FREE Neonatal Nurse Practitioner for Professional Questions and Answers
Two weeks after giving birth, a mother brings her term baby—her first child—in for a checkup. The infant's skin turgor is weak, his or her face is drawn, and he or she hasn't gained any weight since birth. The woman is nursing her baby. The best course of action to take is
The mother should be interrogated regarding the number and manner of her breastfeeding sessions as well as be observed doing so. Since this is her first kid, she might require additional help nursing the baby properly to make sure the youngster gets enough nutrition. Although additional testing could be necessary, dehydration and inadequate nourishment should be addressed immediately because these symptoms point to such conditions. Child protective services are not now needed because there are no additional signs of neglect. Rarely is it required to switch from human milk to formula if moms receive sufficient guidance and assistance.
Frequent blood tests were performed on a baby to check his electrolyte and glucose levels. Despite the fact that the newborn is not acutely hypoxemic, this phlebotomy has resulted in anemia of prematurity (AOP). The first course of action is
In AOP associated with phlebotomy, rHuEPO is recommended to increase erythropoiesis. Transfusions may be necessary for infants exhibiting symptoms of hypoxemia, such as poor eating, tachypnea, tachycardia, and pallor. AOP is a pathologic amplification of the typical hematocrit drop that every baby experiences.
An osteogenesis imperfecta (OI) type 1 diagnosis is made at delivery for a term newborn. Before bringing their child home, parents should be given the following information.
The parents of an infant with OI type 1 should receive information about methods of handling, bathing, and placing their child in the crib to minimize trauma and avoid fractures. OI is a genetic disorder of collagen synthesis that results in brittle, easily fractured bones. Common features of OI include brittle bones, bowing of long bones, shortened limbs, blue sclera, skeletal deformities (including scoliosis), respiratory difficulties, and weak muscles. Type 1 is non-lethal and the mildest of 4 types of OI. OI type 2 causes severe breathing problems that often prevent the neonate’s survival. OI infants do not generally require feeding tubes or have aspiration risks. OI is usually inherited in a dominant fashion, but a new mutation may cause the disorder in approximately 25% of cases.
The following action should be taken if a patient's membranes burst and meconium-tinted amniotic fluid is discovered.
There is no longer a recommendation for an emergency cesarean delivery when there is meconium in the amniotic fluid, contrary to earlier norms. Instead, due to the possibility of respiratory distress secondary to aspiration, the fetus should be carefully watched for symptoms of distress and the appropriate team should be present during the birth of the neonate. Except when they are weak and do not react to noninvasive therapies, these neonates shouldn't be routinely suctioned and/or intubated.
Due to the father's recent diagnosis of Huntington's disease, the parents of a newborn are thinking about genetic testing for their kid. They seek advice from the NP. The best course of action is
Huntington's disease testing cannot provide information for health promotion or illness prevention, so parents should be advised to postpone testing until their kid is old enough to make an informed choice. For young individuals who may not receive enough assistance and counseling prior to testing, this knowledge can be heartbreaking. Some persons with adult-onset diseases want not to be examined, and testing children takes away this option from them.
Neonatal early-onset sepsis (72 hours) typically manifests as
The most common symptoms of early-onset sepsis are pneumonia and meningitis with late-onset sepsis being bacteremia. Preterm infants weighing less than 1000 g are particularly at risk for neonatal sepsis, which can be brought on by a variety of bacterial and viral infections. The causes of early onset (72 hours) and late onset (4-90 days) are typically maternal transmission and intrusive devices, respectively. Tachypnea, sternal retraction, grunting respirations, cyanosis, and apneic episodes are typical signs of septic pneumonia.
Neonatal hypoxia resulted in neurological impairment and mild hypoxic ischemic encephalopathy (HIE). The method of treatment LESS likely to be used for this ailment is
Therapeutic hypothermia has advanced in use, and it is now the first line of treatment for moderate to severe HIE, with the target temperature based on the degree of encephalopathy. Phenobarbital is an additional therapy option for the management and/or prevention of seizures. Fluid resuscitation is not recommended in HIE; in fact, a fluid restriction is frequently imposed on a baby with HIE to prevent further swelling. When the brain's oxygen supply is compromised, HIE occurs. Depending on the severity of the symptoms and the degree of ischemia, HIE is categorized as mild, moderate, or severe. Severe HIE can result in chronic brain damage, whereas mild and moderate HIE often go away in 3–4 days and 1–2 weeks, respectively.