Newborn w/Infection

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Author:
sdelap
ID:
131496
Filename:
Newborn w/Infection
Updated:
2012-01-29 18:35:22
Tags:
Maternal Child Newborn Infection
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Description:
Maternal Child: Care of NB w/Infection
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  1. Sepsis Neonatorum
    Infection of NB up to 1 month of age, caused by organisms that don't cause disease in older children.

    Newborns lack IgM (protects against bact) b/c it doesn't cross pacenta.
  2. Testing of Neonate exposed to Infective Agent
    • Blood culture - peripheral site - an and aerobic
    • Spinal fluid if CNS s/s
    • Urine culture (sterile/suprapubic)
    • Skin cultures
    • Trachael aspirate cultures

    • CBC
    • WBC w/diff (low 5000 = sepsis)
    • Low neutroph/high band = infection
    • Serum IgM elevated = infection
    • CRP
    • Xray chest
  3. Behaviors that Warrent Investigation in Neonate
    • Subtle behavioral changes
    • Temp instability
    • Feeding intolerance
    • Hyperbilirubinemia
    • Tachycardia w/apnea/bradycardia
  4. Maternally Tx NB Infections
    • Group B Strep
    • Congenital Syphilis
    • Gonorrhea
    • Herpes Type 2
    • Cytomegalovirus (CMV)
    • Oral Candidal Infection (Thrus)
    • Chlamydia Trachomatis
  5. Neonatal Sepsis ABX/AVR Therapy
    • Acyclovir IV: Herpes
    • Ampicillin IM/IV: listeria, ecoli, meningitis
    • Cefotaxime IM/IV: NOT pseudomonas or listeria
    • Gentamicin IM/IV: staph, e coli, pseudos (toxicity!!!)
    • Vancomycin IV: MRSA
  6. Physiological Support to NB w/Septicemia
    • Thermal, humidity, O2
    • Resp support
    • CV support
    • Caloric support
    • F/E support (homeostasis) (wt maint) (urine)
    • Monitor: hypoglycemia/natremia/calcemia (or hyper), acidosis

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