UnIT.9:.REVIEW:.IS.THE.BABY.SICK?.IDEnTIFYInG.AnD.CARInG.FOR.SICK.AnD.AT-RISK.BABIES
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C. Blood Pressure (Normal varies by gestational age and postnatal age.)*
Observe Think Act
Below normal range Shock from blood loss
Sepsis
Acidosis
Poor oxygenation
Poor cardiac output
Check arterial blood gas, hematocrit, WBC
count with differential.
Attach oximeter and adjust Fio2 to achieve
Spo2 5 88% to 92%.
Give volume expander (10 mL/kg) slowly, if
indicated (suspected hypovolemia).
If blood loss suspected, send blood sample
for type and cross-match.
Consider cultures and antibiotics.
*Refer to graphs in Unit 4, Low Blood Pressure, in this book.
D. Respirations (Normal is approximately 20 to 60 breaths per minute.)*
Observe Think Act
Grunting, flaring,
retractions, tachy-
pnea (sustained
respiratory
rate .60 breaths
per minute), or
stridor
Respiratory distress syndrome
Transient tachypnea
Meconium aspiration
Pneumonia
Pneumothorax
Airway obstruction
Sepsis
Shock
Hypoglycemia
Polycythemia
Anemia
Hypothermia
Hyperthermia
Diaphragmatic hernia
Tracheoesophageal fistula
Congenital heart disease
Attach oximeter and adjust Fio2
to
achieve Spo2 5 88% to 92%.
Check blood pressure, arterial blood gas,
blood glucose screening test, hematocrit,
chest x-ray, temperature, WBC count with
differential.
Roughly estimate gestational age and size.
Review history.
Consider cultures and antibiotics.
Consider assisted ventilation.
Gasping Severe acidosis Attach oximeter and adjust Fio2 to
achieve Spo2 5 88% to 92%.
Obtain blood gas; especially check pH.
Consider assisted ventilation.
Apnea Worsening respiratory distress
Low blood oxygen
Hypoglycemia
Sepsis
Other significant illness (eg, nec-
rotizing enterocolitis)
Shock
Acidosis
Low calcium
Low sodium
Central nervous system disorder
Cold-stressed baby rewarmed
too rapidly†
Preterm
Attach oximeter and adjust Fio2 to
achieve Spo2 5 88% to 92%.
Consider assisted ventilation.
Check blood pressure, temperature, blood
glucose screening test, hematocrit, arterial
blood gas, chest x-ray, calcium, sodium,
WBC count with differential.
Consider lumbar puncture.
Obtain cultures and start antibiotics.
Review history.
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