Preterm and Postmature Infants, Meconium Aspiration Syndrome - Maternity Nursing | @LevelUpRN

Summary

In this video, Meris from Level Up RN discusses the care and challenges of premature infants, postmature infants, and meconium aspiration syndrome. She explores the risk factors, signs, and symptoms for each condition, emphasizing the importance of proper nursing care in neonatal intensive care units (NICUs). Key topics include respiratory distress, thermal regulation, clustering care, feeding methods, and managing complications like hypoglycemia and fetal hypoxia. Meris also provides insights into the potential risks posed by meconium aspiration and offers helpful quiz questions to test viewers' knowledge on these critical neonatal topics.

Takeaways

• 😀 Preterm infants are born before 37 weeks of gestation, with risk factors such as maternal gestational hypertension, cervical incompetence, and uterine abnormalities.
• 😀 Major complications for preterm infants include respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), anemia, and intraventricular hemorrhage.
• 😀 Nursing care for preterm infants includes maintaining warmth, providing respiratory support, and minimizing stimulation to reduce stress on the infant.
• 😀 Postmature infants are born after 42 weeks of gestation, with risk factors such as maternal obesity and previous prolonged pregnancies.
• 😀 Meconium aspiration syndrome (MAS) occurs when an infant inhales meconium, leading to respiratory issues such as airway obstruction, pneumonia, and inactivation of surfactant.
• 😀 For preterm infants, oxygen levels must be carefully monitored, as too much oxygen can cause damage like retinopathy and blindness.
• 😀 The use of synthetic surfactant helps preterm infants' underdeveloped lungs by keeping alveoli open for effective breathing.
• 😀 Clustering care for preterm infants, such as feeding and diaper changes together, minimizes the number of times they are disturbed, which is crucial for their well-being.
• 😀 Postmature infants may exhibit signs such as hypoglycemia, polycythemia, and wrinkled skin, and they are at risk for birth trauma due to their large size.
• 😀 If meconium aspiration is suspected due to green-stained amniotic fluid, nurses should prepare for resuscitation and deep suctioning if needed, alongside providing oxygen and surfactant.

Q & A

What defines a preterm infant?

A preterm infant is one that is born before 37 weeks of gestational age.

What are some key risk factors for preterm birth?

Risk factors for preterm birth include maternal gestational hypertension, cervical incompetence, amnionitis, prior preterm delivery, uterine abnormalities, PPROM (preterm premature rupture of membranes), and placenta previa.

What is the primary complication associated with preterm infants?

The primary complication associated with preterm infants is respiratory distress due to underdeveloped lungs, which can lead to conditions like respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD).

How does a preterm infant's ability to regulate temperature compare to a full-term infant?

Preterm infants have a significantly lower ability to regulate their body temperature due to less body fat. This makes it essential to use radiant warmers or incubators to keep them warm.

Why is positioning important for preterm infants in the NICU?

Preterm infants in the NICU may be placed in side-lying or prone positions to improve oxygenation, as these positions can help with their breathing. However, these positions are not recommended once the infant goes home.

What is synthetic surfactant, and why is it used in preterm infants?

Synthetic surfactant is a substance used to help keep the alveoli (air sacs in the lungs) open in preterm infants who lack sufficient surfactant. It helps prevent lung collapse and aids in respiration.

What is a common complication for postmature infants?

Common complications for postmature infants include fetal hypoxia, meconium aspiration, being large for gestational age (LGA), and birth trauma due to the baby growing too large for the birth canal.

What are some signs that an infant may be postmature?

Signs of a postmature infant include being born after 42 weeks of gestation, meconium-stained amniotic fluid, long hair and nails, hypoglycemia, polycythemia (increased red blood cells), loose, wrinkled skin, and little to no vernix caseosa.

What is meconium aspiration syndrome (MAS), and what are the risks associated with it?

Meconium aspiration syndrome occurs when a newborn inhales meconium, the first stool, into their lungs. This can lead to airway obstruction, inactivation of surfactant, pneumonia, and severe respiratory distress, which can be life-threatening.

How should a nurse respond if they observe green-stained amniotic fluid during labor?

If green-stained amniotic fluid is observed, it indicates a risk for meconium aspiration. The nurse should prepare resources such as respiratory therapy, the NICU team, and resuscitative equipment, while ensuring that suctioning and other interventions are ready if airway obstruction occurs.