RESUMO
Necrotizing enterocolitis is one of the most common gastrointestinal disease processes affecting infants in the neonatal intensive care unit. Its morbidity and mortality are substantial. This devastating and challenging process results in immediate and long-term morbidities for the affected infant and frustrates the clinician who struggles to prevent the process, recognize it when it does develop, and provide management techniques to enhance the outcome.
Assuntos
Enterocolite Necrosante , Doenças do Prematuro , Terapia Intensiva Neonatal/organização & administração , Enfermagem Neonatal/organização & administração , Colectomia/efeitos adversos , Colectomia/estatística & dados numéricos , Procedimentos Clínicos/organização & administração , Nutrição Enteral/efeitos adversos , Nutrição Enteral/estatística & dados numéricos , Enterocolite Necrosante/diagnóstico , Enterocolite Necrosante/epidemiologia , Enterocolite Necrosante/terapia , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico , Doenças do Prematuro/epidemiologia , Doenças do Prematuro/terapia , Papel do Profissional de Enfermagem , Avaliação em Enfermagem/métodos , Pais/educação , Pais/psicologia , Assistência Perioperatória/enfermagem , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
This is the report of a newborn with Down syndrome diagnosed with transient myeloproliferative disorder (TMD) that required chemotherapy on the first day of life. Children with Down syndrome have a 10- to 20-fold increased risk of developing TMD. TMD is characterized by an uncontrolled proliferation of myeloblasts in the infant's peripheral blood and bone marrow. In most instances, this unique disorder has the ability to spontaneously "turn off" the overproliferation and enter a state of remission. Only supportive care is recommended for TMD during the first months of life unless the clinical condition requires intervention. As more cases of this baffling disorder are presented, it is important to share our experience to aid in management and diagnosis.
Assuntos
Síndrome de Down/complicações , Transtornos Mieloproliferativos/etiologia , Transtornos Mieloproliferativos/fisiopatologia , Adulto , Antimetabólitos Antineoplásicos/administração & dosagem , Comorbidade , Citarabina/administração & dosagem , Síndrome de Down/fisiopatologia , Educação Continuada em Enfermagem , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Idade Materna , Transtornos Mieloproliferativos/diagnóstico por imagem , Transtornos Mieloproliferativos/tratamento farmacológico , Cuidados de Enfermagem/métodos , Gravidez , Radiografia , Fatores de RiscoRESUMO
Umbilical arterial catheters (UAC) are routinely used in the care of critically ill newborns. Complications related to UACs include vascular compromise, hemorrhage, complications related to malposition, severance of the catheter itself, and infection. This article is Part II in a series dedicated to assessing infants with an umbilical catheter. Part I focused on infants with umbilical venous catheters; this article will focus on the physical assessment relevant to infants with an UAC. Complications related to UACs can occur during any phase of treatment: insertion, while indwelling, or after discontinuing the catheter. Review of clinical signs of complications along with clinical photographs, will assist caregivers in promptly recognizing UAC-related complications.
Assuntos
Cateterismo/efeitos adversos , Enfermagem Neonatal , Artérias Umbilicais/anatomia & histologia , Artérias Umbilicais/fisiopatologia , Cateterismo/enfermagem , Embolia Aérea/etiologia , Hemorragia/etiologia , Humanos , Recém-Nascido , Infecções/etiologia , Guias de Prática Clínica como Assunto , Trombose/etiologiaRESUMO
The use of umbilical catheters in the care of critically ill neonates has become standard practice. Both arterial and venous umbilical catheters are a vital component of care, providing a stable route for fluid and medication administration, vascular pressure monitoring, and frequent blood sampling. Although commonplace, umbilical catheters are not without complications. Neonatal caregivers must be aware of and monitor carefully for associated complications. This article, Part 1 of a 2-part series, provides a systematic guide to the physical assessment of infants with umbilical venous catheters with an emphasis on early and ongoing recognition of complications related to this device. Part 2 will focus on umbilical arterial catheters, their use, and assessment of the infant to detect device-specific complications.
