BOOK
Core Curriculum for Neonatal Intensive Care Nursing E-book
M. Terese Verklan | Marlene Walden
(2009)
Additional Information
Book Details
Abstract
Perfect as a resource in the field or for exam preparation, this authoritative reference from the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) includes in-depth coverage of the most common neonatal disorders and their management. The concise outline format highlights the essentials of each condition including definition, etiology, pathophysiology, signs and symptoms, diagnostic tests, treatments, and outcomes to help you find important information quickly.
- Coverage of key content on the neonatal intensive care nursing certification exam prepares you for test success.
- Information on families, ethics, legal issues, research, case management, and the transition to home emphasizes the importance of total care of the neonatal patient and family.
- New and updated content on late preterm infants, neurologic disorders, and ventilatory strategies provide the latest information from the field for more effective patient outcomes.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Half title page | i | ||
| Title page | iii | ||
| Copyright page | iv | ||
| Foreword | v | ||
| Dedication | vii | ||
| Contributors | ix | ||
| Reviewers | xiii | ||
| Preface | xv | ||
| Table of contents | xvii | ||
| Chapter 1: UncomplicatedAntepartum,Intrapartum, andPostpartum Care | 1 | ||
| Objectives | 1 | ||
| Terminology | 1 | ||
| Normal Maternal Physiologic Changes by Systems | 1 | ||
| Antepartum Care | 6 | ||
| Normal Labor and Birth | 11 | ||
| Puerperium: “Fourth Trimester” | 17 | ||
| References | 18 | ||
| Chapter 2: Antepartum-IntrapartumComplications | 20 | ||
| Objectives | 20 | ||
| Anatomy and Physiology | 20 | ||
| Conditions Related to the Antepartum Period | 24 | ||
| Conditions Related to the Intrapartum Period | 28 | ||
| Obstetric Analgesia and Anesthesia | 35 | ||
| References | 39 | ||
| Chapter 3: Perinatal SubstanceAbuse | 41 | ||
| Objectives | 41 | ||
| Introduction | 41 | ||
| Drugs of Abuse | 42 | ||
| Stimulants | 46 | ||
| Cannabinoids | 49 | ||
| Narcotics and Opioids | 50 | ||
| Sedatives/Hypnotics | 52 | ||
| Inhalants | 53 | ||
| Other (Antidepressants) | 53 | ||
| General Management Recommendations | 58 | ||
| Nursing Interventions | 59 | ||
| Drug Screening | 63 | ||
| Breastfeeding | 64 | ||
| Problems Associated with Maternal Drug Use | 65 | ||
| Ethical and Legal Considerations | 67 | ||
| References | 68 | ||
| Chapter 4: Adaptation toExtrauterine Life | 72 | ||
| Objectives | 72 | ||
| Anatomy and Physiology | 72 | ||
| Routine Care Considerations in the Transition Nursery* | 77 | ||
| Recognition of the Sick Newborn Infant | 82 | ||
| Parent Teaching | 88 | ||
| References | 90 | ||
| Chapter 5: Neonatal DeliveryRoom Resuscitation | 91 | ||
| Objectives | 91 | ||
| Definitions | 91 | ||
| Anatomy and Physiology | 92 | ||
| Risk Factors | 93 | ||
| Anticipation of and Preparation for Resuscitation | 94 | ||
| Equipment for Neonatal Resuscitation | 95 | ||
| Apgar Scoring | 95 | ||
| Decision-Making Process | 97 | ||
| Unusual Situations | 103 | ||
| Complications of Resuscitation | 107 | ||
| Postresuscitation Care | 107 | ||
| References | 109 | ||
| Chapter 6: Thermoregulation | 110 | ||
| Objectives | 110 | ||
| Identifying Infants at Risk for Thermal Instability | 110 | ||
| Physiology of Thermoregulation | 111 | ||
