Preterm Labor Tips : How To Care Of The Premature Baby Safely (For Nurses)
If the baby is born 3 or more weeks before the calculated date of birth (less than 37 weeks gestation), he is said to be premature. If his weight is less than 2500 grams (5 ½ pounds) he is said to be premature. If his weight is less than 2500 grams termine which babies would require special care. Currently, the individual’s behaviour and appearance are also considered in reaching the diagnosis of prematurity.
Although only 7 to 10 percent of all live births are premature, it, is a fact prematurity is the most frequent cause of death in infants. Premature birth may be due to abnormal conditions in the mother, multiple pregnancy, or induced labor. The survival of the premature infant depends on the skill, patience, devoition and judgement of those giving nursing care.
The basic principles to be observed in carin for the premature infant include :
a 1. Maintenance of body temperature
2. Protection from infection
c 3. Maintenance o airways and adequate oxygen intake
d 4. Conservation of infant’s energy
e 5. Adequate fluid and calorie intake
Mechanical devices such as incubators and isolettes are of great value in maintaining the body heat of the infant and in providing him with isolation from sources of infection. They are designed to provide controlled heat and humidity and for the administration of oxygen, if prescribed. His temperature is taken every 2 or 3 hours until it has stabilized. Initially it is taken by rectum, but in the smaller infants it may be taken by axilla every 3 hours until the weight of 1500 grams is reached. As with the heavier infant, the temperature is then taken only twice a day when it has stabilized. In the isolette the baby wears only a diaper, the premature babies not in isolates are dressed in shirts, diapers and blankets. To further protect him from infection, all personnel working in the premature nursery must be free of respiratiory infections. Routine checkups are given and masks may be ordered. In addition, the personnel are required to wear special uniforms, scrub their hands carefully, and wear gowns when handling the infant.
The color, respiratory rhythm and ease of breathing of the premature infant must be carefully checked at frequent intervals. The infant is placed in the incubator with the head of the bed lowered four to six inches to allow the mucus and secretions to drain out. Suctioning equipment and oxygen should be available in case they are needed. All babies weighing less than 1500 grams, those with cyanosis, those babies having difficulty regulating body temperature, and infants who have respiratory difficulty require incubator or isolette care. The procedures followed in caring for the baby in the isolette are included in part 2.
The baby who has no sucking or swallowing reflexes may have to be fed by gavage or medicine dropper. The frequency and manner of feedings as well as the type and quantity of formula is prescribed by the paediatrician.
Babies weighing 1500 grams or more who can suck and swallow are fed in the usual manner with bottle and soft nipple. Usually five percent sugar solution is offered for four feedings on the second day of life. This is followed on the third day by an individually calculated formula. Since premature infants are more susceptible to deficiency diseases, vitamin preparations and iron are given after the seventh day.
To conserve his energy, handling of the infant is kept to a minimum. He is left in his bed for his bath, feedings and examinations until he weighs about 2000 grams. He is weighed onlyabout twice a week, unless he is in an isolette where trapeze-type scales can be used. There he can be weighed daily and his formula requirements calculated every twenty-four to forty-eight hours.
When the infant weighs about 2500 to 2700 grams he may be discharged. A public health nurse will visit the home prior to his discharge to help the mother plan for his care. After he goes home, she will visit at regular intervals to observe his growth and offer assistance as needed.
The American academy of pediatricians is studying the amount of nursing care required for infants of infants of various sizes and conditions and the types of personnel required to give this care. During your assignment to a pediatric service, therefore, you may not have an opportunity to work in the premature unit. Generally, about five hours of nursing care per infant would seem desirable. This would mean about one nurses to every babies. If student nurses re assigned to the premature nursery, they usually first give care to the larger “preemis”, 2500 to 2500 grams and then proceed to the smaller infants. The nurse in charge of the premature unit has received advanced training and has extensive experience in the care of the premature infant. She is responsible not only for the care of babies, but also for the training of personel and education of the parents as well.