For my graduation project I have chosen to do the study of Neonatology the care of premature infants. A baby that is born before 37 weeks is known as a “premature baby”, because most babies arrive between 38 and 41 weeks within pregnancy, making them here before there accurate due date. Reasons for preterm labor is due to poor nutrition, a history of preterm labors, a weakened cervis that begins to open (Dilate) early which is called cervical incompetence, a birth defect of the uterus, Infection, Preeclampsia which is high blood pressure and protein in the urine that develop after the 20th week of pregnancy, premature rupture of the membranes, the age of the mother, being African-American, the lack of prenatal care, a low socioeconomic status, and the use of tobacco, cocaine, or amphetamines. Infants that are born at 24-28 weeks are known as “extremely premature” these infants who are born 12-16 weeks early usually weigh between 1-3½ pounds,10-13 inches long, and spend most of their time trying to sleep. The infants head will be quite larger due to its size of it's body because it haven't had time to get proportional with it which is called lanugo.They will be very thin and fragile because the fatty layer of the skin as not yet build up. Their skin will look transparent meaning you can see the delicate pattern of blood vessels throughout their entire bodies. They would appear darkish red, at first because his circulation may not be very good yet, and his blood may not contain enough oxygen. Also, can get bruised very easily even a monitor lying in the same place for some time can cause some brushing because their skin is fragile and vulnerable to excessive handling. Your baby's eyes may be fused shut for about 10 weeks in utero, w... ... middle of paper ... ...n the surrounding air. Premature infants get IV lines which stands for intravenous “inside the vein”. This lining is threaded into one of the babys main veins It may be in her arm,leg,scalp,or umbilical cord. If he or she is very unwell or extremely premature, he or she can be fed through this tube. This tube can also give your baby extra fluids, extra nutrients or medications through their IV line. When this is required for a long time, a central cathetr is inserted. This line last much longer than an IV line, which means fewer changes to the line and less discomfort from your baby. Nasogastric Tube(NG), Orogastric Tube(OG), Transpyloric Tube are fine, flexible, plastic feeding tubes. A NG tube is threaded through your babies nose, an OG through its mouth down his or her throat and into her stomach. A transpyloric tube goes directly to the baby's small instestine.
The case study that I chose to focus my literature review on is concerning premature babies who developed Necrotising Enterocolitis (NEC) from a milk thickener that was given to them while while was on the Neonatal Intensive Care Unit (NICU), and which some babies were discharge home on. In one example of this occurrence, which I will use to guide my search for literature, the staff on the NICU had noticed that the baby’s heart rate slightly slowed down when he ate, so they thought that he was having difficulty feeding. To combat this difficulty the staff added a thickener, SimplyThick, to his feedings. When he was discharged home they gave the thickener to the parents to take home with them. Thickening foods makes them easier to swallow because it allows them to move more slowly in the mouth giving more time for a patient to close their airway, which can prevent aspiration (Queensland Health Dietitians, 2007). SimplyThick is a thickener made of Xanthan Gum, which is a substance commonly added to thicken foods for adults. There is a lack of information on how safe Xanthan Gum is for babies. SimplyThick was marketed to speech language pathologists as being easy to dissolve in breast milk as well as maintaining its consistency when mixed. These pathologists recommended SimplyThick as an additive to milk for babies with problems swallowing.
The very low birth weight are newborns that weigh less than 3.3 pounds (1,500 grams). Unfortunately, newborns that are under 3.3 pounds (1,500 grams) do not often survive, and the ones that do have delayed motor skills and cognitive development. The numbers decrease further to extremely low birth weight of 2.2 pounds (1,000 grams), where chance of life is very small. Low birth weight babies 1,500 grams – 2,500 grams (3.3 -5.5 pounds) have a good chance they will survive with proper care. Newborns that are small-for-date are placed in incubators that are sealed beds where temperature and air quality is regulated. The beds isolate the infants from pathogens and the environment. The babies need sensory stimulation to grow, so a recorded tape is played of the mothers soothing voice. Visual stimulation from video, and tactile stimulation helps foster physical and cognitive development in the baby. At five months while the fetus is in the womb ithas sensory capabilities, and can hear the mother’s heart beating, food digestion, speaking, and others speaking to her! The incubator stimulates this environment. There is great success with proper attention and care to the low birth weight babies, and. Many of the low birth weight babies are effects of parents that live in poverty, unable to access adequate medical care, and they experience stress due to an unhealthy family life.
