Nursing management of low birth weight babies -Right now discuss about Low Birth Weight infant. You realize that Low Birth Weight (LBW) and rashness are significant supporters of newborn child mortality in India and they represent biggest number of hospitalization in Neonatal Care Unit.
Meaning of low birth weight babies
As indicated by WHO, infant weighing 2500 gm or less during childbirth independent of his time of incubation is called Low Birth Weight (LBW).
Reasons for low birth weight(LBW) babies
The high occurrence of LBW are because of poor financial condition, lack of education, maternal ailing health and weakness, maternal disease like diabetes mallitus, hypertension, low maternal weight, young pregancy, too visit labor, maternal smoking and medication expansion, various pregnancy, placental brokenness, antepartum drain, Pregnancy-Induced-Hypertension, intense enthusiastic pressure, untimely beginning of work, intrauterine contaminations, innate abnormalities, and so on.
Classification of low birth weight babies
a) Preterm Babies
They are conceived before 37 finished a long time of development. They weight between tenth 90th percentile of mean load for their gestational age.
b) Small for Date (SFD) Babies:
They are conceived at term yet their development rate was impeded. They are additionally called Intra-Uterine Growth Retardation (IUGR) child. They weight under tenth percentile underneath mean load for their gestational age.
Clinical Features of LBW Baby
A) Physical Characteristics
– Weight under 2500 gm.
– Length under 47 cm.
– Head outline under 33 cm.
– Chest outline not as much as head perimeter by in excess of 3 cm.
– General movement poor and powerless cry.
– Attitude loose and appendages reached out with poor tone.
– Sucking, gulping, hack and moro reflexes are slow or fragmented.
– Skin sparkling, free, slight, fragile, pink with meager vernix and bounty lanugo.
– Less subcutaneous fat and edema.
– Head bigger than body, skull bones are delicate, sutures and fontanelles are wide.
– Ears are delicate and level, ligament not completely created.
– Eyes stay shut and jutting.
Nursing management of low birth weight babies
a) Maintenance of Respiratory Function
– Position the infant with neck marginally broadened.
– Clear the air section by delicate suctioning.
– Monitor and record respiratory rate, mood, indications of pain, withdrawals, nasal flaring, apnea, cyanosis and so forth.
– Providing material incitement by sole flicking to animate respiratory exertion.
– Administer oxygen treatment with pack and veil, at first in 100% fixation at that point diminished to 40% to forestall retrolental fibroplasia.
– Provide chest physiotherapy by percusion, vibration, postural waste to release and expel respiratory emissions.
b) Maintenance of Thermoregulation
To keep up stable internal heat level and to forestall hypothermia and its related entanglements, the accompanying measures to be taken:
– Environmental temperature to be kept up at 30 + 2OC via climate control system, brilliant hotter, hot blowers, room radiator and so forth to give thermo-nonpartisan environment.
– Skin temperature of the infant to be kept up at 36.5-37.5OC.
– Baby should be minded in incubater with wanted degree of stickiness (60%-65%), oxygen and warmth.
– Constant observing of the internal heat level’s is basic, low perusing thermometer is valuable.
– Measures to be assumed to forestall heat misfortune during care.
c) Maintenance of Nutrition and Fluid
LBW infant required 120-150 kcal/kg body weight/day, water 150-200 ml/kg/day, Protein 4-6 gm/kg/day for initial scarcely any days to meet the prerequisite for ideal development.
– Early taking care of ought to be begun to forestall hypoglycemia, hyperbilirubinemia and kernicterus.
– Frequent taking care of ought to be given.
– In poor sucking reflex, I/V liquid and naso gastric cylinder taking care of might be required. Dropper, spoon and pipette can be utilized to take care of the LBW child.
– Weight to be recorded every day to survey weight gain ideally before taking care of, in same machine and same measure of garments.
d) Prevention of Infections
Poor insusceptibility power makes of LBW infant progressively inclined to contaminations. Measures to be taken to forestall diseases:
– Thorough hand washing with cleaning agents must be done before contacting and caring each child.
– Each neonates ought to have separate clothings, taking care of articles, thermometer, stethoscope, and so on.
– All staff working in exceptional consideration unit must change their shoes and wear nursery shoes and sterile outfit and cover.
– Any individual having any contaminations ought not enter the neonatal consideration unit.
– Visitors ought to be limited in the unit.
– Nursery floors and surfaces to be cleaned with cleansers or carbolic arrangement in each move. Hatcheries and infant beds ought to be cleaned with cleanser water and germicides.
– Clothing and material must be autoclaved.
– Infected infant ought to be kept in independent unit.
– Baby shower to be retained in the unit however broad neatness to be kept up.
– Any difficulties saw as treated quickly.
e) Provide Stimulation
Medical caretaker ought to give tactile incitement to the LBW infant by talking, singing, snuggling, delicate contacting during care. Visual incitement can be given by vivid hanging object. Child’s situation to be changed at interim. Infant ought to be put on right side in the wake of taking care of to forestall spewing forth and desire. Mother ought to be permitted to mind the body with vital insurances or to visit nursary to see, to contact and to deal with the child.
f) Informing the Parent about Infant’s Progress
Infant’s condition and progress to be disclosed to the parent to diminish their anxiety.Necessary treatment intend to be examined. Parent ought to permit to see the infant. Care after release to be talked about with the parent. Parent ought to find out about warmth, taking care of, development and clean practices at home. The LBW infant is normally released from extraordinary consideration unit when the infant put on adequate weight approimately 2000 gm or more, having great energy and ready to suck effectively.
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