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Late Term Infact

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Yin Yin Htay

on 16 February 2016

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Transcript of Late Term Infact

62
ECG
bpm
Thank You!
LPTs 8.66% of all birth.
70% of all preterm birth.
Mother who has PIH, HTN, DM, GDM, heart Disease, kidney disease, planceta previa, plancenta abruptio, sustance abuse, smoking, alcohol,
Hyperbilirumenia ( Jaundice)
fetal hemoglobin levels are necessarily higher than postnatal to carry oxygen to grow
at birth and shortly thereafter, oxygen getting via respiration.
Hemoglobin begin to hemolyze.
hemolysis causes bilirubin and The liver then conjugates the bilirubin for excretion.
livers are not as fully developed as a full-term newborns
livers are not as fully developed as a full-term newborns
Extreme hyperbilirubinemia can lead to kernicterus, an severe form of bilirubin-related brain damage.
Problem with with body Temperatuer maintenance
although heat loss problem in full trem, it is more significant in preterm and LPT.
thin skin with blood vessel near the surface and less subcutaneous fat for insulation.
less brown fat.
keeping infant warm, dressed with one more layer than an adult would wear.
Indication of inadequate thermoregulation including poor feeding or intolerance feeding.
axillary temperature normal: 36.3'C to36.9'C
sign of inadequate thermoregulation: lethargy, wear dry or suck, skin pale, cool to touch, mottled or cyanosis, hypoglycemia, poor weight if chronic.
Problem with Feeding
may have immature suck and swallow reflexes.
shorter awake period.
fall asleep during feeding before they fed adequately.
difficulty with latch.
low tone and weak suck may decrease the amount of milk.
monitor hypoglycemia.
need increase caloric and should be feb Q 3-4 hrs.
Urine and stool output are monitor.
supplemental feeding may be nessary .
football and cross-cradle holds are helpful for breastfeeding.
use nipple shields to get baby latch on the breast well and getting milk well.
avoid overstimulation because environmentally stress cause physiologic and behavior change.
check body temperature and teach thermoregulation: keep baby in warm consistant environment.
any change condition: lethargy, irritability, poor feeding, weak cry, cyanosis, cool or mottled skin,
body temperature instable, decrease urine output, dry skin and mucous membrance dry, sunken anterior fontanel,
difficulty breathing, grunting, flaring nares, and retracting chest.
all symptomes need to be seek health care provider.
Respiratory Disorder
poor developed cough reflex and narrow respiratory passage.
Increase risk for respiratory difficulty.
Inadequade inflates lung after birth or insufficient surfactant.
recently research shows: corticosteroid therapy before late pretern delivery reduce respiratory complication in baby.
Late Preterm Infant (LPT)
Born between 34 week and less than 37 weeks
they look similar to full term baby but physiologically and metabolically immature.
have higher mortality and morbility.
Higher risk for rehospitaliztion after discharge.

Etiology and Complication
Risk for
Respiratory disorder
problem with body temperature maintenance.
Hypoglycemia ( low blood sugar).
Hyperbilirubinemia ( abnormal Juandice).
Feeding difficulties.
Acidosis ( fluid and electrolyte imbslance) and Sepsis ( infection).
longtern neurodevelopmental disorder as well as cognitve and behavioral problem. ( Jorgensen 2008)
Discharge
vital sign should be stable at least 24 hours
should not be discharged before 24 hours.
teach/consult and assess for successfully breastfeeding.
follow up visit with health care provider should be arranged for 24 hours to 72 hours after discharge.
Teaching
any questions?
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