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Newborn - Preterm

A preterm newborn is one born before 37 weeks' gestation. Preterm newborns exhibit immaturity in all body systems which hinders their adaptation to extrauterine life. They are at higher risk for respiratory, cardiovascular, gastrointestinal, fluid imbalance, infection, temperature regulation and neurological issues. Nursing management focuses on providing respiratory support, monitoring vital signs, ensuring adequate nutrition/fluids, maintaining neutral thermal environment, preventing infection, and promoting parent-newborn attachment.

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Rex Magallanes
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17 views12 pages

Newborn - Preterm

A preterm newborn is one born before 37 weeks' gestation. Preterm newborns exhibit immaturity in all body systems which hinders their adaptation to extrauterine life. They are at higher risk for respiratory, cardiovascular, gastrointestinal, fluid imbalance, infection, temperature regulation and neurological issues. Nursing management focuses on providing respiratory support, monitoring vital signs, ensuring adequate nutrition/fluids, maintaining neutral thermal environment, preventing infection, and promoting parent-newborn attachment.

Uploaded by

Rex Magallanes
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Newborn

Nursing Care of At-Risk/ High Risk/ Sick Client


Preterm newborn
• Description:
A preterm newborn is one
born before 37 weeks’
gestation.
Preterm newborn
• Etiology:
(1) The etiology of preterm labor is
poorly understood.
(2) Possible factors include the
following:
1. Multiple gestation
2. Maternal history of preterm delivery
3. Hydramnios
4. Uterine anomalies
Preterm newborn
• Etiology:
10. Maternal substance abuse (especially
5. More than one second trimester cocaine)
abortion. 11. Maternal age less than 18 years, poor
nutrition, and lack of prenatal care.
6. Incompetent cervix
7. Infection
8. Uterine structural anomalies
9. Premature rupture of membranes
Pathophysiology:
Preterm newborns
exhibit anatomic and
physiologic
immaturity in all body
systems, this
immaturity hinders
the adaptations to
extrauterine life that
the newborn must
take.
Assessment findings.
1. Associated findings. Altered
parenting as evidenced by:
(a) Decreased or absent parental visits
(b) Parental resistance or refusal to
participate in newborn care
(c) Denial of severity of newborn illness.
(d) Resistance or refusal to touch
newborn.
(e) Persistent verbalization of guilt.
Clinical manifestations: There is a higher risk for the following
manifestations with a younger gestational age.

(a) Respiratory manifestations (c) Gastrointestinal manifestations


include tachypnea, grunting, include feeding intolerance, gastric
nasal flaring, retractions, reflux, vomiting, and gastric residuals.
cyanosis, decreased oxygen
saturation, decreased oxygen
levels and abnormal arterial
blood gas (ABG) values.
(b) Cardiovascular manifestations
include poor tissue perfusion,
hypotension, and patent ductus
arteriosus.
Clinical manifestations:
(d) Altered fluid status may be (e) Iatrogenic anemia secondary to
manifested by fluid excess or fluid blood sampling may be present, it is
deficit . exhibited by tachycardia, pallor,
decreased blood pressure,
(1) Fluid excess is manifested by increasing oxygen requirements, and
edema and congestive heart apnea.
failure.
(f) Infection may occur.
(2) Fluid deficit is manifested by
tachycardia, poor skin turgor, (g) Hypoglycemia or hyperglycemia
decreased urine output, abnormal may be present.
electrolyte levels, and decreased
blood pressure.
Clinical manifestations:
(h) Ineffective temperature control (j) Hyperbilirubinemia is
may be observed, and is exhibited by characterized by rapid destruction of
an inability to maintain core body red blood cells, jaundice, and
temperature. lethargy. Kernictus is the deposition
of unconjugated bilirubin in the brain
(i) Neuromuscular system cells and is associated with mental
manifestations include decreased retardation.
suck and swallow reflex, hypotonia,
and altered state transition.
1. Provide respiratory support.
2. Perform the following assessment .
(a) Assess heart sounds for presence of
murmurs.
(b) Assess pulse and perfusion.
(c) Monitor blood pressure, heart rate, and
pulse pressures.
3. Provide adequate fluids and electrolytes and
nutrition.
4. Maintain a neutral thermal environment.
5. Prevent infection.

Nursing Management
6. Assess for readiness for selected interventions.
(a) Provide stimulation when appropriate to infant state and readiness.
(b) Encourage flexion in the supine position by using blanket rolls.
(c) Provide the newborn with body boundaries through swaddling or using
blanket rolls against the newborn’s body and feet.
7. Promote parent-newborn attachment.
8. Initiate phototherapy as required

Nursing Management

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