soon
as a woman discovers she is pregnant can help avoid
premature birth.
 Maintain proper hygiene to prevent infections.
 Provide iron rich diet to the pregnant mother

24. CONT….
 Give your child over-the-counter and prescription medicines
only as told by your child’s health care provider.

25. SUMMARY
 Introduction
 Definition
 Causes
 Pathophysiology
 Sign & symptoms
 Diagnostic test
 Management
 Health education

26. CONCLUSION
 RDS is the commonest cause of respiratory distress in the
newborn, particularly, in preterm infants. It carries a high
mortality rate and the incidence is more than that
documented in the Western world.

27. BIBLIOGRAPHY
 Book reference:
1. Dutta Parul, textbook of pediatrics, 3rd edition, published by Jaypee Brothers, page no. 306-
309.
2. Sharma Rimple, textbook of pediatrics, 2nd edition, published by Jaypee Brothers, page no.
256-258.
 Net reference:
1. www.slideshare .com
2. www.medlineplus.com
3. www.wikipedia.com