Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
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Breast milk has replaced proprietary formulas as an important feeding for the premature and sick neonate. Over 30 milk banks have been established in the United States to provide breast milk to high-risk neonates. ⋯ A format for developing a breast milk bank and the protocol for donor screening, collection techniques, transport and storage of milk are presented. Rationale supporting each section of the protocol is also included.
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The use of epidural anesthesia for the obstetric patient is increasing in many areas of the country. The maternity nurse needs to have a basic understanding of the technique used by the physician to initiate this type of anesthesia, and also has a responsibility to know the contraindications, possible complications, and disadvantages and advantages of epidural anesthesia. This information is presented below. Skilled nursing and medical management will reduce the potential risks of epidural anesthesia for both the mother and fetus.
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A review of persistent fetal circulation, which involves the presence of a right to left extrapulmonary shunt that is sustained into neonatal life, is presented. Clinical signs exhibited by the infant often resemble those of respiratory distress. Treatment is accomplished with hyperventilation and/or pharmacologically with tolazoline which, in addition to the usual attention to the overall condition of the infant, requires intensive monitoring by the nurse.