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Thermal protection of the newborn ("thermal" chain)
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- 3) Anatomical and physiological features of the newborn. Border States of the newborn period. Transient (physiological) conditions of newborns
| Thermal protection of the newborn ("thermal" chain).
Thermal protection of the newborn is a series of measures that are taken at birth and in the first days of life and provide a regimen in which the newborn does not get supercooled or overheated, but maintains a normal temperature of 36.5-37.5 ° C. The lower the weight of the newborn, the greater the risk. Temperature stability increases with the weight of the child. Heat loss in a newborn baby occurs in four different ways. The main heat loss occurs due to the evaporation of amniotic fluid from the baby's body. But heat loss also occurs due to conduction, if a naked child is placed on a cold surface (table, scales or a cold mattress), due to convection, if cool air surrounds a naked child, when heat is radiated from a child to cooler objects nearby (cold wall or window), even if the child does not touch them. With the movement of air, heat loss increases and in a draft the child runs the risk of overcooling, even if the room temperature is 30 ° C. The " thermal chain " is a series of interrelated activities that take place at birth and in the first few hours and days of life to minimize heat loss in all newborns. Failure to do any of these actions breaks the chain and puts the newborn baby at risk of hypothermia. The 10 steps of the "heat chain" imply: 1.Warm delivery room 2.Immediate rubdown 3.Skin-to-skin contact 4. Breastfeeding 5. Postpone weighing and bathing 6. Appropriate swaddling or wrapping 7. Joint stay of mother and child 8. Transportation in warm conditions 9. Resuscitation in warm conditions 10. Increasing the level of training and knowledge 3) Anatomical and physiological features of the newborn. Border States of the newborn period. Transient (physiological) conditions of newborns 1. Syndrome of a newly born child: at the time of childbirth, in response to an abundance of stimuli, a primary orienting reaction appears - instant immobilization, a deep breath, a cry, increased muscle tone and a typical posture of a newborn - the limbs are bent, brought to the body, the hands are clenched into fists. 2. Cardiorespiratory adaptation: breathing with periodic deep breaths and labored exhalation, apnea, the cry of a child contributes to the expansion of the lungs. In children of the first 2-3 days, physiological hyperventilation of the lungs is 1.5-2 times greater than in older children. There is also a change in blood flow, the ductus ductus arteriosus, the foramen ovale, the remains of the umbilical vessels are closed, the ICC and BCC begin to function. 3. Physiological weight loss: observed in the first 3-4 days of life in all newborns and does not exceed 10%, in premature 12-14%. Recovery occurs by 7-10 days of life. In sick, debilitated and premature babies - later. To prevent a large loss of body weight, early attachment to the breast, feeding on demand, and compliance with the thermal regime are recommended. 4. Transient changes in the skin: simple erythema - hyperemia of the skin, sometimes with a slight cyanotic tinge in the area of the hands and feet. Develops in response to new environmental conditions. The intensity and duration depends on the maturity of the child, usually from several hours to 2-3 days. In premature babies - 5-7 days. Toxic erythema is manifested by an allergic reaction on the 2nd-5th day of life. The condition is not disturbed, the rash code shows hyperemic spots, nodules, vesicles. They do not happen on the palms, feet, mucous membranes. 1. Transient (physiological jaundice of newborns): due to the presence in the blood and tissues of free bilirubin, which is formed during the breakdown of fetal Er. A functionally immature liver cannot ensure the conversion of a large amount of free bilirubin into a non-toxic form and remove it from the body. VF appears on the 2-3rd day of life in the form of icteric staining of the skin, mucous membranes. Feces and urine of normal color, liver and spleen are not enlarged. The general condition is not broken. Jaundice disappears by 7-10 days. In injured and premature babies in 2-3 weeks. With severe jaundice, the child is often applied to the chest, phenobarbital and phototherapy are prescribed. 2. Sexual crisis: due to the transition of maternal estrogen to the fetus in utero and with breast milk. It appears more often in girls. It includes several conditions: Engorgement of the mammary glands - manifests itself regardless of gender on the 3-4th day of life, increasing max by 7-10 days. Symmetrical, the skin is not changed, sometimes slightly hyperemic, the contents of gray or white-milky color can stand out. Should not be squeezed out. With severe engorgement - apply a warm bandage. Bleeding from the vagina - occurs on days 5-8, duration 2-3 days, volume 0.5-2 ml. Careful hygiene is required. Girls may also experience gray-white discharge from the genital slit, while boys may experience hyperpigmentation of the scrotum and skin around the nipples. Sexual crisis may be accompanied by swelling of the genital organs. 3. Transient feature of the kidneys: in the first 3 days, 10% of healthy newborns have physiological oliguria (little urine), the number of urination is 4-5 r / day, later more often, by day 10 up to 20-25 times. Albuminuria occurs in all newborns (protein in the urine). Urinary infarction appears on the 3rd-4th day of life and is a deposition of uric acid in the form of crystals in the lumen of the urinary tubules. Brown spots with a sediment in the form of sand remain on the diapers. Gradually, as diuresis increases, the salts are washed out and the heart attack disappears within 7-10 days. 4. Meconium - the original feces - is excreted in the first days after birth. It is a dark, thick, viscous mass of dark green color. Such a chair is called transitional. After 2-4 days, it becomes mushy and yellow, the frequency is several times a day. Adaptation of the newborn to new living conditions The only source of familiar emotions for a newborn is the mother, so the baby needs unity with her, including care and satisfaction of physiological needs. The most important is physiological contact: warmth, hands, touches, stroking, etc. such contact is necessary for the normal development of the endocrine, immune and other systems. жүктеу/скачать 20,5 Kb. Достарыңызбен бөлісу:
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