KDiarrhea 1Five or six stools a day is normal especially when breastfeeding

Kdiarrhea 1five or six stools a day is normal

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K.Diarrhea 1.Five or six stools a day is normal, especially when breastfeeding. a.Diarrhea is excessive loss of electrolytes and fluid in the stool. b.Causes include: i.Viral infection (most common, especially rotavirus infection) ii.Poisoning, which may have the following additional symptoms: (a)Profuse sweating (b)Lacrimation (c)Hypersalivation (d)Abdominal cramps (e)Intussusception (f)Malrotation (g)Increased ICP (h)Metabolic acidosis iii.Gastroenteritis iv.Lactose intolerance v.Neonatal abstinence syndrome vi.Thyrotoxicosis vii.Cystic fibrosis c.Severe cases can cause dehydration and electrolyte imbalance, with physical signs of: i.Ill general appearance ii.Poor vital signs iii.Capillary refill of greater than 2 seconds iv.Dry mucous membranes v.Absent tears vi.Weight loss vii.Low urine output 2.Assessment and management a.Estimate the number and volume of loose stools, decreased urinary output, and degree of dehydration based on: i.Skin turgor
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ii.Mucous membranes iii.Presence of sunken eyes b.Patient management begins with ABCs. i.Ensure adequate oxygenation and ventilation. ii.Perform chest compressions in addition to PPV if pulse rate is less than 60 beats/min. iii.Fluid therapy may be necessary. L.Neonatal jaundice 1.Results from immaturity of the liver to conjugate bilirubin in the first week. a.Considered pathologic when: i.Clinically visible in first 24 hours after birth ii.Total serum bilirubin increases by more than 5 mg/dL/d. iii.Total bilirubin exceeds 12 mg/dL in full-term infants. iv.Conjugated bilirubin exceeds 15 to 20 mg/dl. v.Persists for more than 1 week in full-term infants and for more than 2 weeks in preterm infants b.Can result from: i.Hemolysis ii.Red blood cell deficiencies iii.Polycythemia iv.Bowel obstruction c.Cholestasis can present after first 2 weeks. 2.Assessment and management a.Transport is essential for bilirubin measurement at the hospital. b.Additional assessments not available in the field include: i.Blood type and Rh of mother and infant ii.Antiglobulin (Coombs) test on the infant iii.Hematocrit value iv.Reticulocyte count c.Start on IV fluids if the neonate shows significant clinical jaundice. d.Communicate with medical control about any newborn with jaundice. e.If potential cholestasis, management includes diagnostic testing and treatment of cause. VII. Pathophysiology, Assessment, and Management of Conditions Related to Thermoregulation A.Thermoregulation is limited in a newborn. 1.Average normal temperature of newborn—37°C (99.5°F) a.Range for neonate—36.6°C to 37.2°C (97.9°F to 99°F) b.The production of heat by metabolism (nonshivering thermogenesis) is the newborn’s primary source of heat production. i.Brown fat is unique to newborns. (a)Deposited in fetus after 28 weeks of gestation (b)Stored around the scapula, kidneys, adrenal glands, neck, and axilla 2.Heat loss occurs through: a.Evaporation—water evaporates from the skin and respiratory tract.
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