1、Care of preterm infants,Neonatal classification,The characteristics of preterm infants,The reasons of preterm infants,Relevant nursing problems and measures,1,2,3,4,Health education,5,Main Content,Neonatal classification,Birth weight,Weight and gestational age,Gestational age,According to the classi
2、fication of gestational age,Full-term infant：37足周胎龄42足周 Pre-term infant：28足周胎龄37足周 Post-term infant：胎龄42足周,According to the classification of birth weight,1.Normal weight infant： 2500gBW4000g2.Low birth weight infant： BW2500g的新生儿3.Very low birth weight infant: BW1500g的新生儿4.Extremely low birth weight
3、 infant: BW1000g的新生儿5.Giant infant：BW4000g的新生儿,According to the classification of birth weight,According to the relationship between birth weight and gestational age,1.Appropriate for gestational age 第10百分位体重第90百分位2.Small for gestational age 出生体重第10百分位3.Large for gestational age 出生体重第90百分位,Appearanc
4、e characteristics,Physiological characteristics,The characteristics of preterm infants,The appearance of premature infants,The appearance of premature infants,Appearance,Premature babies,四肢屈曲状,肌张力差,Full moon,The skin,红润，皮下脂 肪丰富，毳毛少,绛红，水肿，发亮，毳毛多,Premature babies,Full moon,Genitals (male),Premature ba
5、bies,睾丸已降，阴囊多皱摺,睾丸未降、阴囊少皱摺,Full moon,Genitals (female),Full moon,Premature babies,大阴唇遮盖小阴唇,大阴唇不能遮盖小阴唇,Mammary gland,Premature babies,Full moon,Plantar-print,Premature babies,Full moon,Auricular,Premature babies,Full moon,生理特点,循环,呼吸,泌尿,消化,神经,免疫,体温,Physiological characteristics,Respiratory system: 1.
6、The respiratory center is not mature, easy apnea 2. Alveolar surface active substance, less easy to happen pulmonary hyalinem embrane disease 3. The cough response is poor, prone to inhalation lung inflammation or atelectasisCirculatory system: heart rate, blood pressure was lower than those of full
7、 term, the capillary abnormal blood vessels, high brittleness, encounter easily bleeding,Physiological characteristics,Digestive system: 1. The stomach capacity is small, cardiac sphincter relaxation, suck force and the swallowing reflex is poor, easy to spill the milk, choking milk.2. A variety of
8、digestive enzymes, secretion of bile salt less fat digestion and absorption of fat is poor, prone to necrotizing enterocolitis;The liverThe function is not perfect, is not entirely to bilirubin metabolism, and physiology Jaundice is heavier, and the long time;The liver synthesis of clotting factors
9、and eggs White matter less prone to produce anemia and hypoalbuminemia, liver glycogen storage deposit, less prone to hypoglycemia.,Physiological characteristics,Thermoregulation: body temperature adjustment function is not perfect, basal metabolism is low,Easily happened hypothermia and hard swolle
10、n, sweat gland function at the same time can is poor, the environment of high temperature heat easily.Immune system: the humoral immunity and cellular immunity are not perfect, and easy to develop .All kinds of infectious diseases, and the difference after the illness is the more heavy, they are eas
11、y in sepsis.,Physiological characteristics,Urinary system: renal function is not perfect, prone to water and electricity solution quality, and the disorder.Function of the nervous system: the smaller the age, the poor, all kinds of reflection also the more bad.,Pregnant women factors: 1. The uterine
12、 tumor, endometritis, and cervix relaxation;Pelvis and spinal deformities2. Pregnancy-induced hypertension syndrome: 3. Chronic diseases such as :heart disease, kidney disease, nephritis, liver disease, sugar Urinary disease, endocrine disorders, severe pulmonary tuberculosis4. Anemia and severe hem
13、olytic disease;Acute infectious diseases accompanied by high fever acute or chronic poisoning; 5. Intense emotional fluctuations, or strain6. Accidental injury or surgery.7. Bad habits and hobbyFetal placental factors：1. The twins or fetal abnormalities2. Early rupture or placenta previa, placenta e
14、arly stripping3. Multiple pregnancies or hydramnios, abnormal umbilical cord, etc,The reasons of preterm infants,Relevant nursing problems and measures,Infant feeding invalid,Temperature regulation is invalid,There is a risk of infection,Unable to maintain spontaneous breathing,Anxiety,Nursing probl
15、ems,Nursing measures,1.General care:1)Suitable for the environment：室温24-26晨间护理增至27-28，湿度55-65.2)Give the right position： 侧卧，每2-3h更换1 次. 3)Closely observe the illness：监测体温、呼吸、脉搏等生命体征，注意观察患儿的精神、进食、反射、面色、哭声以及大小便的情况等。,2.Symptomatic care1)Keep stable temperature：To keep warm：合理设置暖箱的温度 出箱的条件：体重增至2000g以上，体
16、温能保持正常, 吸允良好Prevent heat dissipation：双手温暖，氧气应加温、加湿Monitor the body temperature：每4小时一次。体温稳定后每天测2次，并记录,The normal temperature of different birth weight,出生 温 箱 温 度 体重（kg） 35 34 33 321.0 初生10天内 10天后 3 周以后 5 周以后1.5 初生10天内 10天后 4 周以后 2.0 初生2天内 2天后 3 周以后2.5 初生2天相对湿度 5565%,2)Reasonable master fed milk volum
17、e and time interval,喂养时注意观察婴儿面色及心率、血氧的变化,选择合适的奶头与体位,3) To prevent infection:医护人员严格消毒隔离制度，强化洗手意识。应加强口腔、皮肤及脐部的护理：发现微小病灶都应及时处理，保持皮肤的完整性和清洁；确保空气及仪器物品洁净，严格控制入室人数，防止交叉感染。,4) To maintain normal breathing, position under the shoulder pad is a soft pillow； 出现呼吸暂停时： 吸氧：持续低浓度（30-40） 拍打足底、托背呼吸等5) Promote the interactions with the baby, more touching them 保持环境安静整洁，光线柔和，集中护理 操作，减少对宝宝的刺激,1.保持室内空气清新，温湿度适宜，定时通风2.注意保暖，宝宝衣物穿着舒适安全3.做好皮肤护理，常与婴儿抚触4.奶具每餐消毒，按时添加辅食5.提倡母乳喂养，选择适宜奶头6.避免交叉感染，定期健康复查7.按时计划免疫，做好儿童保健,Health education,Thank u !Wish u have a good time!,