| Mechanisms of Heat Transfer | 113 | ||
| Strategies for Managing Thermoregulation | 114 | ||
| References | 118 | ||
| Chapter 7: Physical Assessment | 120 | ||
| Objectives | 120 | ||
| Perinatal History (See Chapters 1, 2, 3, and 4) | 120 | ||
| Gestational-Age Instruments | 123 | ||
| Classification of Growth and Maturity | 127 | ||
| Physical Examination | 132 | ||
| References | 154 | ||
| Chapter 8: Fluid and ElectrolyteManagement | 156 | ||
| Objectives | 156 | ||
| Fluid Balance | 156 | ||
| Disorders of Fluid Balance | 159 | ||
| Electrolyte Balance and Disorders | 161 | ||
| Acid–Base Balance and Disorders | 168 | ||
| References | 170 | ||
| Chapter 9: Glucose Management | 172 | ||
| Objectives | 172 | ||
| Glucose Homeostasis | 172 | ||
| Hypoglycemia | 173 | ||
| Infant of Diabetic Mother | 177 | ||
| Hyperglycemia* | 178 | ||
| Transient or Permanent Neonatal Diabetes | 179 | ||
| References | 180 | ||
| Chapter 10: NutritionalManagement | 182 | ||
| Objectives | 182 | ||
| Anatomy and Physiology of the Premature Infant’s Gastrointestinal Tract | 182 | ||
| Nutritional Requirements | 186 | ||
| Parenteral Nutrition (PN) | 190 | ||
| Enteral Feedings: Human Milk and Commercial Formulas for Term, Special-Needs, and Premature Infants | 194 | ||
| Enteral Feeding Methods | 199 | ||
| Nursing Interventions to Facilitate Tolerance of Enteral Feedings | 202 | ||
| Nutritional Assessment and Standards for Adequate Growth | 203 | ||
| References | 205 | ||
| Chapter 11: DevelopmentalSupport | 208 | ||
| Objectives | 208 | ||
| Barriers to Infant Development in the NiCU Setting | 208 | ||
| Developmental Care Standards | 209 | ||
| References | 227 | ||
| Chapter 12: Pharmacology | 233 | ||
| Objectives | 233 | ||
| PRINCIPLES OF PHARMACOLOGY | 233 | ||
| PHARMACODYNAMICS | 234 | ||
| PHARMACOKINETICS | 236 | ||
| MEDICATION CATEGORIES | 243 | ||
| CENTRAL NERVOUS SYSTEM (CNS) MEDICATIONS | 246 | ||
| NURSING IMPLICATIONS FOR MEDICATION ADMINISTRATION IN THE NEONATE | 250 | ||
| References | 251 | ||
| Chapter 13: Laboratory Conceptsand TestInterpretation | 252 | ||
| Objectives | 252 | ||
| LABORATORY TESTS IN THE NICU | 252 | ||
| PURPOSE OF LABORATORY TESTING | 255 | ||
| PROCESS OF LABORATORY COLLECTION | 255 | ||
| CONCEPTS OF LABORATORY TEST INTERPRETATION | 258 | ||
| PRINCIPLES OF TEST UTILIZATION | 259 | ||
| IATROGENIC SEQUELAE OF LABORATORY TESTING—PREVENTIVE STRATEGIES | 260 | ||
| DECISION—QUESTIONS TO ASK PRIOR TO OBTAINING A LABORATORY TEST | 262 | ||
| LABORATORY INTERPRETATION—DECISION TREE | 264 | ||
| References | 268 | ||
| Chapter 14: Radiologic Evaluation | 270 | ||
| Objectives | 270 | ||
| Basic Concepts | 270 | ||
| Terminology | 270 | ||
| X-ray Views Commonly used in the Newborn Infant (Fig. 14-1) | 271 | ||
| Radiographic Densities | 272 | ||
| Risks Associated with Radiographic Examination in the Neonate | 272 | ||
| Approach to Interpreting an X-ray | 272 | ||
| Respiratory System | 274 | ||
| Pulmonary Parenchymal Disease | 275 | ||
| Pulmonary Air Leaks | 279 | ||
| Miscellaneous Causes of Respiratory Distress | 280 | ||
| Thoracic Surgical Problems | 281 | ||
| Cardiovascular System | 284 | ||
| Gastrointestinal System | 287 | ||
| Skeletal System | 293 | ||
| Indwelling Lines and Tubes | 294 | ||
| Diagnostic Imaging | 296 | ||
| References | 298 | ||
| Chapter 15: Common InvasiveProcedures | 299 | ||
| Objectives | 299 | ||
| Airway Procedures | 299 | ||
