Neonatal Sepsis

7/21/2019 Neonatal Sepsis

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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.



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



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


• 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.




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


• 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



• #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



• 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+.


>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+



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.


&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



nurturing and protecti$e parenting beha$iors desired beha$iors

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Neonatal Sepsis