Predatory Synthesis Essay

Classic BPD had four stages and each has radiographically and pathologically differences. In Stage 1; Days 2-3, the infant is intubated and receives positive pressure ventilation with high Fi02 concentration. The CXR shows a typical

overexposed to oxygen for extended periods (Jobe & Kallapur, 2010). When a baby is born

The APN leader interviewed for this paper is a Board Certified Nurse Practitioner (CNP), Chery Arnett works in the Neonatal Intensive Care Unit for Memorial Hospital of Carbondale. She began as a registered nurse in 1981, then in 2001earned her CNP title. She manages and cares for the ill neonate, collaborates with Neonatologist and Pediatricians to improve overall health outcomes. She provides support and assists ventilation, assists with deliveries both “normal” and high risk infants, provides care for the healthy newborns, also providing guidance to parents for caring for the “neonate” or healthy newborns. She is also responsible for assessments, orders, treatment plans, medications, and discharge of the infant. CNP’s provide initial, ongoing and comprehensive care, including managing patients with acute and chronic illness and diseases for both premature infants and term infants.

Jace Sauseda Clinical Rotation Mrs. Ysaguirre 17 November 2015 NICU Clinical Report At the Neonatal Intensive Care Unit doctors, nurses, and all staff unite together with one primary goal for each new life they receive, that goal being to achieve the best outcome for each premature and critically ill baby. The NICU, at University Hospital, care for 600 infants annually. Inside is a 58-bed facility, offering the highest level care led by on-site neonatologist (University Health system). The (NICU) is specialized to care for premature infants (those less than 37 weeks gestation) as well as sick newborns.

This could lead to different types of diseases such as; BPD (Bronchopulmonary Dysplasia) , Asthma, or even SIDS (Sudden Infant Death Syndrome). BPD is more commonly found in premature infants but in some cases healthy babies can also get this disease. One of the reasons why BPD is common in premature babies is because their immune systems are weak. BPD is from damage to the lungs caused by mechanical ventilation (respirator) and long-term use of oxygen. This occurs in premature babies because a lot of time they have to be put on oxygen to help them breath until their lungs become stronger. When an infant is diagnosed with a chronic lungs disease it can lead to other types of infections or complications. If a baby has to be put on a ventilator it could cause complications with their lungs. Ventilators force breathing which means that the ventilators will be forcing high oxygen levels into the lungs of an infant or premature baby. This could possibly cause damage to their lungs. Another chronic lung disease that is commonly found in babies is SIDS (Sudden Infant Death Syndrome). SIDS is an unexplained death, it usually happens while the baby is sleeping, it can happen to a healthy baby who is less than a year old. Some physicians say that the cause of SIDS is from the brain stem being defected; the brain stem controls breathing. Out of 60,000

Neonatal Nurse Practitioners (NNP) refers to and cares for newborns in their first 28 days of life. Neonatal nurse practitioners practice advanced skills in order to provide care for healthy newborns, as well as newborns who need individualized attention. These nurses care for premature and sick newborns in many different settings: neonatal intensive care units (NICU), emergency rooms, delivery rooms, or specialty clinics(Nurse). NNP’s level of care enables them to preform multiple duties consisting of: monitoring specialized equipment, providing education to the families of the sick newborns, administering medications, preforming diagnostic tests and other procedures in order to establish a treatment plan for the newborns,

Karen Meunier, is the education consult for New Orleans’s Childrens Hospital Ventilator Assisted Care Program (VACP). Mrs. Meunier educated the audience on the history of ventilators. Next, Mrs. Meunier stated the criteria for the children who are enrolled in the Ventilator Assisted Care Program. Overall, these children either have a neuromuscular, brain and/or spinal cord injury, and/or birth related diagnosis. The children in the program live at home in Louisiana, under the age of 26, Medicaid eligible, and require daily mechanical support of respiratory efforts. Lastly, Mrs. Meunier informs the audience about each member in the VACP staff. The VACP staff includes an education consultant, respiratory therapist trainer, two case managers,

For the past two decades, the limit of gestational viability has been 22-24 weeks (Bhat, Weinberger, & Hanna, 2012). Around 50 years ago, a premature infant born between 22-24 weeks was not considered viable and resuscitation was only considered at 27-28 weeks (Kushchel & Kent, 2011). Medicine and technology advances have improved neonatology drastically and infants are surviving at lower gestational ages. However, many studies show very low survival rates of 22-week neonates and some physician refuse to resuscitate and provide only comfort care. In the NICHD Neonatal Network between 2003 and 2007, infants that were incubated and resuscitated had a 6% survival rate at 22 weeks and a 55% survival rate at 24 weeks (Bhat et al, 2012). Another study followed a hospital for many years were they delivered 85 infants at 22-week

