Physiological loss of initial body weight. Physiological weight loss in newborns

04.08.2019

(physiological weight loss).

It is observed in 100% of newborns. By the 3-4th day of life, the child loses weight, a maximum of 10% of the initial weight at birth is allowed. On average, the weight loss is 4-5%. Recovery occurs by the 7-10th day of life.

The reasons:

Malnutrition in the first days of life;

Excretion of water through the skin and lungs;

Loss of water in urine and stool;

Insufficient fluid intake;

Regurgitation of amniotic fluid;

Drying of the umbilical cord.

Tactics:

Early breastfeeding;

Feeding at the request of the child;

Fight against hypogalactia;

Child weight control.

Physiological catarrh of the skin.

(transient erythema of the skin).

It is manifested by simple and toxic erythema.

Simple erythema - reactive redness of the skin (sometimes with a slight bluish tinge of the hands and feet). The reason is the reflex expansion of the skin vessels due to the powerful influence of environmental factors (cold) on the skin receptors of the newborn. In mature full-term newborns, it persists for several hours, less often 1-2 days.

Toxic erythema - is a kind of allergic reaction of the skin of a newborn. Unlike simple erythema, it does not occur immediately after birth, but on the 2-5th day of life. It manifests itself in the form of hyperemic spots, papules, vesicles on the entire skin, except for the palms and feet. The rash fades after 2-3 days, after which there is a slight peeling.

Tactics:

Thorough skin care;

Hygienic bath with a solution of potassium permanganate.

Transient fever.

It develops as a result of unstable water exchange and imperfection of thermoregulation. Manifested on the 3rd-5th day of life in the form of fever with a temperature of 38-39 degrees C, anxiety, thirst, dry skin and mucous membranes. In 1-2 days the temperature will return to normal.

The reasons:

Insufficient amount of fluid intake in the body;

Overheating of the child;

Entry of E. coli endotoxins during the initial colonization of the intestine by microflora.

Tactics:

Physiological jaundice of newborns.

(transient jaundice).

The appearance of icteric staining of the skin and mucous membranes without disturbing well-being. It appears on the 3rd day, reaches a maximum by the 4th-5th day and disappears by the 12th-14th day of life.

The reasons:

Underdevelopment of the enzymatic functions of the liver, in which the death and processing of red blood cells occurs;

Massive destruction of fetal red blood cells (the number of which in the fetus is very large).

As a result of this combination of factors, the erythrocyte pigment that did not have time to be processed accumulates in the skin and mucous membranes, staining them yellow.

Tactics:

Monitoring the child's condition;

Additional drink 5% glucose;

Timely and adequate treatment for a protracted course.

Hormonal (sexual crisis).

It manifests itself as a result of the transition of mother's hormones (estrogens) into the blood of the fetus in the antenatal and intranatal periods and their entry to the newborn with mother's milk.

It may appear as:

Physiological mastopathy in boys and girls. At the same time, the child has a symmetrical engorgement of the mammary glands without signs of inflammation. There may be a grayish discharge from the nipples. It appears on the 3rd-4th day, reaches its maximum by the 7th-8th day and disappears by the end of the 2nd-3rd week.
swelling of the scrotum in boys, which is also symmetrical and resolves without treatment.
Vulvovaginitis in girls. At the same time, discharge from the genital slit of a grayish-white, and sometimes brownish color appears. It manifests itself in the same way as swelling of the scrotum in boys, in the 1st days of life and disappears by the 3rd day.

Tactics:

Careful child care.

Uric acid infarction of the kidneys.

This is the deposition of uric acid in the form of crystals in the lumen of the urinary tubules.

Manifested by changes in urine. It becomes cloudy, yellowish-brown in color. After drying of such urine, brown spots and sand remain on the diapers. It is found on the 3-4th day of life against the background of physiological oliguria (reduced daily urine volume). As the diuresis increases and the crystals are washed out (within 7-10 days), it disappears.

The reasons:

Increased breakdown of a large number of cells;

Features of protein metabolism.

Tactics:

Additional drinking of boiled water, 5% glucose.

