The Journal of perinatal & neonatal nursing
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J Perinat Neonatal Nurs · Mar 2000
ReviewNeoteric physiologic and immunologic methods for assessing early-onset neonatal sepsis.
Septicemia is a growing problem among low birth weight infants. Early identification and treatment of sepsis in these infants would help to reduce the high mortality and morbidity seen with this disorder. Newer techniques may make earlier diagnosis a reality. ⋯ Physiological signs, laboratory indicators, skin temperature, peripheral perfusion, and the interaction of macro-environmental factors are also discussed. Newer (neoteric) immunologic and cytokine markers of sepsis are reviewed. Finally, thermography, a noninvasive bioinstrument measuring vasoactive peripheral perfusion, which has potential for early recognition of neonatal septicemia, is described.
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J Perinat Neonatal Nurs · Dec 1999
ReviewContinuous insulin intravenous infusion therapy for VLBW infants.
Very low birth weight (VLBW) infants less than 1,000 g often experience hyperkalemia and hyperglycemia during the initial hospital course. Hyperkalemia has been noted in 44% to 50% of infants less than 800 g birth weight or less than 28 to 29 weeks' gestation. ⋯ Insulin has been used for VLBW infants less than 1,000 g to manage hyperkalemia, control hyperglycemia, and optimize parenteral nutrition. A protocol for using exogenous insulin therapy for VLBW infants is described.
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J Perinat Neonatal Nurs · Sep 1999
ReviewCarrier screening for cystic fibrosis: a perinatal perspective.
Cystic fibrosis (CF) is one of the most common autosomal recessive disorders in the United States today. One in 29 Americans, greater than 10 million people of Caucasian ethnicity, is a carrier for this genetic condition. ⋯ It can be anticipated that perinatal nurses will be part of the process of carrier screening of CF for prenatal patients. This article describes the nature of CF, the options for testing, and the basics of the molecular testing so nurses can be instrumental in the education process when this becomes standard practice.
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J Perinat Neonatal Nurs · Jun 1998
The clinical experience of continuous quality improvement in the neonatal intensive care unit.
Central line catheters are commonly placed in extremely low-birthweight infants to provide venous access for administration of hyperalimentation and medications. Infections is the most common complication of central line catheters in this patient population. ⋯ The continuous quality improvement process was used to modify central line practices, which led to a decrease in the rate of central line infections. For the first 8 months of 1997, the infection rate was below the 25th percentile according to the National Nosocomial infections Surveillance System data.
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J Perinat Neonatal Nurs · Jun 1998
Outcome measures after standardized pain management strategies in postoperative patients in the neonatal intensive care unit.
Written guidelines based on current research on infant pain assessment and management were developed by an interdisciplinary team in a neonatal intensive care unit of a regional medical center. Charts for infants who had undergone abdominal surgery were reviewed to compare patient outcomes before and after use of this pain management protocol. With the standardization of pain management strategies, the following improvements were noted: decreased length of time to extubation, decreased length of stay, better fluid management, and reduced side effects of narcotics. Additional benefits included improved pain management documentation, decreased cost, and decreased nursing time.