Central venous catheter-induced pericardial effusion in a neonate: a case study and recommendations for practice.

Pericardial effusion (PCE) and tamponade as a complication of central venous catheters (CVCs) continues to occur in the neonatal population. It is imperative that clinicians managing neonates with CVCs practice vigilance regarding proper catheter tip location. Furthermore, it is of equal importance that clinicians have a high index of suspicion regarding the catheter tip location any time a neonate with a CVC has a clinical deterioration. It is clear that the ultimate outcome of PCE depends on rapid identifi cation and a quick response when pericardial tamponade occurs. PCE can occur any time during the duration of the catheter dwell time, and education of staff caring for neonates will assist in prevention and rapid treatment.

A etiopatogênese do processo de Restrição de Crescimento Intra-Uterino: um estudo bibliográfico / The etiopathogenesis of the Intra-Uterine Growth Restriction process: a bibliographical study

Revisão bibliográfica, realizada junto aos bancos de dados MEDLINE, SciELO, ScienceDirect e LILACS, com o objetivo de identificar a produção científica na área de saúde sobre os principais fatores envolvidos na etiopatogênese do processo de Restrição de Crescimento Intra-Uterino (RCIU), entre os anos de 1990 e 2008. A RCIU constitui a segunda causa de mortalidade perinatal. O recém-nascido com RCIU possui um aumento de duas a dez vezes nas porcentagens habituais de mortalidade perinatal e apresenta complicações associadas à prematuridade. A morbidade está diretamente relacionada às alterações metabólicas e imunológicas, desacelerações cardíacas, acidose fetal, baixo Índice de Apgar, hipóxia, hipoglicemia, hipotermia, asfixia, coagulação intravascular disseminada, hemorragia intracraniana e aspiração meconial. A identificação das principais alterações maternas, fetais e neonatais envolvidas no processo de RCIU é de fundamental importância para o planejamento de ações de prevenção e melhora da qualidade da assistência de enfermagem prestada às gestantes no pré-natal, pré-parto, parto e puerpério, bem como ao recém-nascido com RCIU durante o período neonatal.

Part 1: a matter of size: evaluating the growth-restricted neonate.

The relative size of a neonate impacts many aspects of prenatal and postnatal surveillance and care. The designations of appropriate for gestational age, small-for-gestational age, intrauterine growth restriction, and large-for-gestational age are systematic categorizations used to assess and monitor growth throughout pregnancy and delivery. Each abnormal growth descriptor aids in anticipating neonatal needs after birth because each has the potential for complications related to feeding, glucose utilization, short- and long-term growth, and development. Maternal risk factors that impact the neonate's size-related can have immediate implications in the delivery room as well as significant effects postnatally. Caring for neonates at risk for size complications requires knowledge based on prenatal and postnatal complications. Neonates must be carefully measured and plotted on growth charts to confirm a visual assessment of size. Each growth complication requires individual attention to detail and careful planning to maximize adequate postnatal growth and nutrition. Size matters when it comes to the health and welfare of neonates. Anticipatory guidance can improve outcomes in the neonate at risk for failure to thrive from size complications at birth. Part 1 of this article provides an overview of the size classifications and a discussion of clinical factors that are associated with or contribute to small-for-gestational age births. Once the neonate's size for gestational age is calculated, a focused physical assessment is described along with nursing care and prognostic implications. Part 2 will focus on the physical assessment, nursing care, prognosis, and complications associated with large-for-gestational-age neonates.

Discordant twins: a case report.

Multiple gestations account for 10 to 12 percent of perinatal deaths. Of all intrauterine deaths in twins, 73 percent are associated with monochorionic placentation. Monochorionic twins have higher rates of perinatal mortality, birthweight discordancy, and intrauterine growth retardation than do dichorionic twins. Follow-up studies indicate that twins remain at a disadvantage for subsequent growth and intellectual achievement. The history and hospital course of a set of discordant twins is presented, describing the extensive morbidity and prolonged hospitalization.

Quantitative and qualitative home assessment of primary caretaker-child interactions in lower socioeconomic families.

Assessment is an important component of nursing management of at-risk children. Low socioeconomic status and intrauterine growth retardation are often considered to be risk factors for developmental disabilities. Home visitation is often suggested as a way to assess adult-child interactions. In this article, the author provides information about assessments conducted in lower socioeconomic homes and difficulties encountered in conducting them. She raises several questions for consideration as a result of her efforts to assess home environments and primary caregiver-child interactions of children with intrauterine growth retardation.

Long-term hospitalization of women with high-risk pregnancies. A nurse's viewpoint.

The addition of high-risk pregnancy units to perinatal care systems provides a setting for daily maternal-fetal surveillance during complicated pregnancies. These units permit safe prolongation of pregnancy when the fetus is immature and timely delivery when either the mother's or infant's health is in jeopardy. Hospitalization also encourages maternal rest with its beneficial effects during complicated pregnancy. Nursing functions and goals as developed in the High-risk Pregnancy Unit at Parkland Memorial Hospital in Dallas, Texas, are presented.