So, your baby is born, and neonatologists tell you the height and weight of the newborn. But the readings of the scales during the daily examinations of the child by the specialists of the maternity hospital show that the baby is losing weight. The neonatologist should explain to you in detail why this is happening and reassure you that the process of loss is quite physiological and normal.

Why do children lose weight?

Getting into the extrauterine aggressive environment, the child goes through a rather difficult period of adaptation. Almost all vital processes now proceed differently than in the mother's stomach - the baby breathes with his lungs, his digestive and excretory systems begin their work.

In the process of adaptation, the newborn loses a lot of moisture, and mainly because of this, physiological weight loss occurs.

Moisture is spent on the following processes:

humidification of the breath;
excretion of meconium (first feces);
urination;
regurgitation;
drying of the remnant of the umbilical cord.

Also, a large percentage of the fluid the newborn loses through the evaporation of moisture from the skin.

Replenishment of moisture loss occurs with the help of mother's milk or artificial mixtures. But since the mother does not yet have enough plentiful lactation, the volume of colostrum that the baby receives is not enough to equalize the loss and intake of moisture. In addition, the newborn is still learning to eat, and drinking a small amount of the first mother's milk, he gets tired and falls asleep. As a result, temporary dehydration occurs, and the baby loses weight.

What can aggravate weight loss?

Some children lose more weight than they should. This is due to the circumstances of childbirth, the lactation process and the conditions in the ward:

premature babies take longer and more difficult to adapt to extrauterine existence;
children born in prolonged labor;
a long break between the discharge of the waters and the moment of the birth of the child;
children with birth trauma;
insufficient volume of colostrum in the mother;
dry air in the room;
high air temperature in the ward;
babies weighing more than 4 kg.

What is the normal rate of weight change in the first week?

The weight loss of the newborn is calculated as a percentage relative to the body weight recorded at birth. The maximum loss, as a rule, is noted on the 3rd-5th day of the child's life and is 10%. So, if a baby was born with a weight of 3600 grams, then its critical loss will be 360 grams. If the weight of the baby does not fall below 3240 gr. and on the 5th-6th day he will begin to gain it, so everything is fine with him.

As a rule, if the volume of colostrum or formula for the child is sufficient, it will not approach critical numbers, and the percentage of weight loss will be only 6-8%. Under favorable conditions, mass gain will begin quite quickly, and on the 6-7th day, the decrease will be restored by 80%.

In premature infants, as well as newborns weighing more than 4 kg, the rate of recovery of lost body weight is somewhat slower.

How to help?

You can help the newborn and create conditions that will reduce moisture loss, and as a result, weight loss.

If possible, create in the room in which you are with the baby, optimal temperature conditions (22-24 degrees).
If the air is too dry with heating devices, humidify it using a special device or by placing a container of water by the crib.
Breastfeed your newborn more often to encourage lactation and avoid severe weight loss in the baby.
Do not wrap up the baby and check by feeling his neck if he is hot, because sweating will increase the loss of moisture.

Further weight gain

At routine examinations by a pediatrician from a month to a year, the child will be regularly weighed on a scale. The doctor will compare early data from the maternity hospital, take into account the weight loss of the baby after birth and its subsequent increase in co. They indicate the norm, how much the baby should add to his weight for a certain period.

Pediatricians rarely have claims to artificialists, since such children eat a certain amount of the mixture, which can be visually controlled. Breastfed babies suck an unknown amount of milk from their mother's breasts. Moms, along with doctors, can judge whether it is enough by weight gain or loss, as well as by the general condition of the child. That is why regular weighing of the baby's body up to a year is so important.

If your baby is slightly ahead of his peers in terms of weight gain, or the doctor determines that you are underweight, do not be discouraged. The pediatrician will advise you on how to adjust the feeding process so that the child's weight returns to normal. You may need to weigh your child before and after meals to find out how much milk he is drinking and write these numbers down. You will show the received data to the pediatrician. If the shortage is due to a lack of a product of your lactation, the doctor will recommend that you feed your baby more often to increase it, or decide on supplementing the baby with formula.

