123 School Work

care of pre term infant

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  The Compromised Neonate          Care of Preterm Infant and SGA
  
  Developmental Care
  This term is used to describe interventions, which maintain and lead to stabilisation, recovery and development of infants and their families who require intensive care. Developmental care is particularly appropriate to low birth weight infants-these babies are at risk of: -     Medical complications
                      Lack of normal growth patterns
                      Neurological impairment
                      Cognitive and behavioural problems
  
  During the last trimester it is thought that the human brain undergoes its most rapid phase of development, the baby born prior to or during this trimester is greatly disadvantaged. The environment within the neonatal unit is stressful
  
  Developmental care aims to: -
       Counteract neonatal sensory overload or deprivation
       Prevent faulty maternal-infant attachment
       Help parents come to terms with a premature delivery
       Help parents recognise and respond to infant cues
       Develop programmes of care specifically for infants with developmental      deficit or chronic illness.
  
  Issues, which require identification in order to promote the best possible infant prognosis
  
  Assessment of Neonatal Behaviour
  Term babies- stable motor and autonomic system function as demonstrated by; -
  
  Sleep/drowsy states
  Quiet /active alert states
  Fussy, irritable crying states
  Can be consoled/satisfied
  Able to shut out stimulation for rest and sleep
  
  Preterm babies-immature systems
  
  Autonomic
  Areas requiring assistance     respiratory
                           cardiovascular
                           digestive
  
  
  May be stable but stability challenged by      handling
                                     environmental disturbance
                                     pain
  illness     
  
  Motor
  Immature CNS
  Reduced muscle power and bulk resulting in: -     
  poor mobility
  difficulty in counteracting gravity
  inability to move away from or near to stimuli
  tremulous and diffuse movements
  
  Sleep wake states in preterm infant
  Become distinct phases after 28 weeks, however can be difficult to determine by observing behaviour. Sleep /wake states tend to be erratic, influenced by stressors, both internal and external. Difficulty in achieving deep sleep, problems with hyperalertness and arousal collapse and exhaustion
  
  Observable behaviour-     stress or avoidance signals
                      comfort/stability signals
  
  Positioning and Postural SupportWhy?
  Unable to counteract the effects of gravity-without support leads to head, shoulder and hip flattening, leading to lack of mobility. If infants not positioned and supported more exposed to environmental hazard autonomic arousal influencing energy, oxygen expenditure and systems stability.
  
  Head containment seems to soothe and calm infants-using soft roll but avoiding neck roll, which can cause head extension, sheet can be gently tucked under the shoulders.
  
  Prone position-especially if respiratory support or recovering from respiratory illness-improved oxygenation and ventilation...