hypoclycemia

hypoclycemia

1. cause- separted from moms supply, not feeding well

2. S&S- jittery, irratble, drowsy, feeding difficulty

3. intervention- frequent feed, asses temp, Ac/Pc

4. Hypothermia

   • Cause- large SA for weight, less SQ fat (reduced brown fat- heat production)
   • Different ways- Evaporation, Conduction, convention, radiation
   • S&S- CNS dep, hypoglycemia, hypoxia, tachypnea
   • intervention- dry well, stable temp before bath, encourage feeding, warm room
   • Hyperbilirubinemia
     • kinds- Pathological- first 24 hr, Physiological- after 24 hr
     • unconjugated vs conjugated
     • why? - immature liver function
     • S&S- lethargic, poor feeding, yellow skin, eyes
     • Intervention- hydrate, frequent feeding, phototherapy
     • Phototherapy- changes bilirubin into products that can pass through system
       • Care- eyes, skin, hydration, elmination, temp, daily weights, feedings

5. @ risk- preterm, GDM, small or large for gestational age, hypothermia

6. Spontaneous abortion

   • Threatened, inevitable, incomplete, complete, missed, habitual
   • 1st trimester- fetal abnormalities
     • 2nd trimester- maternal condition
   • pain, cramps, passage of clots/fetal products, bleeding
   • Gestational diabetes
     • fetus- to much glucose= pacrease= extra glucose= extra insulin and glucose= extra weight
     • mom- monitor glucs during labor, encourage frequent feedings
     • at risk for breathing problems, hyperbilirubinemia, heart function, hypocalcemia, overweight in childhood
     • Gestational hypertension
       • high blood pressure
       • pre-eclampsia
         • high BP + proteinuria
         • warning: headache, upper abd pain, vision changes
       • Eclampsia
         • high BP + proteninuria + seizure
       • risks - decreased blood to placenta= decreased o2. placenta abruption, premature delivery,
       • HBP, edema, weight gain, visual changes, N/V, Rt upper abd pain, urinating frequently, change in lever/kidney function
       • treatment- bed rest, low NA diet, lots of water
       • severe- delivery, oxytocin, magnesium sulphate-seizures
         • Mg toxicity- hypotension,sweating, bradycardia, decreased LOC
         • anidote- calcium gluconate
       • HELP
         • H- Hemolysis
         • EL- Elevated Liver enzymes
         • LP- low Platetes
         • S&S- headache, n/v, rt upper abd pain- liver, bleeding, swelling
         • delivery is best to reduce complications
       • Placenta Previa
         • placenta covers the cervix
         • complete, partial, marginal, low lying
         • S&S- painless red bleeding
         • treatment- bed rest, medication for preterm, FHR
         • education neonatal survival, bed rest, o2 for fetal distress
         • FHR, kick count, NST
         • Placental abruption
           • placenta separates from uterine wall, hemorrhage
           • Mild- internal bleeding, moderate- external bleeding, severe- external hemorrhage, shock
           • Labs- decreased fibrinogen, platelets, prolonged INR/PTT
           • assess of DIC- loss of clot forming, all clotting is used up
           • Left lateral position, strict bed rest, 02, fundal height- bleeding,

7. Preterm labour

   • before 37 weeks
   • cause- infection, twins/triples, illict drugs indeqaute weight gain
   • treatment- bed rest, tocolytics- relax uterus
   • Postpartum hemorrhage
     • primary- first 24, secondary- up to 6 weeks
     • 4 T's: Tone, tissue, Trauma, Thrombosis
     • Assess- fundus, bleeding, perineum, urine output, v/s- shock, LOC

8. Seizure disorders

   • symptomatic- cause is known, idiopathic- cause unknown
   • Occur when brain nerves misfire,burst of abnormal electrical acivity
   • Generalized- both left and right hemispheres
     • Absence- blank state- very short
     • Tonic- crying, fallls Clonic- convulsions, twitiching, last 1-3 minutes
   • Partial- one hemisphere
     • Simple- remain aware, can't control function
     • Complex- altered awareness, automatismic movements(walking, pulling at clothes)
   • Febrile-seizure from fever
   • Status eliepticus- life threatening- state of continuouss seizures

9. Meningitis

   • Bacterial- severe, higher risk to die, can be contagious(resp)
   • Viral- less severe, resolve on own, spread through fecal contamination
   • S&S- fever, headache, bulging fontanels, muscle aches, pale, stiff neck, lethargy, seizures
   • Diagnosis- lumbar puncture(CSF), CT, CBC, antibiotics
   • NSG- neuro v/s, minimize stimulation, feeding assessment

10. Head Trauma

    • head injury vs brain injury
    • GCS
      • 14 to 15- Minor
      • 9 to 13- Moderate
      • less than 8- Severe
    • causes- falls, sports, bicycle or motor vehicle, intracranial- over 3 feet or twice kids height

11. Cerebral Palsy

    • damage to brain in developement causing disturbances in movement and coordination
    • Spastic- most common, stiff/tightness in muslces
    • Athetoid- uncontrolled movements
    • Ataxic- least common, shaky, unsteady movements
    • diagnosis- early in infants at risk, when see a delay in milestones , abnrormal tone, poor coordination

12. Osteomyelitis

    • bacterial infection of the bone and soft tissue surrounding
    • S&S- fever, bone pain, guarding, redness, can't support weight
    • antibiotic, pain meds, debridement

13. Juvenile Arthritis

    • autoimmune- body attacks self
    • swollen joints, fever, rash, stiffness, eye problems
    • labs- RH, ESR, CBC, bone scan, bone density
    • treatment- NSAID's, Corticoseriods DMARD's

14. Diabetes

    • deficiency of insulin
    • complications- eyes, heart, vessels, nerves,kidneys
    • insulin- decrease glucose levels in blood by making liver, fat and muscle take it up in a stored form
    • polyuria, polydipsia, polyphagia
    • exercise- snack and monitor glucs
    • treatment of hypo- 15/20g of glucose, recheck in 15
    • Metabolic Acidosis
      • ketones build up causing the body to become acidic
      • labs- ph, bicarbonate
      • when sugars are low the body breaks down fat for energy- keytones are the byproduct
      • diabetic ketosis- ketones and glucosie in urine
      • diabetic ketoacidosis- dehydration, acidosis, kussmauls resp