bConvectionheat lost to cooler surrounding air cConductionheat lost to cooler

Bconvectionheat lost to cooler surrounding air

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b.Convection—heat lost to cooler surrounding air c.Conduction—heat lost to cooler solid objects in direct contact to the newborn
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d.Radiation—heat lost to cooler objects not in direct contact to the newborn B.Fever 1.Fever: Rectal temperature greater than 38°C (100.4°F). a.Oral temperature—0.6°C (1°F) lower than rectal temperature on average b.Axillary temperature—1.1°C (2°F) lower than rectal temperature on average 2.A newborn may not always present with fever in an illness or infection because of the immaturity of its temperature regulation system. a.May become hypothermic or hypoglycemic instead b.No matter the presenting symptoms, it is imperative to identify serious bacterial infection in newborns so they can be treated. i.Of infants younger than age 28 days with a temperature of more than 38°C (100.6°F), approximately 13% will have serious bacterial infection. 3.Fever may be caused by overheating or dehydration. 4.Limited ability to control their temperature a.Do not sweat when they are hot b.Do not shiver to raise temperature c.Core temperature may drop in newborns with serious life-threatening infection, giving them a higher risk of: i.Hypoglycemia ii.Metabolic acidosis 5.Signs and symptoms include: a.Irritability b.Somnolence c.Decreased feeding d.Warm to touch 6.Assessment and management a.Examine for presences of rashes, especially: i.Petechiae ii.Pinpoint pink or red skin lesions b.Obtain a careful history about: i.General activity ii.Feeding iii.Voiding iv.Stooling c.Note increased respiratory rate and work of breathing. d.Obtain vital signs, and ensure adequate oxygenation and ventilation. i.Provide free-flow supplemental oxygen and chest compressions as necessary. e.Antipyretic agents are controversial in the field. i.Do not give ibuprofen. f.To cool: i.Remove additional layers of clothing. ii.Improve ventilation in environment. C.Hypothermia
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1.A drop in body temperature to less than 25°C (95°F) a.Linked to impaired growth and infection vulnerability b.Moderate hypothermia linked with increased risk of death in low birth weight newborns c.Newborns have increased surface area-to-volume ratio and are sensitive to environmental conditions, especially when wet after delivery i.Metabolic function increase to overcome heat loss can cause: (a)Hypoglycemia (b)Metabolic acidosis (c)Pulmonary hypertension (d)Hypoxemia d.If a newborn is hypothermic, investigate for infection. 2.Assessment and management a.Hypothermic newborns may be: i.Cool to the touch, initially in the extremities ii.Pale with acrocyanosis b.May present with: i.Decreased respiratory effort ii.Apnea iii.Bradycardia iv.Cyanosis v.Irritability vi.Weak cry viiSclerema (hardening of the skin associated with reddening and edema) on the back, limbs, or over the entire body.
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