This document discusses the care of sick neonates and outlines several common medical conditions seen in neonates. It describes the role of the practical nurse in carefully observing the neonate to monitor for any significant changes. Over 12 problems that may affect the neonate are then outlined, including SGA, LGA, prematurity, jaundice, intracranial hemorrhage, tracheoesophageal fistula, Down syndrome, erythroblastosis fetalis, respiratory distress syndrome, and infants of addicted mothers. For each condition, characteristics are provided along with important nursing considerations such as monitoring vital signs, feeding, temperature regulation, and supporting parents.

2. DR. MARYAM VEYSIZADE
ASSISTED PROFESSOR
TEHRAN UNIVERSITY OF MEDICAL
SCIENCES

3. SICK
NEONATE

5. General
:
The neonatal at birth represent the culmination •
of genetic , antepartal, and intrapartal factors
-.that affect its immediate activity future well
being
Many neonates ,when born, have already been
introduced to in utero insults and birth trauma,
.which severly jeoparadized their future welfare
Their survival and perhaps their quality of life, is
entrusted to the knowledge, and expertise of the
.health care team

6. ;Contd
The practical nurse performs a vital role in caring
for the sick neonate. Constant attention must be
directed to the accurate observation of the
neonate so that significant changes may be
.reported immediately
This season will consist of twelve problem of the
.neonate

7. :Weight related gestational age
:SGA
:Characteristic
,Chromosomalproblem,smoking,preeclampsia
eclampsia, insufficiency prenatal care,
Glc↓,hypothermia,polycythemia
.congenital anomaly,
Nursing care:monitoring blood glucose,observe
sign of respiratory distress, monitor input and
output, daily weight, lab test based on local
policy,support the parents by listening to their
.concerns and answering question

8. Contd
:LGA
Characteristic
Special attention to
hypoglysemia,hypocalcemia,polycythemia,hyper
,blbemia,RDS,congenital anomaly
:Nursing consideration
Monitoring vital sign and temprature, level of
glucose,calcium,bilirubin,hematocrit,prevent
.infection

9. Contd
Premature infant
Characteristics:skin,finger nail, reflexes, state of
placental insufficiency,pulmonary
.hemorrhage,pneumonia,pneumothorax
:Nursing consideration
Monitoring intake and output, observe of
respiratory distress, stable termoregulation,
.support the parents

10. Jaundice
:Pathologic or physiologic
:Nursing care
Consideration of lethargy, poor feeding, dark stool,
highpitch cry, seizure, neurologic damage.
monitoring of skin turgor, daily weight, eye
,problem, termoregulation

11. Intracranial hemorrhage
:Characteristic
Cold, pale, clammy skin. bulging or tense
fontanel, unequal pupils, diminishing moro
,reflexes,opistotonus,siezure
Nursing consideration
Quiet space, avoid stimulation, monitor
respiratory function, feed as tolerated,
control of bleeding

12. TE fistula
,Type of anomaly, VACTREL syndrom
Nursing consideration
Pattern of feeding and respiration, stomach
distention, chemical pneumonitis,
recurrent fistula, esophageal stricture,
recurrent pneumonitis, failure to thrive,
.decreased esophageal motility
Pulmonary physiology, control intake and
input, supportive care of gastrostomy tube
feeding

13. Down syndrom
Sign and symptom
Nursing consideration
Feeding monitoring, complication
monitoring, developmental stimulation,
Encourage prenatal participation in the
.infants care

14. Erythroblastosis fetalis
,Characteristic: jaundice, edema, ptechia
respiratory problem, neurologic unresponsiveness
Nursing consideration
Termoregulation, resussitative equipment,
,monitoring of transfusion complication

15. Respiratory distress syndrom
,Sign and symptoms
Nursing consideration
Monitoring of pulmonary function, infection,
,circulation, thrombosis

16. Infant of addicted mother
Etiology, Degree of withdrawal symptoms,
,onset of symptoms, sign of withdrawal
:Nursing consideration
Be familiar with withdrawal syndrome,
checking abstinense syndrome, maintain
.fluid/caloric requirement

17. Others
:Monitoring of
Fever, Breathing difficulties, Diarrhea,
Vomiting, Excessive sleepiness,
Floppiness, Jitterinous, Rash, Eye or Ear
.trouble