Neo Natal Sepsis

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Neo natal sepsis


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Introduction

The term sepsis has been around since ancient times; modern definitionsof sepsis were described in detail in the early 1990s, at a consensusconference convened by the American College of Chest Physicians and theSociety of Critical Care Medicine. At that time, sepsis was described as asystemic response to a physiologic insult including infectious and otheretiologies that lead to the development of further organ injury, ultimately

culminating in multiple organ dysfunction syndromes. Neonatal sepsis, alsotermed Sepsis neonatorum, refers to a group of physical and laboratoryfindings that occur in response to invasive infection within the first 30 daysof life. As will be discussed below, there are various infectious causes ofneonatal sepsis; however, the pattern of presentation is quite similar in allcases, as is the approach to treatment. The importance of neonatal sepsis asa diagnosis is found in the fact that this diagnosis occurs in between 1 to 8children per 1000 live births in the United States, and may be associatedwith a fatality rate of up to 30%. As such, it is essential that caregivers thatare involved with the management of neonates have a reliable approach tothe diagnosis and treatment of infants with sepsis, and that appropriateintervention be instituted in a timely manner.


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Neonatal Sepsis is an infection in the blood that spreads throughout the

body and occurs in a neonate. Neonatal Sepsis is also termed as NeonatalSepticemia and Sepsis Neonatorum. Neonatal Sepsis has 2 types: The onethat is seen in the first week of life is termed as Early- onset sepsis and mostoften appears in the first 24 hours of life. The infection is often acquiredfrom the mother. This can be cause by a bacteria or infection acquired by themother during her pregnancy, a Preterm delivery, Rupture of membranes

(placenta tissue) that lasts longer than 24 hours, Infection of the placentatissues and amniotic fluid (chorioamnionitis) and frequent vaginalexaminations during labor. The second type or the Late-onset Sepsis isacquired after delivery. This can be cause by contaminated hospitalequipment, exposure to medicines that lead to antibiotic resistance, having a

catheter in a blood vessel for a long time, staying in the hospital for anextended period of time. Signs and symptoms of Neonatal Sepsis includesbut is not limited to: body temperature changes, breathing problems,diarrhea, low blood sugar, reduced movements, reduced sucking, seizures,slow heart rate, swollen belly area, vomiting, yellow skin and whites of theeyes (jaundice). Possible complications are disability and worst is death of

the neonate. (Greene, 2007)


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Neonatal sepsis occurs at an estimated rate of 1 to 2 cases per 1000live births in the U.S. The highest rates occur in low-birth-weight(LBW) infants, those with depressed respiratory function at birth,and those with maternal perinatal risk factors. The risk is greater inmales (2:1) and in neonates with congenital anomalies (Merck,

2005). According to the Philippine Mortality Fact Sheet 2006 of theWorld Health Organization, in 1000 live births of neonates 17% of itdied due to severe infection that includes deaths from pneumonia,meningitis, sepsis/septicemia, and other infections during theneonatal period.

Neonatal sepsis can occur in any infant. However, the diagnosis issignificantly more common in pre-term infants than full terminfants, and can affect up to 30 to 1000 live births in the pre-termpopulation. Sepsis is also more common in males than females, andin developing countries.


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MORTALITY STATISTICS OF

NEONATAL SEPSIS

2007 No. % 2008 No. %

1. Pulmonary Tuberculosis 38 7.92 1. CVA 46 9.83

2. Pneumonia 36 7.50 2. Pneumonia 43 9.19

3. CVA 29 6.04 3. Pulmonary Tuberculosis 27 5.77

4. Hypertension 23 4.79 4. Hypertension 23 4.91

5. Prematurity 21 4.38 5. Vehicular Accident 12 2.56

6. Neonatal Sepsis 18 3.75 6. Acute Gastroenteritis 11 2.35

7. Malaria 17 3.54 7. Sepsis Neonatorum 11 2.35

8. CNS Infection 10 2.08 8. Congestive Heart Disease 10 2.14


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Nurse Centered Objectives:

At the end of this study, the student nurse will be able to:

have critical thinking skills necessary for providing safe and

effective nursing care. have a comprehensive assessment and implement care base on our

knowledge and skills of the condition

familiarize themselves with effective inter-personal skills toemphasize health promotion and illness prevention.

Impart the learning experience from direct patient care.


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Patient and Family Centered Objectives:

At the end of this study, the patient/family will be able to:

Identify measures that could minimize the risk of occurrence of the

disease. Identify possible risk factors that may have contributed to the

development of Neonatal Sepsis.

Increase awareness on the risk factors of Neonatal Sepsis.

Develop the familys support system and distinguish their respective

roles in improving patients health status. Involve them in promoting the health care of the patient.


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NURSING HISTORY

History of Present Illness


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Laboratory

DiagnosticProcedure

Normal Values Patients Result Interpretation ClinicalSignificance

HGB 120-160 g/L 123 g/L Result is in normal

amount

To determine the O

carrying capacity ofthe blood

HCT 38-47 vol % 37 vol % Hematocrit is innormal range

To aid diagnosisof abnormal

states ofhydration,

polycythemia andanemia and aidsin calculation of

erythrocyte

indices


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Nursing Responsibilities Prior: Verify doctors order. Know the type, amount, and indication of IV therapy Prepare for the IV infusion set. Clean the insertion site. During: Do hand washing Open and prepare the infusion set Do the IV insertion procedure Dress and label the venipunctures site After: Label the IV tubing with the date and time of attachment and

initials of the nurse. Regulate IV. Observe for potential complication. Document relevant data and record the start of the infusion on the

clients chart.


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A.IVF IVF D10W 500cc x 8 ugtts/min Sept. 9, 2009 12:15 a.m. This medication is a solution given by vein (through an IV). It

is used to supply water and calories to the body. It is also used

as a mixing solution (diluent) for other IV medications.Dextrose is a natural sugar found in the body and serves as amajor energy source. When used as an energy source,dextrose allows the body to preserve its muscle mass.

IV solutions containing dextrose are indicated for parenteralreplenishment of fluid and minimal carbohydrate calories asrequired by the clinical condition of the patient. It is also useas a mixing solution for other IV medication.

the client adhered well and did not manifest for any sideeffects


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Neo Natal Sepsis

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