Pediatric Nursing Department

* Student's name: Matthew medhat atala

* Group No. : A2

* Date: 15 / 3 / 2023

* Supervision Doctor: Dr asmaa awad – Dr walid tawfik

* Hospital Name: Al-Hussein University Hospital

 Pediatric Nursing Department

Objectives of premature clinical area:

At the end of this experience the student should be able to:

* Differentiate between full term and pre term baby.
* Identify needs of the premature baby.
* Identify methods of feeding.
* Acquire knowledge and understanding of the causes and
handicaps of the premature baby
* Perform nursing skills accurately and safety in order to provide
safe care to premature baby.

Presentation:

1- Jaundice & Blood exchange.

2- Respiratory distress syndrome.
3- Neonatal sepsis.
 Pediatric Nursing Department

- Student's Name: Matthew medhat - Date: 15 / 3 / 2023

- Infant's Name: son of azaa fekri - Age: 2 days
- Sex: male
- Gestational age at birth: 38 weeks - Birth date: 13 / 3 / 2023
- Diagnosis: Hypoglycemia, RDS, Risk for D.M, Down score 5

1- Examination of the baby:

Characteristics In neonate Comparison with the normal

Weight 4.150 Kg > (2.700 : 3.850) kg
Length 54 Cm
Head circumference 36 Cm
Abdomen circumference 36 Cm
Mid-arm circumference NA Cm
Temperature 37.3 C
Heart rate 127 : 133 B/M
Respiration C/M

2- General Behavior and Observations:

 Skin: (Pink – Bright red – Smooth – Dry – Vernix caseosa - Ecchymosed – Milia –
Lanugo hair – Erythema – Mongolian spots – Acrocyanosis – Edema.)
 Head: (Molding – Caput-succedaneum – Cephalohematoma)
 Anterior fontanel: Shape: diamond (Open – Close) (Pulgging – Depressed).
 Posterior fontanel: Shape: triangle (Open – Close) (Pulgging –Depressed).
 Posture (Flexion of the head and extremities – Extension of the extremities –
Extended legs – Rotated thigh – Extended neck)
 Eyes: (Open - Close – absence of tears- blinking reflex- ability to follow midline
objects- inability to follow objects- discharge)
 Ears (Pinna at the level of the eye – low set ear)
 Mouth (Intact – Cleft lip – Cleft palate – Absent or minimal salivation – Natal teeth)
 Neck (Short – Thick – Excessive folds – Persistence to flexion)
 Chest: Shape (Symmetry – Asymmetry)
 (Anterior – Posterior and lateral diameter equal – Slight sternal retraction – Pigeon
chest – Breast enlargement)
 Lung (Normal respiration - Abnormal respiration – Bilateral equal bronchial breath
sounds – Retraction – Periodic irregular breathing – Wheezing)
 Heart (Normal heart sounds - Abnormal heart sounds)
 Abdomen (Distention - Cylindrical – Umbilical hernia – Absent of bowel sounds –
Enlarges liver – Enlarges spleen – Ascites – Inflammation of the cord stump –
Equal femoral pulses- Absent femoral pulses)
 Male genitalia (Urethral opening at the tip of glans of the penis – epispadies –
hypospadias – tests palpable in the scroutum – undescended tests – hydrocele –
mass in the scroutum).
 Rectum and anus (passage of meconium – anal fissure – imperforated anus)
 Back (spin intact – opening – mass – prominence curves – spinal bifida).
 Extremities (symmetry – asymmetry – nails pink – cyanosis of nails – full range of
motion – sole covers with creases – no creases – hip dislocation). Hands: No of
digits RT: 5 LT: 5 Polydactyly -Syndactyly
 Feet: No of digits RT.: 5LT.: 5 (Polydactyly – Syndactyly)

Reflex Present Weak Absent

Blinking reflex Pupils
reflex Grasping reflex
Sucking reflex
Swallowing reflex
Rooting reflex
Gagging reflex
Tonic neck reflex
Moro reflex
Startle reflex
4- Medications:

Name Time Dose Route Indications Side effect

unasyn Every 12 h 1.5g/20ml I.V Sulbactam blocks Rash
12am and take the enzyme which Cramp
breaks down
4.2cm Diarrhea
ampicillin and it
allows ampicillin to
attack and kill the
bacteria. (A.B)
Calcium Every 12 2cm+8 cm I.V Fluid, electrolyte Constipation
gluconate h glucose balance and Diarrhea, low BP
homeostasis Nausea, vomiting
12am 5%
Impilin Every 12 500/20ml β-lactam A.B, used Diarrhea, Nausea,
h G5%, take 24 I.V as empiric therapy vomiting, gastric
unit and add for early onset sepsis pain
12am
2 cm G5% and provides
coverage against
pathogens including
Group B Streptococcus,
Listeria monocytogenes
and Escherichia coli
konakion Every 12 10 unites Vitamin k1 Bruising,
h every 72 hrs I.M As a supplement swelling at the
12am it is used to treat injection area
certain bleeding
disorders.

5- Diagnostic/Laboratory Data

Test Results Normal Value Test Results Normal Value

WBCs 31.7 NEU 23%
LYMPH 64% RBCs 4.8
HB 18 HCT 55
MCV 112 MCH 36
PLT 77X10^3 CA 8.9
PH 7.43 PCO2 36
PO2 59 Na+ 139
K+ 3.4 CA++ 0.63
GLU 61 LAC 1.9
HCO3- 23.9 TCO2 25
SO2c 91%
 Nursing Record

- Student name: Matthew medhat - Date:

- Patient name: - Sex:
- Date of admission: - Weight on admission:
 - Diagnosis: - Age:
- Diet:
Time Items Nursing Actions
- Temp - Pulse
- Resp - B.P
*growth & development:
- Wt - Ht - Teeth No
- Sitting - Standing - Walking
- Bladder control
- Bowel control
* Bath care
- Bed bath - Partial
- Tub bath - Shower
* Stool
- frequency
- Color - Consistency
* intake & out put
- Intake
- kind - Amount
- Out put
- kind
- Amount
* Medication

*Treatment
- Compresses --------
- O2 Therapy -------- -
Dressing --------
- Others --------

Nursing Care Plan

* Patient's name: * Diagnosis:
* Date: * age:
* Sex:
 Nursing Goal Nursing intervention Evaluation
Diagnosis

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Student's Signature Matthew medhat