In a newborn suffering cold stress, hypertonia does not exist. During cold stress, a newborn can become hypotonic with slack muscular tone, especially preterm infants who may already have some degree of hypotonia due to their immaturity. Because hypotonia can be found in hypoxia, it is critical to identify the source and, if feasible, rectify it. If a newborn develops hypertonia symptoms, an examination into the reason and subsequent care is required.
It is critical to stay current on one's abilities and knowledge base in an ever-changing area like neonatology, where new technology and treatment methods are always being enhanced. Charting must also be based on objective facts that can be measured and quantified. Feelings are a vital aspect of nursing, but they should not be recorded. Although it is advantageous for a nurse to be able to operate independently without continual monitoring, a nurse should always speak with other colleagues when making decisions.
Bypassing the GI tract, total parenteral nutrition (TPN) allows doctors to provide patients the vital nutrients they need. Because this frequently necessitates long-term IV access, it is only regarded suitable when full bowel rest is required. This might include neonatal short-gut syndrome, gastroschisis, intestinal blockage, or persistent diarrhea. TPN administration is fraught with danger and should only be utilized when absolutely required.
Respiratory distress syndrome, caused by a shortage of pulmonary surfactant required to preserve alveolar integrity, is a significant and rather common condition in premature infants. When RDS is severe, the newborn may require mechanical ventilation, which raises the air pressure in the neonatal lungs dramatically. The damage caused by the increased air pressure on already weakened and noncompliant alveoli might lead them to burst, resulting in neonatal pneumothoraxes.
Central, peripheral, and differential cyanosis are the three basic forms. The infant's lower extremities are frequently cyanotic while the upper extremities and head stay pink in differential cyanosis. The existence of a PDA (patent ductus arteriosus) is the primary cause of differential cyanosis (DC). DC occurs when unoxygenated blood is pushed through the PDA opening in the heart and into the descending aorta, causing cyanosis in just the lower limbs. Large PDAs can generate extremely loud, mechanical-sounding murmurs.
Toxoplasmosis, various illnesses, rubella, cytomegalovirus, and herpes simplex are all included in the TORCH syndrome. In TORCH syndrome, the "other" group of disorders includes syphilis, coxsackievirus, varicellazoster, parvovirus, and HIV. TORCH syndrome can result in a variety of catastrophic complications on the fetus/neonate, including jaundice, microcephaly, intellectual handicap, deafness, eye difficulties, autism, and death. The prognosis varies according to the type of infection and the stage of pregnancy at the time of infection. If the etiology is bacterial and the mother is treated promptly with antibiotics, the infant has a fair prognosis. If the etiology is viral, there is no effective therapy. In the case of the viral TORCH syndrome, maternal immunization is essential for prevention.
The most common complication of ECMO is bleeding, which is likely due to the massive quantities of heparin required to keep the blood from clotting during the mechanical procedure. Bleeding may occur in any internal organ, but it is most dangerous when it happens in the brain. As a result, newborns receiving ECMO are checked for cerebral hemorrhages on a regular basis.