| Circulatory Access Procedures | 307 | ||
| Blood Sampling Procedures | 320 | ||
| Miscellaneous Procedures | 324 | ||
| References | 331 | ||
| Chapter 16: Pain Assessment andManagement | 333 | ||
| Objectives | 333 | ||
| Definition of Pain | 333 | ||
| Neonatal Intensive Care Unit Procedures That Cause Pain | 333 | ||
| Physiology of Acute Pain in Preterm Neonates | 334 | ||
| Standards of Practice | 336 | ||
| Pain Assessment | 336 | ||
| Pain Assessment Instruments | 338 | ||
| Nursing Care of the Infant in Pain | 340 | ||
| Pain Management at End of Life | 344 | ||
| Parents’ Role in Pain Assessment and Management | 345 | ||
| References | 345 | ||
| Chapter 17: Families in Crisis | 347 | ||
| Objectives | 347 | ||
| Crisis and The Birth of The Sick or Premature Infant | 347 | ||
| Specific Population of Parents: Adolescents | 349 | ||
| The Family in Crisis | 349 | ||
| Summary of Parental Needs to Be Met By Nicu Staff | 359 | ||
| References | 360 | ||
| Chapter 18: Patient Safety | 361 | ||
| Objectives | 361 | ||
| References | 380 | ||
| Chapter 19: Discharge Planningand Transition toHome Care | 383 | ||
| Objectives | 383 | ||
| Introduction | 383 | ||
| General Principles | 383 | ||
| Health Care Trends | 384 | ||
| Discharge Criteria must be Established and Individualized to the Infant and Family (Box 19-2) | 385 | ||
| Parental Needs and Role in the Discharge and Transition to Home Process | 386 | ||
| Discharge Planning and Transition to Home | 387 | ||
| Neonatal Teaching Needs | 392 | ||
| Family and Infant Care Postdischarge (see Box 19-9) | 395 | ||
| References | 397 | ||
| Chapter 20: Genetics: From Benchto Bedside | 399 | ||
| Objectives | 399 | ||
| Basic Genetics | 399 | ||
| Chromosomal Defects | 402 | ||
| Prenatal Diagnosis | 402 | ||
| Postnatal Testing | 406 | ||
| Human Genome Project | 406 | ||
| Genetic Counseling | 407 | ||
| Newborn Care | 408 | ||
| REFERENCES | 414 | ||
| Chapter 21: Intrafacility andInterfacility NeonatalTransport | 415 | ||
| Objectives | 415 | ||
| Historical Aspects | 415 | ||
| PHILOSOPHY OF NEONATAL TRANSPORT | 416 | ||
| INTRAFACILITY NEONATAL TRANSPORT | 416 | ||
| INTERFACILITY NEONATAL TRANSPORT | 417 | ||
| SELECTION OF TRANSPORT VEHICLES | 418 | ||
| TRANSPORT PERSONNEL | 419 | ||
| TRANSPORT EQUIPMENT | 421 | ||
| NEONATAL TRANSPORT PROCESS | 422 | ||
| DOCUMENTATION | 427 | ||
| SAFETY | 428 | ||
| DISASTER PREPARATION | 429 | ||
| AIR TRANSPORT CONSIDERATIONS | 430 | ||
| LEGAL AND ETHICAL CONSIDERATIONS | 430 | ||
| TOTAL QUALITY MANAGEMENT | 431 | ||
| REFERENCES | 432 | ||
| Chapter 22: Care of the ExtremelyLow Birth WeightInfant | 434 | ||
| Objectives | 434 | ||
| Prenatal Considerations | 434 | ||
| Delivery Room Management | 435 | ||
| Admission To The Nicu | 436 | ||
| Parameters Of Clinical Assessment And Nursing Management | 437 | ||
| References | 445 | ||
| Chapter 23: Care of the LatePreterm Infant | 447 | ||
| Objectives | 447 | ||
| References | 452 | ||
| Chapter 24: Respiratory Distress | 453 | ||
| Objectives | 453 | ||
| Lung Development | 453 | ||
| Physiology of Respiration | 455 | ||
| Respiratory Disorders | 455 | ||
| Pulmonary Air Leaks (Pneumomediastinum, Pneumothorax, Pneumopericardium, Pulmonary Interstitial Emphysema) | 475 | ||
| Pulmonary Hypoplasia | 477 | ||
| Pulmonary Hemorrhage | 477 | ||
| Other Causes of Respiratory Distress | 478 | ||
| References | 480 | ||
| Chapter 25: Apnea | 484 | ||
| Objectives | 484 | ||