But not always weight loss occurs due to lack of mother's milk:

A slight lack of body weight may be associated with hereditary factors: one of the relatives of the child could grow and gain weight for up to a year not as intensively as their peers; in addition, if the child has miniature parents, you should not expect him to quickly gain weight.
Children under one year old develop in leaps and bounds, they can show a shortfall on the scales for some time, and then “overfulfill” the plan, such uneven weight gain, as well as growth closely related to it, is a physiological norm.

Increase rates

In 2004, the WHO released growth and weight gain tables for children. It differs from the previous version in that it slightly differs in the rate of development of artificers from the rate of babies in breastfeeding.

In the first six months, the rate of increase in a child averages 600-800 grams per month. Further, due to the increase in physical activity, the baby will gain weight more slowly - about 400 grams per month for up to a year.

If in one of the first 4 months the weight gain is less than 500 grams, there is a clear shortage, the doctor will definitely recommend supplementing the child, indicate how much it should be in volume, and select the appropriate one. There is no need to wait for everything to work out by itself - any problems in the nutrition and development of a baby up to a year will inevitably affect his health.

From the age of five months, the baby moves more actively, and this consumes quite a lot of energy received from food. Small failures and underweight during this period are the physiological norm.

When your baby finally comes into this world, then you, along with the news of his birth, are happy to tell all relatives and friends two important numbers - the baby’s height and body weight (or, as is customary for most, weight). However, by the time of discharge from the hospital, the weight of the baby in most cases decreases slightly. This means that a physiological loss of body weight characteristic of the neonatal period has occurred. What is it and is it worth worrying if the baby has lost a little weight?
Normally, a decrease in body weight should not exceed 5-8% of the weight at birth. That is, if the baby weighed 3000 g at birth, then a physiological loss of up to 240 g is quite acceptable. With greater weight loss, the doctor must take all necessary measures to prevent further weight loss. The maximum weight loss is observed in most full-term newborns on the 3-5th day of life, the restoration of body weight occurs 6-12 days after birth. In premature babies, weight loss also depends on birth weight, but it is restored only by the second or third week of life, and even then not in all newborns.
There are three degrees of loss of the initial body weight of the newborn:

first degree (weight loss is less than 6% of birth weight). In this case, the child does not show signs of dehydration, but there may be greed during feeding, anxiety. At the cellular level, laboratory studies reveal minor signs of intracellular hypohydration. Most newborns belong to this group.
second degree (newborn weight loss within 6-10%). In this case, some signs of dehydration may appear: thirst, brightness of the mucous membranes, pallor of the skin, increased heart rate, shortness of breath, irritability is noticeable in the child's behavior. Under laboratory conditions, there are signs of intracellular hypohydration and extracellular dehydration.
third degree (weight loss more than 10%). In this case, signs of dehydration are more pronounced: severe thirst, dry mucous membranes and skin, shortness of breath, severe tachycardia, fever, the child is restless or inhibited. Laboratory observed pronounced signs of intracellular and extracellular hypohydration.

Loss of more than 10% of body weight can lead to a significant deterioration in the child's condition, so the doctor individually decides whether additional supplementation or formula feeding is necessary.
Let's see what can cause weight loss: dehydration due to significant energy costs of the body. Indeed, in the first days of life, a child receives a very small amount of colostrum - from a few drops to several milliliters, while consuming a significantly larger amount of energy. In addition, some children suckle very sluggishly in the first days, which also contributes to a longer lactation and, accordingly, slows down the rate of weight gain in the baby; fluid loss associated with evaporation through the skin; loss of fluid associated with the excretion of urine and meconium (this is the original feces - a dark-colored mass formed from the amniotic fluid and secretions of the digestive system swallowed by the baby); the prerequisites for a more pronounced weight loss can be prematurity of the baby, birth weight of more than 4 kg, difficult or prolonged labor, early discharge of amniotic fluid, the presence of birth trauma.
Prevention of excessive weight loss in a newborn can be early breastfeeding, free breastfeeding, rational temperature in the room where the baby is.

