Our Lady of Fatima University

Quezon City Campus

College of Nursing

NAME: Madera, Alexandra Claire C. DATE: Feb 27, 2021

Yr./Sec.: BSN 2-Y2-4S Score:

PEDIA Lec: Course Task 2

1. Identify and discuss the nursing considerations/ interventions when administering
surfactantsin premature infants to treat respiratory distress syndrome. (200-300
words)

Most premature infant needs intensive care from the moment of birth because they
are more prone than others. Premature born children with immature lungs which are not
able to make surfactant themselves. They are vulnerable to respiratory distress syndrome.
A Respiratory Distress syndrome a severe breathing disorder can develop if the infant are
lack of surfactant or it has not changed to its mature form at birth. Surfactant deficiency
is worse for neonates at lower gestation resulting in alveolar collapse and poor
oxygenation. RDS can be prevented by the administration of surfactant at birth for an
infant at risk because of low congenital age. The position is very important for the infant
in tipped to upright position following administration and the infant airway is not
suctioned as long as safely possible after administration of surfactant to help it reach
lower lung areas and to avoid suctioning the drug away.
Surfactant is administered slowly from a syringe via the endotracheal tube during
active ventilation. The endotracheal tube should be positioned just beyond the vocal
cords to allow for equal distribution to both lungs. Make sure and confirm correct
position of the endotracheal tube via chest x-ray prior to giving surfactant. Surfactant
administration is a two-person procedure. It should be performed by at least one medical
practitioner or a neonatal nurse practitioner who administers the surfactant and one
registered nurse as the assistant. Careful observation of the baby is essential, and changes
in ventilator settings may be necessary, although surprisingly little distress is caused to
the infant Endotracheal suction is not recommended for several hours after
administration. If the infant appears to be self-ventilating with good gases, the
endotracheal tube can be removed and the infant reassessed to receive continuous
positive airway pressure or ambient oxygen. The early use surfactant helps to reduces the
risk and result in better insure result.
Reference:

Maternal & Child Health Nuring, Silbert-Flagg Pillitteri, Eigth Edition

2. Download a research article on any Acute Conditions of the newborn from
ScienceDirectand submit a 200 – 300 word essay reflection.

One of the acute conditions of the newborn is Neonatal sepsis it is refer to an

infection involving bloodstream in newborn infants less than 28 days old. It continues to
remain a leading cause of morbidity and mortality among infants. Neonatal sepsis is
divided into two groups based on the time of presentation after birth: early-onset sepsis
(EOS) and late-onset sepsis (LOS). Early onset sepsis is that when the child occurs
within 72 hours after birth in this early mostly develops the infection during the time of
birth. So there are possible ways to get infection during the time of birth like if the genital
tract of the mother contains some pathogenic organisms when the child is born by normal
vaginal delivery it can get those are infected with those organism present in the genital
tract of the mother or other ways is the unsterile labor room in which the site has been
delivered. There are prenatal risk factors during the delivery of the child the chance of
EOS also increases like prolonged ruptures of membranes, prolonged labor. While the
Late Onset Sepsis which occurs at 72 hours or later after the child is born. LOS acquired
from the organisms which are present in the surroundings where the child is kept. Health
care providers are often involved in transmission of pathogens. LOS has risk factor which
is low birth weight, lack of breastfeeding for the neonate and poor cord care.
Neonatal sepsis usually there will be non-specific symptoms by alteration of
feeding behavior, poor cry, Lethargy and irritability. So as nurses, we should have aware
in the suspicion of neonatal. Lab tests can help diagnose neonatal sepsis and identify the
cause of the infection. Blood tests may include If the neonate with suspected sepsis,
blood culture should be immediately drawn. Those are need Complete blood count
(CBC) with differential and C-reactive protein (CRP) are important lab tests to obtain and
are often collected on a serial basis. As we give nursing care we provide neutral normal
thermal environment and also provide adequate nutrition. The more quickly an infant gets
treatment, the better the outcome.

Reference:

https://www.statpearls.com/ArticleLibrary/viewarticle/25678
Maternal & Child Health Nuring, Silbert-Flagg Pillitteri, Eigth Edition