| Definitions of Apnea | 484 | ||
| Types of Apnea | 484 | ||
| Pathogenesis of Apnea in the Premature Infant | 485 | ||
| Causes of Apnea | 487 | ||
| Evaluation for Apnea | 488 | ||
| Management Techniques | 489 | ||
| Home Monitoring | 491 | ||
| References | 493 | ||
| Chapter 26: Assisted Ventilation | 494 | ||
| Objectives | 494 | ||
| Physiology | 494 | ||
| Treatment Modalities | 499 | ||
| Nursing Care of the Patient Requiring Respiratory Support or Conventional Mechanical Ventilation | 502 | ||
| High-Frequency Ventilation | 505 | ||
| Nursing Care during Therapy | 511 | ||
| Medications Used during Ventilation Therapy | 513 | ||
| Weaning from Conventional Ventilation | 516 | ||
| Interpretation of Blood Gas Values | 517 | ||
| References | 518 | ||
| Chapter 27: ExtracorporealMembraneOxygenation | 521 | ||
| Objectives | 521 | ||
| Ecmo: A Historical Perspective | 521 | ||
| Criteria for Use of Ecmo | 522 | ||
| Venoarterial Perfusion | 522 | ||
| Venovenous Perfusion | 523 | ||
| Circuit Components and Additional Devices | 524 | ||
| Physiology of Extracorporeal Circulation | 526 | ||
| Care of The Infant During Ecmo | 527 | ||
| Post-ECMO Care | 531 | ||
| Parental Support | 531 | ||
| Follow-Up and Outcome | 531 | ||
| References | 532 | ||
| Chapter 28: CardiovascularDisorders | 534 | ||
| Objectives | 534 | ||
| Cardiovascular Embryology and Anatomy | 535 | ||
| Congenital Heart Defects | 542 | ||
| Risk Assessment and Approach to Diagnosis of Cardiac Disease | 544 | ||
| Defects with Increased Pulmonary Blood Flow | 553 | ||
| Obstructive Defects with Pulmonary Venous Congestion | 560 | ||
| Obstructive Defects with Decreased Pulmonary Blood Flow | 562 | ||
| Mixed Defects | 567 | ||
| Congestive Heart Failure | 573 | ||
| Postoperative Cardiac Management | 576 | ||
| Postoperative Disturbances | 578 | ||
| References | 585 | ||
| Chapter 29: Gastrointestinal Disorders | 589 | ||
| Objectives | 589 | ||
| Gastrointestinal Embryonic Development | 589 | ||
| Functions of the Gastrointestinal Tract | 590 | ||
| Assessment of the Gastrointestinal System | 590 | ||
| Abdominal Wall Defects | 595 | ||
| Obstructions of the Gastrointestinal Tract | 599 | ||
| Necrotizing Enterocolitis* | 612 | ||
| Short Bowel Syndrome* | 615 | ||
| Biliary Atresia* | 617 | ||
| Cholestasis* | 618 | ||
| Gastroesophageal Reflux* | 620 | ||
| Multisystem Disorders with Gastrointestinal Involvement* | 623 | ||
| REFERENCES | 635 | ||
| Chapter 30: Endocrine Disorders | 638 | ||
| Objectives | 638 | ||
| The Endocrine System | 638 | ||
| Pituitary Gland Disorders | 640 | ||
| Thyroid Gland Disorders | 641 | ||
| Adrenal Gland Disorders | 649 | ||
| Disorders of Sexual Development | 655 | ||
| Pancreatic Disorders | 662 | ||
| References | 663 | ||
| Chapter 31: Hematologic Disorders | 666 | ||
| Objectives | 666 | ||
| Development of Blood Cells | 666 | ||
| Coagulation | 671 | ||
| Anemia | 672 | ||
| Hemorrhagic Disease of The Newborn | 678 | ||
| Disseminated Intravascular Coagulation | 679 | ||
| Thrombocytopenia | 681 | ||
| Polycythemia | 684 | ||
| Inherited Bleeding Disorders | 685 | ||
| Transfusion Therapies | 686 | ||
| Recombinant Hematopoietic Growth Factors | 690 | ||
| Evaluation by Complete Blood Cell Count | 691 | ||
| References | 691 | ||
| Chapter 32: Immunology and Infectious Disease | 694 | ||
| Objectives | 694 | ||
| Immune System | 695 | ||
| Transmission of Infectious Organisms in the Neonate | 698 | ||
