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neonatal sepsis
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7/21/2019 Neonatal Sepsis
http://slidepdf.com/reader/full/neonatal-sepsis-56da422355b1b 1/8
Neonatal sepsis (neonatal septicemia or sepsis neonatorum) is an infection in the
blood that spreads throughout the body and occurs in a neonate. Neonatal Sepsis
has two types:
Early-onset Sepsis
Onset of sepsis and most often appears in the rst 24 hours of life. he infection is
often ac!uired from the mother. his can be cause by a bacteria or infection
ac!uired by the mother during her pregnancy" a #reterm deli$ery" %upture of
membranes (placenta tissue) that lasts longer than 24 hours" &nfection of the
placenta tissues and amniotic 'uid (chorioamnionitis) and fre!uent $aginal
eaminations during labor.
Late-onset Sepsis
he second type or the ate*onset Sepsis is ac!uired after deli$ery. his can be
caused by contaminated hospital e!uipment" eposure to medicines that lead to
antibiotic resistance" ha$ing a catheter in a blood $essel for a long time" staying in
the hospital for an etended period of time.
Signs and Symptoms
Signs and symptoms of Neonatal Sepsis includes but is not limited to:
• body temperature changes"
• breathing problems"
• diarrhea"
• low blood sugar"
• reduced mo$ements"
• reduced suc+ing"
• sei,ures"
• slow heart rate"
• swollen belly area"
• $omiting"
• yellowish s+in and whites of the eyes (-aundice).
#ossible complications are disability and worst is death of the neonate.
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Nursing are #lans
/ere are 0 Neonatal Sepsis Nursing are #lans.
Hyperthermia
1ue to the presence of an infectious agents" stimulation of the monocytes triggers
the release of the pyrogenic cyto+ines that stimulate anterior hypothalamus which
results in ele$ated thermoregulatory set point that leads to an increased heat
conser$ation (asoconstriction) and increased heat production which results to
fe$er.
Assessment
Patient may manifest
• &rritability
• 3ea+ness
• emperature abo$e normal le$el (5 o)
• S+in warm to touch
• #resence of tachycardia (abo$e 657 bpm)
• #resence of tachypnea (abo$e 57 bpm)
• 38 ele$ated
Nursing Diagnosis
• /yperthermia related to in'ammatory process9 hypermetabolic state as
e$idenced by an increase in body temperature" warm s+in and tachycardia
Outcomes
• #atient will maintain normal core temperature as e$idenced by $ital signs
within normal limits and normal 38 le$el
• #atient will still maintain normal core temperature as e$idenced by normal
$ital signs and normal laboratory results.
Nursing Interventions Rationale
onitor neonate;s condition. o determine the need for
inter$ention and the
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e<ecti$eness of therapy.
onitor $ital signs o ha$e a baseline data
#ro$ide S8/elps in lowering down the
temperature
=nsure that all e!uipment used for infant is
sterile" scrupulously clean. 1o not share
e!uipment with other infants
#re$ents the spread of pathogens
to the infant from e!uipment
>dminister antipyretics as ordered>ids in lowering down
temperature
Fluid olume De!cit
?luid $olume decit" or hypo$olemia" occurs from a loss of body 'uid or the shift of'uids into the third space one factor includes a failure of the regulatory mechanism
of the newborn specically hyperthermia
Assessment
Patient may manifest
• 1ecreased urine output
•
&ncreased urine concentration• &ncreased pulse rate (abo$e 657 bpm)
• 1ecreased body temperature (abo$e 5 o)
• 1ecreased s+in turgor
• 1ry s+in9 mucous membranes
• =le$ated hct
Nursing Diagnosis
• ?luid $olume decit related to failure of regulatory mechanism
Outcomes
• #atient will be able to maintain 'uid $olume at a functional le$el as
e$idenced by indi$idually ade!uate urinary output with normal specic
gra$ity" stable $ital signs" moist mucous membranes" good s+in turgor and
prompt capillary rell and resolution of edema.
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Nursing Interventions Rationale
onitor and record $ital signs o note for the alterations in 9S (decreased
8#" &ncreased in #% and temp)
Note for the causati$e factors that
contribute to 'uid $olume decit
o assess what factor contributes to 'uid$olume decit that may be gi$en prompt
inter$ention.
#ro$ide S8 if patient has fe$er o decrease temperature and pro$ide comfort
#ro$ide oral care by moistening lips
@ s+in care by pro$iding daily bath o pre$ent in-ury from dryness
>dminister & 'uid replacement as
ordered%eplaces 'uid losses
>dminister antipyretic drugs if
patient has fe$er as ordered o reduce body temperature
Ine"ective #issue $er%usion
Since the body of the newborn is unable to compensate to the imbalances of the
in'ammatory response related to his condition the body tends to Ahyperdri$eB
causing an inade!uate oygen in the tissues or capillary membrane leading to poor
perfusion.