Independent work

1. Make a plan for a conversation with the mother about the rules for caring for a newborn baby.

2. Prepare an abstract report on the topic: "Modern approaches in medicine for nursing premature babies."

Literature

1. Bisyarina V.P. Children's diseases - M .: "Medicine", 1987.

2. Svyatkina K.A. Children's diseases - M .: "Medicine", 1987.

3. Usov I.N. Healthy child. - Minsk: "Belarus", 1994.

Theoretical material

Scheme of periodization of childhood.

1. Prenatal stage of development:

1. phase of embryonic development (up to 2-3 months);

2. phase of placental development (from 3 months to birth).

2. Extrauterine stage of development:

1. neonatal period (from birth to 28 days):

early neonatal period (from birth to 7 days);

late neonatal period (from 7 days to 28 days);

2. infancy (younger toddler) - from 3-4 weeks to 12 months;

3. The period of pre-preschool and preschool age

pre-preschool age (senior toddler from 1 to 3 years);

§ preschool (from 3 to 6-7 years old);

4. junior school (the period of adolescence - from 6-7 years to 11 years);

5. senior school (puberty - from 12 to 17-18 years).

The period of intrauterine development lasts 280 days, which corresponds to 10 lunar months. In the phase of embryonic development, the external parts of the body and internal organs are formed. After 4 weeks, the contraction of the heart begins. By the end of the 2nd lunar month, the embryo acquires a humanoid appearance. The nervous system of the unborn child is laid already at 1-2 weeks of pregnancy. During the period of embryogenesis, the action of various hazards is especially dangerous: physical factors /mechanical, thermal, ionizing radiation/, chemical /lack of vitamins, trace elements, hormonal preparations, poisons/, biological /viruses, bacteria, protozoa/. Their impact on the developing fetus can lead to the development of severe defects. In this regard, the prevention of embryonic diseases is an important task of modern medicine.

The phase of placental development corresponds to the fatal period, characterized by a rapid increase in body length and weight. On the 3rd lunar month, its growth reaches 9 cm, at 7 months - 35 cm. The mass of the fetus at the age of 5 months reaches 300 g, by the end of the 8th month -1700 g For 9 and 10 lunar months, the mass increases to 3200-3500 g, mainly due to subcutaneous fat.

At 4 months, the fetus is actively moving, and its movements are felt by the mother.

At the 5th month, the sebaceous glands begin to function, and a lubricant is formed.

In the early antenatal period, pathogens of such infectious diseases as toxoplasmosis, listereliosis, syphilis, serum hepatitis, cytomegaly and others, having penetrated the placenta from the mother's body, deeply damage the internal organs and the central nervous system of the fetus.

Late fetopathy includes chronic inflammatory processes /cirrhosis, sclerosis/ resulting from infection in the early period.

In the intranatal period / from the onset of labor to the birth of a child / there may be a violation of blood circulation in the placenta, which leads to asphyxia of the fetus, birth injuries are possible, infection of the fetus with opportunistic flora from the birth canal, and if the mother has inflammatory diseases - and pathogenic microorganisms.

For the normal development of the fetus and the prevention of infection, it is important to provide a pregnant woman with the best hygiene conditions and proper medical supervision.

In terms of preparing the female body for childbearing, preconception prevention is important, which consists in improving the health of girls of all ages, starting from the first years of life, especially in adolescence and youth.

Early monitoring of the course of pregnancy is necessary to identify women at increased risk. Therefore, at the first meeting with a pregnant woman, special attention is paid to a thorough history taking.

Risk factors: mother's age under 20 and over 35, father under 20 and over 40, mother's height up to 150 cm, excess body weight by 25%, occupational hazards, bad habits / smoking, father's alcohol abuse and, especially, mothers/, low level of education, negative attitude towards pregnancy, great emotional stress, material and domestic difficulties of the family, single-parent families and socially dysfunctional marriages. Risk factors for obstetric and gynecological history: the number of previous births 7-8 or more, abortions, miscarriages, stillbirths, developmental defects in previously born children, etc.