| Diagnosis and Therapy | 699 | ||
| History, Sites, and Types of Neonatal Infection | 706 | ||
| Infection with Specific Pathogens | 708 | ||
| Infection Control | 720 | ||
| References | 722 | ||
| Chapter 33: Renal and Genitourinary Disorders | 724 | ||
| Objectives | 724 | ||
| Embryology | 724 | ||
| Renal Anatomy | 725 | ||
| Renal Hemodynamics | 726 | ||
| Renal Physiology | 726 | ||
| Acute Renal Failure | 728 | ||
| Hypertension | 731 | ||
| Potter Syndrome (Oligohydramnios Syndrome) | 733 | ||
| Autosomal Recessive Polycystic Kidney Disease | 735 | ||
| Multicystic Dysplastic Kidney Disease | 735 | ||
| Hydronephrosis | 736 | ||
| Renal Vein Thrombosis | 738 | ||
| Urinary Tract Infections | 739 | ||
| Patent Urachus | 740 | ||
| Hypospadias | 741 | ||
| Exstrophy of the Bladder | 742 | ||
| Undescended Testicles (Cryptorchidism) | 744 | ||
| Circumcision | 745 | ||
| References | 746 | ||
| Chapter 34: Neurologic Disorders | 748 | ||
| Objectives | 748 | ||
| Anatomy of The Neurologic System* | 748 | ||
| Physiology of the Neurologic System* | 751 | ||
| Neurologic Assessment* | 752 | ||
| Neurologic Disorders | 753 | ||
| Intracranial Hemorrhages | 766 | ||
| Seizures* | 771 | ||
| Hypoxic–Ischemic Encephalopathy* | 774 | ||
| Periventricular Leukomalacia* | 778 | ||
| Meningitis* | 779 | ||
| References | 781 | ||
| Chapter 35: Congenital Anomalies | 782 | ||
| Objectives | 782 | ||
| Specific Disorders | 786 | ||
| Nonchromosomal Abnormalities | 794 | ||
| Deformation Abnormalities | 805 | ||
| Congenital Metabolic Problems | 806 | ||
| Disorders of Metabolism | 807 | ||
| References | 811 | ||
| Chapter 36: Neonatal Dermatology | 813 | ||
| Objectives | 813 | ||
| Anatomy and Physiology of The Skin | 813 | ||
| Care of The Newborn Infant’s Skin | 815 | ||
| Assessment of The Newborn Infant’s Skin | 816 | ||
| Common Skin Lesions | 817 | ||
| References | 830 | ||
| Chapter 37: Ophthalmologic and Auditory Disorders | 832 | ||
| Objectives | 832 | ||
| Anatomy of the Eye (Fig. 37-1) | 832 | ||
| Patient Assessment | 834 | ||
| Pathologic Conditions and Management | 834 | ||
| Anatomy OF the Ear (Fig. 37-3) | 844 | ||
| Innervation | 846 | ||
| Patient Assessment | 847 | ||
| References | 848 | ||
| Chapter 38: Foundations of Neonatal Research | 850 | ||
| Objectives | 850 | ||
| Research and Generation of Nursing Knowledge* | 850 | ||
| Research Process and Components of a Research Study | 851 | ||
| Quantitative Research | 853 | ||
| Qualitative Research | 854 | ||
| Areas of Exploration in Neonatal Nursing | 854 | ||
| Nurses as Consumers of Research | 854 | ||
| Ethics in Research and Nurses as Advocates | 856 | ||
| References | 858 | ||
| Chapter 39: Ethical Issues | 860 | ||
| Objectives | 860 | ||
| Examining Ethical Issues in the Nicu | 860 | ||
| Principles of Biomedical Ethics | 860 | ||
| Other Approaches to Ethical Issues | 862 | ||
| Case Analysis Model | 863 | ||
| The Nurse’s Role in Ethical Issues | 863 | ||
| Consulting the Hospital Ethics Committee | 864 | ||
| References | 864 | ||
| Chapter 40: Legal Issues | 865 | ||
| Objectives | 865 | ||
| Nursing Process | 865 | ||
| Standard of Care | 866 | ||
| Malpractice | 869 | ||
| Liability | 869 | ||
| Advanced Practice | 873 | ||
| Documentation | 874 | ||
| Informed Consent | 877 | ||
| Professional Liability Insurance | 878 | ||
| REFERENCES | 880 | ||
| Newborn Metric Conversion Tables | 882 | ||
| Index | 885 |