Encephalopathy viiiDrug withdrawal cHypoxic ischemic encephalopathy Most common

Encephalopathy viiidrug withdrawal chypoxic ischemic

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vii.Encephalopathy viii.Drug withdrawal c.Hypoxic ischemic encephalopathy: Most common cause of seizures in newborns d.Occur 12 to 24 hours after hypoxic event i.Usually more severe over first 2 to 3 days of life. e.Metabolic abnormalities include disturbances in: i.Levels of: (a)Glucose (b)Calcium
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(c)Magnesium (d)Other electrolytes ii.Amino acids iii.Organic acids iv.Blood ammonia v.Certain toxins 6.Assessment and management a.Quickly evaluate prenatal and birth history. b.Perform a careful physical exam. i.Hypoglycemia must be recognized and treated quickly with: (a)Blood glucose measurement and dextrose administration c.Obtain baseline vital signs and oxygen saturation readings. d.Provide additional oxygen, assisted ventilation, blood pressure evaluation, and IV access as necessary. e.If blood glucose level is less than 40 mg/dL, give an IV bolus of 10% dextrose solution and recheck in 30 minutes. f.Before giving an anticonvulsant medication, consult medical control. i.May interfere with respiratory and cardiac function g.Monitor respiratory status and oxygen saturation carefully. h.Maintain normal body temperature. i.Keep family informed as you transport the newborn. I.Hypoglycemia 1.A blood glucose level of less than 45 mg/dL in full-term or preterm newborns a.An imbalance between glucose supply and utilization, with low glucose levels due to: i.Inadequate intake or storage ii.Increased glucose utilization b.Most newborns are asymptomatic until glucose level falls below 20 mg/dL. c.May result in: i.Seizures d.The newborn may be at risk for hypoglycemia due to: i.Disorders related to decreased glycogen stores (a)Small for gestational age (b)Prematurity (c)Postmaturity ii.Increased use of glucose (a)Newborn of a diabetic mother (b)Large for gestational age (c)Hypoxia (d)Hyperthermia (e)Sepsis 2.Assessment and management a.Symptoms may be nonspecific, including: i.Cyanosis
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ii.Apnea iii.Irritability iv.Poor sucking or feeding v.Limpness vi.Irregular respirations vii.Eye rolling viii.Hypothermia b.Symptoms may be associated with: i.Lethargy ii.Tremors iii.Twitching or seizures iv.Coma v.Tachycardia vi.Tachypnea vii.Vomiting c.Check blood glucose level in all sick newborns and evaluate vital signs. d.Manage hypoglycemia after taking care of the ABCs. i.If the blood glucose level is less than 45 mg/dL, medical control may order a bolus of 2 mL/kg IV of 10% dextrose solution. e.Maintain normal body temperature. J.Vomiting 1.Common in newborns a.Ranges from spitting up to severe, bloody, or bilious projectile vomiting i.Bilious and/or bloody emesis needs medical treatment. ii.Persistent vomiting is a warning sign and can cause: (a)Excessive fluid loss (b)Dehydration (c)Electrolyte imbalances b.Persistent vomiting in the first 24 hours may indicate: i.Upper digestive tract obstruction ii.Increased intracranial pressure c.Vomitus with dark blood indicates gut bleeding and may be a sign of life-threatening illness.
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