The main task of the children's polyclinic is to conduct prenatal patronage. The purpose of prenatal care, in addition to ensuring favorable living conditions for the child, is to establish a close contract with the expectant mother. It is carried out by the district nurse. The first visit to the pregnant woman is carried out shortly after being registered by the antenatal clinic.

The state of health of the pregnant woman, marital status, living conditions of the unborn child, the psychological climate in the family, the level of sanitary culture of its members are ascertained.

The nurse finds out whether the pregnant woman follows the doctor's instructions for the day, sleep, work, rest, and care for the mammary glands.

Convinces the pregnant woman of the need for regular visits to the antenatal clinic, tells what needs to be prepared for the newborn, how to equip a corner for him, teaches the rules of child care, feeding methods, warns about the dangers to the fetus of smoking, drinking even small doses of alcohol, warns against taking medications, invites mothers to attend school.

The second prenatal visit is carried out at the 32nd week. Particular emphasis should be placed on the promotion of breastfeeding and the prevention of hypogalactia. He checks whether everything is ready for the child, advises what to take for the newborn when the time comes to take him home from the maternity hospital.

Data on prenatal visits are recorded on inserts that are pasted into the child's developmental history.

The neonatal period is the period of adaptation of the child to existence outside the mother's body. It is more difficult to adapt to extrauterine conditions of life premature and post-term children, who are more prone to birth injuries and the development of asphyxia.

There is a high sensitivity of the body to staphylococcal and streptococcal infections, to opportunistic strains of Escherichia coli, salmonella, etc. Newborns are prone to rapid generalization of the pathological process with the development of severe septic conditions.

During this period, maternal and fetal incompatibility in terms of the Rh factor or antigens of the ABO system, hereditary diseases are manifested.

With the first breath, the respiratory organs begin to function, the fetal circulation is rebuilt into the extrauterine one. In connection with the equalization of pressure in the aorta and pulmonary artery, the blood flow through the botal duct stops and the pulmonary circulation is fully switched on. Stops the flow of blood from the right atrium to the left through the foramen ovale. By 2-3 months, the umbilical vessels and botalis duct are obliterated, by 5-7 months the foramen ovale is overgrown.

The gastrointestinal tract begins to function and adaptation to new nutritional conditions is underway.

There are changes in metabolism. In the first hours of development, metabolic acidosis develops / up to 5 days of life /.

Newborns are characterized by hyperhydration and hydrolability. Water makes up to 75% of the body weight of newborns. A lot of fluid is lost through the skin, because. peripheral vessels are dilated, and the relative surface of the body is larger than in adults. Increased excretion of water through the lungs.

Large water losses can lead to hypernatremia, therefore, newborn children should receive 2.5-3 times more fluid than older children, the concentration of sugar in the blood of a newborn from the moment of birth gradually decreases and by 4-5 days decreases by almost 2 times due to imperfections of enzymatic and hormonal systems.

Hypoglycemia can occur without external manifestations, but there may be cyanosis, tremor, convulsions, etc. At the 2nd week of life, the sugar content is normalized.

The newborn sleeps almost continuously, since inhibition processes sharply predominate in the central nervous system. At 3-4 weeks, conditioned reflexes begin to develop: first to the vestibular analyzer, then to visual, auditory, tactile. At 3-4 weeks, many children begin to respond with a smile.

1. Transient changes in the skin:

Simple erythema is hyperemia of the skin, sometimes with a slight cyanotic tinge in the area of the hands and feet. The reason is the expansion of capillaries in response to new environmental conditions.

1. Lasts from several hours to 2-3 days.

2. With the extinction of erythema, peeling of the skin is noted. With severe peeling, the skin is lubricated with sterile vegetable oil.

3. Toxic erythema is an allergic reaction that appears on the 2nd-5th day of life.

Clinic. Single or multiple hyperemic spots, papules, vesicles. After 2-3 days, the elements of the rash gradually fade away.

Care. Therapeutic baths with a solution of potassium permanganate. Assign antihistamines - cheese-like lubricant.

2. Transient jaundice due to the accumulation in the blood and tissues of free bilirubin, formed during the breakdown of fetal red blood cells.

The functionally immature liver of a child cannot ensure the conversion of a large amount of bilirubin into a non-toxic form.

