11-month-old Bianca is being assessed in the pulmonary clinic today by the nurse. Bianca requires continuous portable oxygen via nasal prongs at 0.5 L/min. Her mother has tried to wean the baby from the oxygen, per physician’s orders, during the nighttime but Bianca’s O2 saturation often will drop to 92% and her respiratory rate will increase. The baby was born at 26 weeks’ gestation and was ventilated for the first week of life. She has been on continuous oxygen since birth.
You must answer those questions:
a.) There is a student nurse observing today. She asks the nurse why the baby is still having respiratory problems. How should you respond?
b.) What things would you be concerned about as the baby gets older?
that baby has an immature lung that can lead to RESPIRATORY SYNDROME.
OU MUST USE THIS BOOK.
Porth, C. M. (2011). Essentials of pathophysiology (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins. PAGES FROM 557 TO 563.
THIS IS A EXAMPLE FROM A CLASS MATE
This baby, Bianca, is having respiratory problems because she was born at 26 weeks’ gestation. Lung compliance is greatly influenced by pulmonary surfactant that is produced in the lungs because it decreases surface tension, increases lung compliance, and makes lung inflation easier (Porth, 2011). However, the cells that produce surfactant mature at the 26th to 27th week of gestation so Bianca does not have sufficient amounts of surfactant in her lungs (Porth, 2011). As a result, she has infant respiratory distress syndrome and she needs continuous oxygen. As the baby gets older, treatment should be focused on maintaining adequate ventilation and gas exchange, clearing pulmonary secretion, and preventing infections and further complications. Morrell (2010) mentions some treatment options, which include mechanical ventilation, fluid management to support other organs, using the prone position, and surfactant replacement. Interestingly, this is the second article I came across that mentioned using the prone position because it improves gas exchange and oxygenation as the heart and diaphragm put less pressure on the lungs (Morrell, 2010). Other concerns would be respiratory acidosis, neurologic impairments related to hypoxia, and apnea.
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