Respiratory Distress Syndrome
surfactant is high in ____, a fatty protein necessary for the absorption of oxygen by the lungs.
lecithin
Heat loss with preterm results from what factors:
lack of brown fat, excessive heat loss by radiation from a surface area that is much larger in proportion to the body weight, large surface area of the head, heat regulating center of the brain isn't mature, sweat glands aren't functioning, preterm is inactive, muscles are weak and cannot shiver, posture of the preterm infants' extremities is one of leg extension, metabolism is high and preterm infant is prone to having hypoglycemia.
Why does this occure?
infant has not remained in the utero long enough to acquire sufficient stores of glucose and fat
why does this occur?
Calcium is transported across the placenta mostly during the 3rd trimester so the preterm infant does not have enough
What is this condition?
disorder of the developing retina in a premature infant that can lead to blindness. It is the leading cause of blindness in newborns weighing less than 1500grams/3.3 lbs
What are manifestations of RDS?
increased breaths of 60 per minute, tachypnea, grunt like sounds, nasal flaring, cyanosis, intercoastal and sternal retractions. edema, lassitude, and apnea occur as the condition gets more severe.
signs and symptoms of cold stress:
decreased skin temperature, increased respiratory rate with periods of apnea, bradycardia, mottling of the skin, lethargy
Plasma glucose lower than ____ indicates hypoglycemia in a term infant
40
What infants are at high risk for early hypocalcemia?
stressed by hypoxia, birth trauma, receiving sodium bicarbonate, and infants born to mothers who are diabetic or who have had a low vitamin D intake
What happens to the eye after accompanied by high levels of oxygen required?
The retina completes an abnormal vascularization process that causes fibrous tissue to form behind the lens of each eye, resulting in blindness and retinal detachment.
What are some treatments for RDS?
Giving the mother betamethasone, surfactant given via endotracheal tube, vitals monitored closely, arterial blood gases are analyzed, and infant is placed into a warm incubator. IV fluids, oxygen, and ventilator.
what is used to monitor the skin temperature?
A skin probe is used and placed on the right upper abdomen. A protector should be placed over the skin probe.
plasma glucose lower than ____ indicates hypoglycemia in a preterm infant
30
What infants are at high risk for late hypocalcemia?
age 1 week in newborn or preterm infants who are fed cows milk. Cows milk increases serum phosphate levels which causes calcium levels to fall.
The academy of pediatrics recommends routine retinal examinations for infants with birth weight between 1500-2000g for a gestational age less than _____ weeks
30
This is a toxic response of the lung to oxygen therapy.
Bronchopulmonary Dysplasia.
Atelectasis, edema, and thickening of the membranes of the lung interfere with ventilation.
Cold stress increases the need for what?
oxygen and glucose
any condition that increases ______ increases glucose needs
metabolism
What is the treatment for infant hypocalcemia and what does the nurse monitor for with the baby?
administer calcium gluconate IV and monitor for bradycardia in the infant
What do you need to carefully monitor in high-risk infants to prevent this condition?
oxygen saturation. It is the level of oxygen in the blood rather than the amount of oxygen received that is the importance of oxygen therapy.
Where should the pulse ox be placed on the infant?
The abdomen.
The incubator is adjusted so that the bodys temperature is kept bewteen ____-____ degrees
97.1 to 98.6
Hypoglycemic preterm infants may need how many kcals a day?
120-150
What are signs of hypoglycemia in the infant?
tremors, weak cry, lethargy, convulsions, and plasma glucose lower than 40 for term infant and lower than 30 for preterm infant.
Maintaining a sufficient level of vitamin ___ and avoiding excessively high concentrations of oxygen are important
E