THE PRETERM INFANT - THEPRETERMINFANT Any infant born prior...

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THE PRETERM INFANT Any   infant   born   prior   to   completing   37   weeks’   gestation   is   identified   as   premature.   Thus,   the   level   of  development and maturity, and often the degree of complications, varies within this group, dependent on the length of  gestation. NEONATAL ASSESSMENT DATA BASE Circulation Apical pulse may be rapid and/or irregular within a normal range (120–160 bpm). Audible heart murmur may indicate PDA. Food/Fluid Weight less than 2500 g (5 lb 8 oz). Body long, thin, limp with a slight potbelly. Suck/swallow reflex may be absent/uncoordinated (impacts feeding choices). Neurosensory Head size large in relation to body; sutures may be easily movable; fontanels may be large or wide open. May demonstrate twitching or eye rolling. Edema of eyelids common; eyes may be fused shut (depends on gestational age). Reflexes depend on gestational age; rooting well established by 32 weeks’ gestation; coordinated reflexes for sucking,  swallowing, and breathing usually established by 32 wk; first component of Moro’s reflex (lateral extension of  upper extremities with opening of hands) appears at 28 wk; second two components (anterior flexion and audible  cry) appear at 32 wk. Dubowitz examination indicates gestational age between 24 and 37 wk. Respiration Apgar scores may be low. Respirations may be shallow, irregular; diaphragmatic with intermittent or periodic breathing (40–60/min). Grunting, nasal flaring, suprasternal or substernal retractions, or varying degrees of cyanosis may be present. Auscultatory presence of “sandpaper” sound indicates RDS. Safety Temperature fluctuates easily. Cry may be weak. Face may be bruised; caput succedaneum may be present; labor or delivery may have been precipitous. Skin reddened or translucent; color may be pink/ruddy, acrocyanotic, or cyanotic/pale. Lanugo widely distributed over entire body. Extremities may appear edematous. Sole creases may or may not be present on all or part of the foot. Nails may be short. Sexuality Female labia minora may be larger than labia majora, with prominent clitoris. Male testes may not be descended; rugae may be scant or absent on scrotum. Teaching/Learning Maternal history may reveal factors that contributed to preterm labor, such as young age; low socioeconomic  background; closely spaced pregnancies; multiple gestation; poor nutrition; previous preterm birth; obstetric  complication such as abruptio placentae, premature rupture of membranes (PROM), premature dilation of cervix, 
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presence of infection; blood incompatibility associated with erythroblastosis fetalis; or use of prescription, over- the-counter, or street drugs. DIAGNOSTIC STUDIES
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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THE PRETERM INFANT - THEPRETERMINFANT Any infant born prior...

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