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*,*,*,*,*,*,*,*,*,*,*,*,*,*,*,*,*,*,*,*,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 classification of gestational age,F,ull-term infant,：37足周胎龄42足周,P,re-term infant,：28足周胎龄37足周,P,ost-term infant,：胎龄42足周,According to the classification of birth weight,1.,N,ormal weight infant,：,2500gBW4000g,2.,L,ow birth weight infant,：,BW2500g的新生儿,3.,V,ery low birth weight infant,:,BW1500g的新生儿,4.E,xtremely low birth weight infant,:,BW1000g的新生儿,5,.,G,iant infant,：BW4000g的新生儿,According to the classification of birth weight,According to the relationship between birth weight and gestational age,1.,A,ppropriate for gestational age,第10百分位体重第90百分位,2.,S,mall for gestational age,出生体重第10百分位,3.,L,arge for gestational age,出生体重第90百分位,Appearance,characteristics,Physiological,characteristics,The characteristics of preterm infants,The appearance of premature infants,Normal newborns,Premature babies,Grying,响亮,低弱,Muscle tension,良好,低下,The skin,红润、皮下脂肪丰满,红嫩、皮下脂肪少,Hair,毳毛少、头发分条清楚,毳毛多、头发细而乱,Auricular,软骨发育良好,耳舟成形,软、缺乏软骨,耳舟不清楚,The appearance of premature infants,Normal newborns,Premature babies,Nails,达到或超过指、趾端,未达指、趾端,Mammary gland,乳晕清楚、结节,4mm,乳晕不清、无结节,或结节,4mm,Plantar-print,整个足底遍及足纹,足底纹少,Genitals,男婴睾丸已降至阴囊,女婴大阴唇盖小阴唇,男婴睾丸未降或未全降,大阴唇不能遮盖小阴唇,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 babies,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,乳腺结节,4mm,，平均,7mm,乳腺无结节或结节,4mm,Premature babies,Full moon,Plantar-print,早产儿,跖纹少,跖纹遍及整个足底,Premature babies,Full moon,Auricular,耳软骨发育好,耳舟成形、直挺,耳软骨发育不良,耳舟不清,早产儿,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. 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 atelectasis,Circulatory system:,heart rate, blood pressure was lower than those of full 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 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 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,swollen, 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 easy,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 tumor, endometritis, and cervix relaxation;Pelvis and spinal deformities,2. Pregnancy-induced hypertension syndrome:,3. Chronic diseases such as :heart disease, kidney disease, nephritis, liver disease,sugar Urinary disease, endocrine disorders, severe pulmonary tuberculosis,4. Anemia and severe hemolytic disease;Acute infectious diseases accompanied by,high fever acute or chronic poisoning;,5. Intense emotional fluctuations, or strain,6. Accidental injury or surgery.,7. Bad habits and hobby,Fetal placental factors：,1. The twins or fetal abnormalities,2. Early rupture or placenta previa, placenta early stripping,3. 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 problems,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 care,1),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 32,1.0,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 volume and time interval,出生体重（,g,）,1000,1000-1499,1500-1999,2000- 2499,开始量,（ml）,1-2,3-4,5-10,10-15,每天隔次增加量,（,ml,）,1,2,5-10,10-15,母乳间隔时（h）,1,2,2-3,3,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!,
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