Assessment
Patient may manifest
• S+in or temperature changes
• 3ea+ pulses
• =dema
• &nade!uate urine output
Nursing Diagnosis
• &ne<ecti$e tissue perfusion related to impaired transport of oygen across
al$eolar and on capillary membrane
Outcomes
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• #atient will demonstrate increased perfusion as e$idenced by warm and
dry s+in" strong peripheral pulses" normal $ital signs" ade!uate urine
output and absence of edema
Nursing
Interventions Rationale
Note !uality and
strength of
peripheral pulses
o asses pulse that may become wea+ or thready" because of
sustained hypoemia
>ssess respiratory
rate" depth" and
!uality
o note for an increased respiration that occurs in response to
direct e<ects of endotoins on the respiratory center in the
brain" as well as de$eloping hypoia" stress. %espirations can
become shallow as respiratory insuCciency de$elops creating
ris+ of acute respiratory failure.
>ssess respiratory
rate" depth" and
!uality
o assess for compensatory mechanisms of $asodilation
>ssess s+in for
changes in color"
temperature and
moisture
o promote circulation 9$enous drainage
=le$ate a<ected
etremities with
edema once in a
while
onser$es energy and lowers O2 demand
#ro$ide a !uiet"
restful atmosphere o maimi,e O2a$ailability for cellular upta+e
Interrupted &reast%eeding
Since the neonate is diagnosed for ha$ing a neonatal sepsis" the baby got
separated from his mother and placed on a Neonatal &ntensi$e are Dnit for better
management and care. &nterrupted breastfeeding de$elops since the mother is
unable to breastfeed the baby continuously due to their separation.
Assessment
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• he newborn is diagnosed with a certain disease (Sepsis)
• he newborn is separated from his mother
• he mother unable to pro$ide breast mil+ to newborn continuously
Nursing Diagnosis
• &nterrupted breastfeeding related to neonate;s present illness as
e$idenced by separation of mother to infant
Outcomes
• he mother will identify and demonstrate techni!ues to sustain lactation
until breastfeeding is initiated
• he mother shall still be able to identify and demonstrate techni!ues to
sustain lactation and identify techni!ues on how to pro$ide the newborn
with breast mil+.
Nursing Interventions Rationale
>ssess mother;s perception and +nowledge
about breastfeeding and etent of instruction
that has been gi$en.
o +now what the mother already
+nows and needed to +now.
Ei$e emotional support to mother and accept
decision regarding cessation9 continuation of
breast feeding.
o assist mother to maintain
breastfeeding as desired.
1emonstrate use of manual piston*type breast
pump.
>id in feeding the neonate with
breast mil+ without the mother
breastfeeding the infant.
%e$iew techni!ues for storage9use of epressed
breast mil+
o pro$ide optimal nutrition and
promote continuation of
breastfeeding process
1etermine if a routine $isiting schedule or
ad$ance warning can be pro$ided
So that infant will be hungry9
ready to feed
#ro$ide pri$acy" calm surroundings whenmother breast feeds.
o promote successful infantfeeding
%ecommend for infant suc+ing on a regular
basis
%einforces that feeding time is
pleasurable and enhances
digestion.
=ncourage mother to obtain ade!uate rest" o sustain ade!uate mil+
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maintain 'uid and nutritional inta+e" and
schedule breast pumping e$ery hours while
awa+e
production and breast feeding
process
Ris' %or Impaired $arent(In%ant Attachment
1ue to the newborn;s physical illness and hospitali,ation" the parents may ha$e fear
on how to handle their baby since the baby is on its fragile state and needed etra
care. >nd since he is the 6st child hospitali,ed in their family" the parents might still
be unsure on how to ta+e care of the baby.
Assessment
• he newborn is diagnosed with a certain disease (Sepsis)
• he newborn is separated from his mother
• he mother unable to pro$ide breast mil+ to newborn continuously
Nursing Diagnosis
• %is+ for &mpaired parent9neonates >ttachment related to neonates physical
illness and hospitali,ation.
Outcomes
• he mother will identify and demonstrate techni!ues to enhance
beha$ioral organi,ation of the neonate
• >fter discharge the parents will be able to ha$e a mutually satisfying
interactions with their newborn.
Nursing Interventions Rationale
&nter$iew parents" noting their perception of
situational and indi$idual concerns
o +now what the parents
feelings about the situation.
=ducate parents regarding child growth and
de$elopment" addressing parental perceptions
/elps clarify realistic
epectations
&n$ol$e parents in acti$ities with the newborn that
they can accomplish successfully=nhances self*concept
%ecogni,e and pro$ide positi$e feedbac+ for %einforces continuation of
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nurturing and protecti$e parenting beha$iors desired beha$iors
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