Appears on the 2-3rd day of life in the form of icteric staining of the skin, mucous membranes of the mouth and sclera.

Feces and urine of normal color, the liver and spleen do not increase, the general condition is not disturbed. Disappears by 7-10 days.

Care. With severe jaundice, plenty of fluids, phototherapy are prescribed. Phenobarbital is prescribed.

Physiological loss of initial body weight.

It is observed in the first 2-3 days of life in all newborns and does not exceed 10% /6-8%/. Restoration of mass occurs by 7-10 days of life.

The reasons. Malnutrition, loss of water in the urine, stool, through the skin and lungs, due to regurgitation and drying of the umbilical residue.

Care. The earliest attachment to the breast, feeding at the request of the child, timely detection of a lack of breast milk and rational tactics in this case, compliance with the thermal regime.

4 . Transient features of heat balance.

The body temperature of a newborn is unstable and in the first hours of life it can decrease by 1-2 C.

Some children have a transient fever on the 3rd-5th day of life, in which the body temperature rises and remains at 38-39C for several hours. The reasons. Dehydration, high protein content in colostrum, imperfection of thermoregulation, overheating, the body's reaction to E. coli endotoxins, during the initial colonization of the intestine with bacterial flora.

Care. Proper feeding. Drinking in the form of 0.9% sodium chloride solution, 5% glucose solution, rehydron. Physical cooling under temperature control. Overheat warning.

5. Sexual crisis caused by the transfer of estrogen from mother to fetus during
intrauterine development and with breast milk after the birth of a child.

Includes

1. Physiological mastopathy/breast engorgement/ is observed regardless of gender and appears on the 3rd-4th day of life, increasing to the maximum by the 7-10th day.

The skin over the gland is slightly hyperemic. A secret of gray or milky white is secreted from the glands.

Care. Do not squeeze out the secret due to the risk of injury and infection. With severe engorgement, a warm sterile bandage is applied to prevent skin irritation.

2. Bleeding from the vagina occurs on the 5th-8th day of life, duration 2-3 days, volume 0.5-2 mm.

Care. Careful observance of the hygienic regimen. A sexual crisis may be accompanied by swelling of the external genital organs, in boys there may be hyperpigmentation of the scrotum, in girls - gray-white mucous discharge from the genital slit.

6 Transient features of the kidneys.

A \ In the first 3 days of life in healthy newborns, physiological oliguria is noted. The number of urination is 4-5 times a day, in the following days the child urinates more often, by day 10 - up to 20-25 times. Urine clear, watery.

B\albuminuria occurs in all newborns in the first days of life and is a consequence of increased permeability of the epithelium of the glomeruli and tubules of the kidneys.

Uric acid infarction appears on the 3-4th day of life and is a deposition of uric acid in the form of crystals in the lumen of the urinary tubules.

The reasons. Increased cell breakdown /mainly leukocytes/ and features of protein metabolism; because of this, a large amount of salt in the urine.

Small amount of urine.

Clinic. Urine cloudy, yellow-brown. Brown spots with a sediment in the form of sand remain on the diapers. As diuresis increases, the salts are washed out and the heart attack disappears within 70 days.

7. Meconium / primordial feces / is released in the first 2 days of life and is an odorless thick viscous mass of dark green color. Consists of secretions of the embryonic digestive tract, epithelium, swallowed amniotic fluid. Later it becomes more frequent, heterogeneous in consistency and color / watery, dark green with yellow and whitish areas /. Such a chair is called transitional. After 2-4 days, it becomes mushy and yellow, the frequency is several times a day.

For all the major systems of the newborn is characterized by a state of "unstable balance", so minor changes in the conditions surrounding the child can cause diseases. This requires careful special care for the newborn, special hygienic conditions for its maintenance, proper organization of feeding.

