Neonatal network : NN
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Neonatal network : NN · Aug 1994
Case ReportsDevelopment of a neonatal intensive care nursery resuscitation and triage team: impact on nursing care and infant outcome.
The admission and initial stabilization of an infant in the neonatal intensive care unit pose a time of increased stress for the neonate as well as the caregivers. Constant observation by nursing personnel is critical so that major physiologic and anatomic changes that naturally occur do not compromise the neonate during this time of extrauterine adjustment. ⋯ The complexity of the admission process should not jeopardize the nursing care of other infants in a busy neonatal intensive care unit. We developed a framework that separates bedside nursing activities from the resuscitation and admission process that ensures the infant's transition to the nursery is met with urgency and consistency without subjecting the remaining infants to a decreased level of care.
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Gram-negative sepsis contributes significantly to neonatal morbidity and mortality. Gentamicin is an aminoglycoside antibiotic used in the treatment of gram-negative infections. ⋯ A literature review reveals pharmacokinetic differences of the neonate that affect gentamicin dosing. Nursing considerations affected by the developmental differences of the neonate include knowing appropriate dosages and routes of administration, pathophysiological and pharmacological conditions that affect gentamicin disposition, serum monitoring, and evaluation of adverse reactions and toxicities.
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The objectives of this study were to (1) develop a behavioral assessment tool for the measurement of pain in the preterm and full-term neonate; (2) establish the construct and concurrent validity, interrater reliability, and internal consistency of the tool; and (3) examine the relationship between the pain scores and infant characteristics. Thirty-eight infants contributed to the 90 procedures videotaped for the study. The Neonatal Infant Pain Scale (NIPS) was used to score behavioral responses before, during, and after each intrusive procedure. ⋯ The six component scores of the NIPS had high internal consistency: Cronbach's alphas were .95, .87, and .88 for before, during, and after the procedures, respectively. Although gestational age and five-minute Apgars were positively associated with NIPS scores over time, there was no association between these factors and responsiveness to pain, as measured by change in NIPS scores from before to during the procedure. Results are discussed in terms of the use of the NIPS in clinical trials and its clinical application in a neonatal intensive care unit.
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In 1981, the Food and Drug Administration approved prostaglandin E1 (PGE1) for use in the treatment of neonates with congenital heart disease. PGE1 is commonly used in neonatal and pediatric intensive care units to maintain patency of the ductus arteriosus in those cardiac lesions that depend on the ductus for either systemic or pulmonary blood flow. Early recognition of hemodynamic instability and prompt initiation of PGE1 therapy is vital to survival in neonates with ductal-dependent cardiac lesions. ⋯ Therefore, a continuous infusion and adequate intravenous access are necessary. Nurses caring for these neonates must have knowledge of all its potential side effects. Some of the most common side effects include cutaneous vasodilation, bradycardia, tachycardia, hypotension, seizure-like activity, hyperthermia, and apnea.