The method used was double blind randomized control study, the neonates were placed into either the experimental or control group by computer. The study was conducted by registered nurses who all had at least two years of experience in the NICU as a staff nurse. The nurse obtaining the study data remained blind to whether the patient received the intervention of sucrose or not, by stepping out of the room while the patients primary nurse opened up an envelope containing information if the patient was to receive 0.5mL of sucrose or not. The primary nurse would then administer the sucrose if indicated prior to the nurse collecting data for the study would return. The sucrose was administered between one and three minutes prior to the arterial puncture procedure. Every neonate was swaddled for the procedure and a pacifier was held in place lightly while the arterial puncture was performed. The nurse investigator would obtain the NIPS score, heart rate, and oxygen saturation, after the needle was inserted and then one minute after completion of the procedure. Milazzo, et al. (2011), found that the average gestation of the neonate in this study was 33.8 weeks and there was no difference in age of gestation for the experimental or control groups. The NIPS score was found to be between zero and three

Postnatal respiratory complications among newborns are common. The most commonly reported cause of neonatal respiratory distress is transient tachypnea of the newborn (TTN), with an estimated incidence of 1% to 2% of in all newborns.1

Now, medical advances make it possible for even the most severe premature babies to survive. As in case of Preterm babies as young as 22 to 23 weeks ( Micro preemies), level 3 NICU offers a wide range of neonatal services including special imaging techniques, advanced ventilation procedures, and special surgeries (Bird, 2014). Advanced technology has helped to increase the survival rate for even the most severe preterm babies, but the costs associated with them is high (Kornhauser & Schneiderman, 2010). The average cost for treating the micro preemie has been estimated to be more than $ 2 million (Kornhauser & Schneiderman, 2010). Nevertheless, this projected cost is excluding the cost of treating long term outcomes in the micro preemies. The

I was also told by my mentor that previously there were a number of cases of nasal trauma in the unit. With that in mind, I initially felt uncertain of what to do. I have not encountered a newborn exhibiting nasal injury due to NCPAP. Amidst that, I knew that it was my responsibility to make sure that my patient is safe and comfortable. This made me want to find out more about nasal care for neonates that are on NCPAP therapy. Knowing this, I asked my mentor for guidance in what I should be doing. I also decided to read more about the topic so that it would lead to better understanding of what interventions I could do to ensure prevention of injury for my patient. I decided to regularly assess the neonate’s nose so that I could monitor if there is trauma or if there is progression of previous trauma. I also made sure that the nasal interface is properly positioned to ensure effectivity and prevent nasal injury. According to Deblasi (2009), the fixation technique is important. The hat should be tight while the straps attached to the nasal interface should be able to apply minimal tension on the nasal

As a newborn makes their entrance to this world from intrauterine life all should go smoothly. The newborn is delivered and is stimulated to breathe and then is followed by inspirations, followed by a cry showing a successful arrival to this world, but not all deliveries go as planned. There are diseases of the respiratory system. The most common disease is Respiratory Distress Syndrome (RDS). The Primary cause of RDS is the underdevelopment of the premature lungs states Perretta, 2015. RDS is caused by a deficiency and immaturity of alveolar surfactant with the anatomical immaturity of the premature infants lungs. The incidence of RDS increases with decreasing gestational age says J. Haitsma, 2010. The biggest factor is surfactant deficiency caused by decreased surface area in the lungs for proper gas exchange and thick alveolar-capillary membranes. “Surfactant replacement therapy for preterm infants with RDS has shown to be a major breakthrough in neonatal medicine,” says J. Wirbelauer and Speer, 2009. It has become routine for the prevention and treatment for infants suffering from respiratory distress syndrome. Surfactant replacement therapy is a life-saving treatment for all neonates showing signs of RDS characterized by surfactant deficiency. By replenishing the lungs with an exogenous surfactant shows

The best management strategy for BPD is to prevent it from developing. Prevention of preterm birth is the ideal method of decreasing both the incidence and severity of BPD (Evans, 2014, p. 8). There are several methods of both prevention and treatment that have reduced the incidence of BPD. Use of prenatal steroids is a method used to prevent the premature delivery. A single course of prenatal glucocorticoids administered to women, who are at high risk for premature delivery results in a significant decrease in the mortality rate and the morbidity associated with prematurity (Jardins & Burton, 2011, p. 459). Another method used is both low oxygen administration and gentle ventilation use. Every effort should be made to administer gentle

Respiratory distress syndrome (RDS) is a common lung disorder that mostly affects preterm infants. RDS is caused by insufficient surfactant production and structural immaturity of the lungs leading to alveolar collapse. Clinically, RDS presents soon after birth with tachypnea, nasal flaring, grunting, retractions, hypercapnia, and/or an oxygen need. The usual course is clinical worsening followed by recovery in 3 to 5 days as adequate surfactant production occurs. Research in the prevention and treatment of this disease has led to major improvements in the care of preterm infants with RDS and increased survival. However, RDS remains an important cause of morbidity and mortality especially in the most preterm infants. This chapter reviews the most current evidence-based management of RDS, including prevention, delivery room stabilization, respiratory management, and supportive care.