It is a closed system where the patient’s blood goes straight from the vein to the inside of the tube through the rubber stopper present at the entrance of the tube without the blood being open to the air. You can collect many tubes by using just a single venepuncture. There is three components required for the evacuated system: double pointed needle, plastic holder or adapter and evacuated sample tube. All constituents of the system ought to be from the same manufacturer to avoid difficulties with the correct needle fit and smooth placement and removal of tubes. The tubes used with the evacuated tube system for blood collection are known as evacuated tubes. With the evacuated tube, blood can be taken straight from the vein into the tube without exposing it to air (closed system). This reduces accidental contact with blood. These tubes have a preset vacuum based on the volume of the tube and the type and amount of additive used in the tube. When the rubber stopper of the tube is penetrated with the back-end of the needle in the needle/tube holder, blood is drawn into the tube from the vein by the vacuum. The vacuum in the evacuated tube permits the accurate amount of blood to go into it. Regardless of whether the anticoagulant in the anticoagulant tubes is a liquid, powder or spray on the inside of the tube, they must be allowed to fill to the finishing point. By not completely filling the
Mphahlele, R. R. (2007). Caring for premature babies - a clinical guide for nurses. Professional Nursing Today, 11(1), 40-46.
Neonatal nursing is a field of nursing designed especially for both newborns and infants up to 28 days old. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin”. Neonatal nurses are a vital part of the neonatal care team. These are trained professionals who concentrate on ensuring that the newborn infants under their care are able to survive whatever potential life threatening event they encounter. They treat infants that are born with a variety of life threatening issues that include instances of prematurity, congenital birth defects, surgery related problems, cardiac malformations, severe burns, or acute infection. Neonatal care in hospitals was always done by the nursing staff but it did not officially become a specialized medical field until well into 1960s. This was due to the numerous advancements in both medical care training and related technology that allowed for the improved treatment and survival rate of premature babies. According to the March of Dimes, one of every thirteen babies born in the United States annually suffers from low birth weight. This is a leading cause in 65% of infant deaths. Therefore, nurses play a very important role in providing round the clock care for these infants, those born with birth defects or other life threatening illness. In addition, these nurses also tend to healthy babies while their mothers recover from the birthing process. Prior to the advent of this specialized nursing field at risk newborn infants were mostly cared for by obstetricians and midwives who had limited resources to help them survive (Meeks 3).
Neonatal nurses spend their career working with babies, those that are healthy and those that are not. Working with newborns is guaranteed to have its challenges, especially for those particular nurses who choose to work in the neonatal intensive care unit. The neonatal intensive care unit, or NICU, is where the infants suffering from potentially fatal diseases/disorders are held. NICU nurses struggle with life and death situations each and everyday, which is sure to be accompanied by specific emotions such as moral distress. In the words of researcher Kain (2006), “moral distress is defined as uncomfortable, painful emotions that arise when institutional constraints prevent the nurse from performing nursing tasks that are deemed necessary and appropriate” (p. 388). In simpler words, Kain (2006) is saying that a nurse experiencing moral distress is undergoing painful emotions that are getting in the way of the nurse’s ability to perform essential tasks (p. 388). Heuer, L., Bengiamin, M., Downey, V., and Imler, N. (1996) pointed out that nurses caring for critically ill and dying infants often feel hopeless, incompetent, and disappointed, especially if the overall outcome for the infant is death (p. 1126). These negative feelings that NICU nurses often have are those that are associated with moral distress and can often lead to prevention of proper performance in necessary nursing duties.
Several skills are beneficial to the nurse and paramedic, but perhaps one of the most important skills is the ability to place an intravenous catheter into a vein. This procedure is most commonly referred to as “starting an IV”. In today’s medical community, intravenous cannulation is necessary for the administration of many antibiotics and other therapeutic drugs. Listed below are the procedures and guidelines for starting a successful IV. Following these instructions will provide a positive experience for the patient and clinician.
