High risk newborn
- 1. Nidhi Chauhan M.sc nursing previous year Batch 2017 Govt. College of Nursing. Jodhpur High risk newborn
- 2. introduction
- 3. definition • Any neonate, regardless of birth weight, size, or gestational age, who has a greater than average chance of morbidity or mortality, especially within the first 28 days of life.
- 5. According to size 1. Low birth weight 2. Very low birth weight 3. Extremely low birth weight 4. Appropriate for gestational age 5. Small for date 6. Intrauterine growth restriction 7. Symmetric IUGR 8. Asymmetric IUGR 9. Large for gestational age
- 6. According to Gestational age • Preterm • Full term • Late preterm • Post term (post mature)
- 7. according to mortality • Live birth • Fetal death • Neonatal death • Perinatal mortality • HIV mortality
- 10. General Anthropometric, shape, size, signs of distress, apparent deformity, posture Skin Mottling, erythma toxicum, cyanosis, birthmark, maningioma, hematoma etc. Head/Eyes/Ears/ Nose/Throat Red reflex, hemorrhage, micorphthelmia, conjunctivitis, patent nare, intact palate Respiratory Shape and symmetry of chest, use of accessory muscles, respiratory rate, auscultate breath sound, oxygen saturation Cardiovascular Heart rate, sound, murmur, pulse, blood pressure, capillary refill, Abdomen Abdominal distension, sign of regurgitation, characteristics of emesis and stool, liver margine, bowel sound Genitourinary Abnormality of genitalia, characteristics of urine, weight of the body Rectum Tone, anus abnormality, meconium passage Neuromuscular Movement of joints, position, flexion, extension, reflex actions, level of consciousness, body size changes, pupillary response, hip alignment
- 11. management
- 12. Temperature regulation Nutrition and fluid maintenance Testing and laboratory procedure Intravenous lines and tubes Procedures and equipments Special care
- 15. methods of thermoregulation • Immediate drying and warming after delivery
- 21. Enteral feeding
- 24. Testing and laboratory procedures Blood group checking Complete blood count Arterial blood gas analysis Blood sugar level Electrolyte level Blood smear test X-ray
- 28. Other equipments Ultrasound X-ray Computed tomography Magnetic resonance imaging ECMO
- 29. Special care
- 31. Follow up schedule • 2 weeks after discharge • At 6,10,14 weeks of postnatal age • At 3,6,9,12 and 18 months of corrected age and 6 monthly visit until at least 5 years
- 32. Follow up • Assessment of feeding and dietary counseling • Growth monitoring • Developmental assessment • Immunization • Ongoing problems • Neurological assessment • Eye evaluation • Hearing evaluation