Pedia

• Global Health Goals related to infant

  • End poverty & hunger
  • Achieve universal primary education
  • Promote gender equality & empower women
  • Reduce child mortality
  • Improve maternal health
  • Combat HIV/AIDS, malaria, & other diseases
  • Ensure environmental sustainability
• Trends in Healthcare Environment

  • Initiating cost containment/ cost effectiveness
  • Increasing health insurance coverage
  • Increasing alternative settings & styles for HC
  • Increasing use of technology
  • Meeting work needs of pregnant/breastfeeding mom
  • Regionalizing intensive care
  • Increasing use of alternative treatment modalities
  • Increasing reliance on home care
  • Increasing concern for QoL
  • Increasing awareness of the individuality & diversity of clients
  • Empowerment of health care consumers
• Child mortality rate


  Probability a newborn would die before reaching 5 yrs. of age (per 1,000 lives)
• Child mortality rate (PH data)- 17.544 deaths/ 1000 live births
• Childhood morbidity rate


  Rate at w/c disease or illness occurs in a population
• Common child morbidity


  • Congenital anomalies
  • Chronic Respiratory Disease
  • Communicable Disease
  • Congenital Heart Disease
  • Childhood Cancer
  • Diabetes
  • Obesity
• Common cause of child morbidity

  • Infectious disease
  • Preterm birth
  • Asphyxia & trauma
  • Congenital anomalies
• Preterm infant


  A live-born infant delivered before the end of 37th week
• Types of preterm infants

  • Early preterm (bet. 24-34 wks)
  • Late preterm (bet. 34-37 wks)
• Preterm birth occurs in approx. 10% of live births
• Preterm infant prone to

  • Hypoglycemia
  • RDS
• Preterm infant prevalence (PH)- 13.0%
• Common factors associated with preterm birth

  • Low socioeconomic level
  • Poor nutritional status
  • Lack of prenatal care
  • Multiple pregnancy
  • Previous early birth
  • Race
  • Cigarette smoking / vaping
  • Age of the mother
  • Order of birth (1st & 4th)
  • Closely spaced pregnancies
  • Abnormalities of female reproductive sys.
  • Infections
  • Pregnancy complications (PRoM, PSP)
  • Early induction of labor
  • Elective cesarean birth
• Anemia of prematurity


  All babies have some anemia when they are born, which normalizes around 3-6 months. Low level of hemoglobin w/ the infant, due to excessive blood drawing.
• Anemia of prematurity


  • S & sx: lethargy, difficult to feed, not very active
• Nursing management of anemia of prematurity

  rest, discreet monitoring
• Medical management of anemia of prematurity

  Blood transfusion, iron (Fe) supplement, Erythropoietin-EPO (last resort)
• Acute Bilirubin Encephalopathy (ABE)


  High level of bilirubin may cause seizures leading to brain cell damage, may cause problems w/ vision, teeth, & intellectual disabilities
• Acute Bilirubin Encephalopathy (ABE)


  • S & sx: lethargy, drowsiness, poor feeding habits, fever, shrill cry, absence of moro reflex
• Management of Acute Bilirubin Encephalopathy (ABE)

  phototherapy, or exchange transfusion
• Necrotizing Enterocilitis (NEC)


  Premature GI tract, Intestinal dysfunction that develops in approx. 5% of all infants in NICU, Bowel develops bacterial infection leading to necrotic patches, interfering w/ digestion and possibly leading to a paralytic ileus, perforation, and peritonitis.
• Treatment of Necrotizing Enterocilitis (NEC)

  bowel rest, gastric decompression, systemic antibiotics, parenteral nutrition
• Retinopathy of premature infant (ROP)


  Eye disease of a premature, or who weigh less than 3 lbs, Happens when abnormal blood vessels grow in the retina caused by vasoconstriction of immature retinal blood vessels
• Retinopathy of premature infant (ROP)

  • S & sx: wandering eye, eye doesn't follow objects, pupils look white, trouble recognizing faces
• Medical management of Retinopathy of premature infant (ROP)

  regular check-up, surgery for severe cases, laser therapy / cryotherapy
• Temperature instability


  Preterm are prone to rapid heat loss & consequent hypothermia, Heat loss via: evaporation, convection, conduction, radiation, Premature brain, heart, lungs, & kidneys.
• Patent Ductus Arteriosus


  AO-PA should close after the baby is delivered (2-3 days), Mgt: indomethacin or ibuprofen may be used, Surgical or interventional catheterization to close PDA
• Periventricular/ Intraventricular hemorrhage


  Bleeding in the brain of a preterm infant, Rapid change in cerebral blood pressure
• Utero placental insufficiency


  Happens when your placenta doesn't transfer enough blood (containing oxygen and nutrients) between you and the fetus, The fetus may not be getting what it needs to grow, Issues with how your placenta attaches to your uterine lining can cause placental insufficiency
• Utero placental insufficiency


  • Most common fetal consequences of this condition include intrauterine growth restriction, prematurity, or, unfortunately, fetal demise, Regular prenatal screening with Doppler ultrasound should be done to increase the chances of detection & diagnosis.
• Post-term infant


  Born more than 42 weeks aog, Prone to hypoglycemia & intracranial hemorrhage, Prone to meconium stain / meconium aspiration
• Post-term syndrome


  Dry, cracked, leatherlike skin, & absence of vernix caseosa, LGA, less amniotic fluid at birth & may be meconium stained, Grown fingernails beyond the end of the fingertips, May demonstrate an alertness much more like a 2- week-old baby than a newborn
• Meconium stain


  Meconium is the first stool the baby passes, Sometimes meconium comes out before the baby is born & goes into the amniotic fluid, Present in 10-20% of all deliveries
• Meconium stain


  • S & Sx: bluish color, coarse bronchial sounds, breathing problems, limpness, Poor gas exchange evidenced by a decreased O2 and an increased Pco2
• Nursing management of meconium stain

  O2 support
• Medical management of meconium stain


  intubation, CPAP (severe), antibiotics (prophylaxis)
• Meconium aspiration syndrome


  Low APGAR score, limp, tachypneic, deep retractions, brady/tachy, cyanotic, Chest x-ray: course, irreg patchy infiltrates, snow storm pattern, Labs- abnormal ABGs, SGPT, Crea
• Management of meconium aspiration syndrome

  close monitoring, high O2, ET intubation
• Polycythemia


  Abnormally high concentration of red blood cells, May result from post maturity, diabetes in the mother, twin-to-twin transfusions, or a low oxygen level in the fetus's blood, Affects 1-5% of newborns
• Management of polycythemia


  partial exchange transfusion