Did you know one out of every eight babies are born prematurely every year in the United States each year, Neonatal nurse practitioners work with infants who are premature or have a health issue up to 28 days after birth. My interest in pursuing the career of a neonatal nurse practitioner is so I can help babies survive and help their families understand what actually is going on. Neonatal nurses are strong willed people, and I am a strong person, who has a very great interest in neonatal nursing. I am good at controlling my emotions in emotional situations and neonatal nurse will experience many emotional situations. The purpose of a Neonatal Nurse Practitioner is to inform the audience about the career by discussing: the history of a neonatal nurse practitioner, education and requirements to become a Neonatal Nurse Practitioner, responsibilities & daily routine, pay, benefits of a neonatal nurse practitioner, and why it interest me. “Nursing is a kind of mania; a fever in the blood; an incurable disease which, once contracted, cannot be got out of the system. If it was not like that, there would be no hospital nurses, for compared dispassionately with other professions, the hours are long, the work hard, and the pay inadequate to the amount of concentrated energy required.
A labor and delviery nurse has vast knowledge of the process and methods that are required for delivery and bring a new life into the world and is educated with the responsibilities of assiting the new born babies with their medical issues. Considering all the responsibilites needed to take on this career, such as assisting women with complications within the pregnancy, delivering a newborn and managing post birth issuses, the nurse must be professional in his or her work at all times. All people wishing to pursue the career of being a Labor and Delivery Nurse must also have good analytical skills, as part of there job to montior and analyze the mother and child (CollegeAtlas.org).
A peripherally inserted central catheter, more commonly referred to as a PICC line, is a wonderful tool in any medical setting. Providing access for drug administration, blood testing, nutrition, etc. Anything, such as medication, supplemented into the bloodstream will work significantly faster than alternative routes like orally, or even intramuscularly. Whatever is provided via the PICC line will immediately be transported in the blood to desired areas in the body; no longer necessitating a need for the body to break down the components first through the GI tract. However, PICC lines do have dangers associated with the same characteristics that make them remarkable. The rapid transit time, and immediate reaction on the body mean that
In the field of nursing almost every tool that is used contains some type of computer technology, from a monitor displaying data to the thermometer used to take temperatures. Specifically, all of the technology that is used in the Neonatal Intensive Care Unit (NICU) is relatively new as this branch of nursing was not established until about the 1960’s. Although most of the technology created resembles a smaller version of the adult model, they must complete slightly different tasks for the babies. The four tools described are the cardiopulmonary monitor, pulse oximeter, continuous positive airway pressure (CPAP), and the incubator or isolette.
3. Nasojejunal (NJ) or Post pyloric: The feeding tube is placed in jejunum by passing the stomach. This prevents the risk of aspiration.
There are many different areas to consider when preparing for and having a newborn. Whether the pregnancy was planned or unplanned or the couple is married or not, a newborn baby brings new responsibilities. Having a baby also forces people to make adjustments both financially and within the family. Parents also express concerns and expectations when having a newborn comma especially when it is their first; including what roles each parent and family member should play, how much confidence they have in their parenting skills, and how much financial strain would be placed on the family once the newborn has arrived. The newest issue in today’s society is the fact that many women are delaying childbirth and having more children in their later years of life.
New technologies are being developed every day. The latest advance in fetal monitoring is the fetal oxygen monitor: “A device that directly measures fetal oxygen saturation during labor and delivery is now available and has the potential to reduce the number of Cesarean sections performed for non-reassuring heart rates.” (Mechcatie) The article by Mechcatie describes the monitor extremely well: “The device’s sensor, located at the end of a flexible tube, is made of pliable plastic and is inserted through the cervical os until it lies along the fetal cheek, where the pressure of the uterine wall keeps it in place during labor. The sensor shines light into the fetal skin and computes the oxygen saturation by measuring the color of the reflected light coming through the blood cells.”
The prenatal period is considered the period between the conception of a baby until its birth. During this time embryo's and fetus go through major changes to prepare for their life after birth. In the years after they are born, what we call infancy and toddlerhood, while as adults we don't seem to change much in a year or two, children go through many changes that are crucial in developing the patterns of their futures.