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22 Cards in this Set
- Front
- Back
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Although heat loss can be a problem for full-term infants, it is even more significant in ? infants. Their skin is ? with ? vessels near the surface, and little ?/? fat is present to serve as insulation. As a result, heat loss is ?
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preterm,
thin, blood, subQ/white, rapid |
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After 28weeks gestation ? fat is accumulated it is used to produce heat by nonshivering ? The preterm infants shorter time in the uterus allows less of this fat to accumulate before birth, impairing the infants ability to produce ?
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Brown,
thermogenesis, heat |
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The extended ? position of the preterm infant allows for more ? loss. Also the underdeveloped ? center of the preterm infant is less mature and may be further impaired by ?
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limp,
heat, brain, asphyxia |
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Complications from heat loss, such as ? and ? problems are more likely to develop in preterm infants. This limits the ? and ? available to increase metabolism as a method of ? production and may cause respiratory ?
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hypoglycemia,
respiratory, glucose, O2, heat, acidosis |
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When the body temperature drops, vasocontriction of the veins occurs this may lead to ? vasoconstriction, impaired ? production, and more ? difficulty. In addition, calories used for heat production are NOT available for ? and ?
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pulmonary,
surfactant, respiratory, growth, weight gain |
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Nsg assessment for thermoregulation: The infants skin temp is monitored continuously by a skin ? on the ?, which is attached to the radiant warmer of the incubator. The normal newborn skin temp is maintained between ?-?C / ?-? F. Initially record temp every ?-? min then q ?-?hrs.
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probe,
abdomen, 36.3-36.9 C/97.3-98.6F, 30-60min, 3-4hrs |
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S/S of inadequate thermoregulation= Poor ?, lethargy, irritability, ↓ ? tone, cool ?, mottled ?, hypoglycemia, ? difficulty.
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feeding,
muscle, skin, skin, breathing |
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Nsg management of thermoregulation= Keep baby in a ?-? environment, and use of a ? heater or warmed ? because the face is very sensitive to cold, cold ? could quickly lead to cold stress.
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neutral-thermal,
radiant, oxygen, oxygen |
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If an infant doesn't need to be in a radiant warmer a ? will be used.
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incubator
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Preterm Infants that are about ?g have a consistent weight gain for ? days, have no ? complications, and are tolerating ?s can begin gradual weening from external heat.
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1500g/3lb5oz,
5, medical, feedings |
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Preterm F/E imbalance: When infants are transferred to an open crib they should be dressed in a ?,?,? and doulbe wrapped with ? blankets
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Shirt,
diaper, hat, WARMED |
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Preterm F/E imbalance: The large surface area of the preterm infant in proportion to body ? and a big ? and lack of muscle ? results in increase trans-? water loss.
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weight,
head, flexion, epiDERMAL |
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Preterm F/E imbalance: Radiant warmers and the heat from phototherapy lights cause even more ? loss through the skin.
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water
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Preterm F/E imbalance: Water loss also occurs through the ? and ? tracts.
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respiratory,
gastrointestinal |
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Preterm F/E imbalance: The ability of the premature infants immature kidneys to concentrate or dilute urine is ? causing a fragile balance between fluid ? and ?
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poor,
overload, dehydration |
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Regulation of electrolytes by the kidneys also is a ? Common imbalances include excess ? and too little or too much ? or ? Preterm infants need higher intake of ? b/c the kidneys do not reabsorb it well, but to much can lead to water retention.
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problem,
calcium, sodium, potassium, sodium |
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30%-90% of preterm infants are born with F/E imbalance of ? due to lack of PTH.
During pregnancy, calcium is transfered to the baby from the mother via placenta. At birth the supply is ? A normal healthy newborn increases their level of ?-hormone to meet the deficiency, but a preterm infant has ? PTH production. |
hypocalcemia,
withdrawn, parathyroid hormone, blunted |
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Nsg assessment for preterm electrolyte imbalance= Monitor ?/?'s via a plastic bag secured to the ? Diapers should be ?'d, the formula is to subract weight of wet diaper from dry diaper and ? gram = ? ml of urine.
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Input/Output,
perineum, weighed, 1g=1ml |
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Nsg assessment of electrolyte imbalance continued: Specific gravity can be measured by collecting a sample using a cotton ball on the ? The baby should be weighed every ?
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perineum,
day |
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Nsg assessment dehydration: Urine ouput of < ?ml/kg/hr, monitor ? loss, dry ?, sunken anterior ?, poor skin ?, ↑ ?, For blood draws elevated ↑?, ↑?, ↑? levels, and hypo-? may be present
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<1ml/kg/hr,
weight, skin, fontanel, turgor, ↑HR, sodium,protein, hematocrit, HYPOTENSION |
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Nsg assessment for over hydration: Urine output
>? ml/kg/hr, ? gain greater than expected causing ?, bulging ?s, moist ? sounds, difficulty ? For blood draws ↓ ?, ↓ ?, ↓? and hyper-? may be present. |
>3ml/kg/hr,
weight, edema fontanels, breath, breathing, sodium, protein, hematocrit, hypertension |
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Radian heat and bili-lights increase the infants ? needs
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fluid
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