Application No. 1

1. What justifies the division of childhood into periods?

2. Name the stages and periods of childhood.

3. Give a description of the antenatal period of development.

4. Timing and role of antenatal care in antenatal care of the fetus.

5. List the changes in the body that occur at the birth of a child.

6. Give a brief description of the boundary conditions.

7. What is the tactics of honey. sisters when the child overheats.

8. What is the maximum weight loss for a newborn? How to avoid her big loss?

9. Name the features of care for toxic erythema.

10. What signs are characteristic of physiological jaundice.

11. What are the features of care for manifestations of a sexual crisis.

12. Give a description of the stool of a newborn child.

13. What are the requirements for the staff of the neonatal unit and the maintenance of the wards?

14. Name the main features of care for full-term newborns.

15. Terms of falling off of the umbilical cord and healing of the umbilical wound in full-term and premature newborns.

16. Tell us about the role of a nurse in the prevention of nosocomial infections in newborns and puerperas.

17. Why is it important to breastfeed early?

19. How to determine the daily and one-time need of a newborn for food /full-term and premature/?

20. How to determine the degree of prematurity, based on gestational age, weight indicator?

21. List the anatomical features of a premature baby.

22. Functional signs of prematurity.

23. What microclimatic conditions are necessary for nursing premature babies at stages 1-2?

24. How to organize the feeding of a premature baby?

25. What complication can develop during feeding? Tactics m / s in this case.

26. Name the criteria for discharge of a premature baby from the hospital.

27. Give advice on caring for a week old baby at home.

28. What is the prevention of premature birth of children?

Application No. 2

TESTS

1. Signs of prematurity:

A) muscle hypotension

B) birth tumor

B) soft ears

D) the head is 1/3 of the body length

2. Weight of a full-term newborn on average:

3. The growth of a premature baby:

A) up to 35 cm

4. The neonatal period is:

A) the first 28 days of life

B) the first 7 days of life

C) the first 29 days of life

D) the first 30 days of life

5. A premature baby with a birth weight of 1400g will catch up with his peers in psychomotor development:

A) by the end of 3 years

B) during the 2nd year of life

C) by 6 months of age

D) by the end of the 1st year of life

6. The gestational age of a full-term newborn baby is:

A) 35-37 weeks

B) 30-32 weeks

C) 37-42 weeks

D) 28-38 weeks.

7. You can bathe a premature baby at the water temperature:

A) 37.5-38 degrees

B) 38.5-39 degrees

C) 39.5-40 degrees

D) 36-37 degrees

8. The air temperature in the ward of premature babies is maintained within:

A) 22-23 degrees

B) 21-22 degrees

C) 24-25 degrees

D) 25-26 degrees

9. In winter, they walk with a premature baby at an air temperature of at least:

A) +5 degrees

B) -10 degrees

C) -5 degrees

D) 0 degrees

10. A premature baby is discharged home weighing:

Application No. 3

Situational tasks

Task #1

The child was removed with abdominal forceps in a state of asflexia. Resuscitation activities were carried out, after 5 minutes. breathing independent, but superficial. The skin is pale, cyanosis around the eyes. Heart rate 110 in 1 min. Reflexes are reduced, muscle tone - the limbs are slightly bent. Carry out the nursing process: identify problems, formulate a nursing diagnosis, draw up a plan for nursing services, ways to implement them. The role of the nurse in disease prevention.

Task #2

A child with a gestational age of 38 weeks was born with a weight of 3300 g, a height of 51 cm. He screamed immediately. Heart rate 120 in 1 min.

active movements.

The reflex to the nasal catheter is sneezing.

The skin is pink all over the body.

Task #3

A full-term newborn baby was born with a body weight of 3400 g. On the 4th day of life, its mass was 3250 g. The condition is satisfactory. Sucking actively.

Task #4

At the patronage of a newborn, a frustrated mother complained to the paramedic about swelling of the mammary glands and bloody discharge from the girl's vagina. On examination: bilateral breast engorgement. The skin above them is of normal color. A yellowish-white liquid comes out of the nipple.

your diagnosis. Implement the nursing process.

Task number 5

When visiting a newborn on the 12th day of life, the mother complained that brown-red spots with a sediment in the form of sand appear on the diapers after the child urinates. At the same time, it turned out that between feedings, the mother does not give water to the child. The general condition is not broken.