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Alteration in Nutrition and
Neonate Hypoglycemia (NH)
Neonate Hypoglycemia (NH)
Enteral Feedings
Thermoregulation
Renal Immaturity
100
Decreased neuro maturity (rooting, sucking, gagging); Underdeveloped cardiac sphincter (regurgitation); Decreased energy level (fatigue, timed feedings); Decreased absorption ability/decreased enzymes; Small stomach volume; Decreased peristalsis; Need for oxygen/ventilation support; Depressed from meds
What is Factors that block use of oral route by preemies
100
FEED: Initial feeding should be within 1 hr of birth with glucose screening 30 minutes after the feed; CHECK: If blood glucose is lower than 25mg/dl, feed again then check BS in 1 hr of feeding. INTERVENE: IV glucose (200mg/kg) is initiated if glucose is lower than 25mg/dl (RAPID BOLUSES AVOIDED= IVH!!)
What is Nursing Management (Feed, Check, Intervene)
100
Trophic Feedings _______ ______ maturation, Promote gut ________ _________ and test _____ ________, priming the gut for later ____________ ___________.
What is Simulate gut; hormone release; gut motility; nutritional feedings.
100
Immature hypothalamus, thin skin, decreased subcutaneous fat, decreased brown fat, decrease flexion/lack of muscle tone, decrease energy stores, decreased shivering response
What is Factors that negatively influence thermoregulation for premature babies
100
Increased risk for metabolic acidosis; Increased potential for toxicity of drugs & dehydration; Greater loss of electrolytes!
What is Risk factors for Renal Immaturity
200
Normal Range for Blood Glucose for a baby...
What is 40-90
200
No _______ before __________!
What is Bath; Feeding
200
Nutritional Feedings ________ for feeding __________
What is Monitor; intolerance
200
CONVECTION air current (port holes left open in isolette); RADIATION ( temp of surfaces surrounding the infant –near cool window); CONDUCTION: direct contact to infant (Scale, cold hands, mattress); EVAPORATION: Water lost from the skin (bathing).
What is The 4 Mechanisms of Heat Loss
200
The normal urine output is ________. 1ML of urine = ______g, So a 4g diaper = ______ML UOP
What is 1-3ml/kg/hr; 1g; 40ML
300
The result of hypoglycemia is potential irreversible _____ ______.
What is CNS Damage
300
Early _____ and ______________ outcomes are linked.
What is Nutrition; Neurodevelopmental
300
Breast milk feedings: Protect against _______ ________! Infants who are exclusively formula fed are 6-10 times more likely to develop _________ ________ then those who are breast fed.
What is Necrosis Enterocolititis (NEC) ; Necrosis Enterocolititis (NEC)
300
Implications for Thermoregulation Instability
What is Increase O2; Increased Metabolic Needs; Increased risk for Hyperbilirubin; Increased risk for Acidosis; Weight loss or impeded weight gain; Decrease blood glucose
300
1.002-1.010 is the desired ________ ________
What is Specific Gravity
400
TREMORS (JITTERINESS), cyanosis/pallor, convulsions/focal seizures, Apnea, Irregular respirations/tachypnea, Apathy/lethargy, High-pitched cry, Flaccidity/floppiness, refusal /poor feed, eyes rolling, temperature instability, Signs of CHF
What is Signs of Neonatal hypoglycemia (NH)
400
Protein intake of ________ is necessary just to prevent catabolism of endogenous protein stores. Protein is provided in ____ via amino acids.
What is 1.5-2g/kg/day; TPN
400
Immature hypothalamus, thin skin, decreased subcutaneous fat, decreased brown fat, decrease flexion/lack of muscle tone, decrease energy stores, decreased shivering response
What is Factors that negatively influence thermoregulation for premature babies.
400
The expected weight gain is : __________ after initial weight loss.
What is 15-30gm/day
500
Small gestational age (SGA), Large for gestational age (LGA), born to mothers who have diabetes, late preterm (34-36 wks gestation).
What is Neonates at high risk for NH
500
Insulin depends on _______ ________ for its release. Without ________, glucose can't get into the cells, causing hyperosmolarity. Potassium will leak out of sells, leading to ____________. THIS IS A METABOLIC EMERGENCY! Early infusion of _________ __________ decreased fluctuations of serum glucose. To prevent ________ _________!
What is Amino Acids; Insulin; Hyperkalemia; Amino Acids; Brain Damage
500
Monitor : WEIGHT (wet diapers), I/O and electrolytes, signs of over hydration, signs of dehydration.
What is Nursing Management of Renal Immaturity