• Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

HIGH DEPENDENCY CARE OF THE NEW BORN. The following discussion will analyse the care of a baby who I have recently looked after in the high dependency who developed necrotising entero colitis(NEC) and consequently had to be re admitted to the NICU.

Extracts from this document...


HIGH DEPENDENCY CARE OF THE NEW BORN (CASE HISTORY) PREDISPOSING CAUSES OF NECROTISING ENTEROCOLITIS Registration NO: 100252125 Module NO : SNM3115 Unit Leader : Angela Thurlby Word Count : 2022 The following discussion will analyse the care of a baby who I have recently looked after in the high dependency who developed necrotising entero colitis(NEC) and consequently had to be re admitted to the NICU. According to Sankaran (2004) NEC is an inflammatory disease of the bowel, predominantly affecting premature infants but it sometimes occurs in 'cohorts'. Whilst caring for the baby he became ill with a profound bradycardia and on turning him over he looked pale, cyanosed with a mottled skin and distended abdomen. He weighed only 1050g, and had previously been moved from ITU to high dependency because he was tolerating full feeds of expressed breast milk (EBM). According to Boxwell (2010) NEC is characterised by transmural intestinal inflammation, ischaemia, necrosis and sometimes perforation which affects one to eight per cent of infants admitted to NICU. As a result of his condition the baby was transferred back to intensive care unit for close observation and further investigation. He had been born at 24 weeks +5 days gestation with a birth weight of 590g but was now 42 days old. ...read more.


Furthermore, McComark (2000) states that ''exchange transfusions can be implicated because it can cause fluctuating mesenteric blood flow''. The baby in this case had a blood transfusion. Boyd (2000) points out that NEC and bowel perforation are common if the UAC is positioned at T7 and T8 due to occlusion of the superior mesenteric orifice. Visceral blood flow may be disturbed and cause bowel injury if high UACs are left in situ for more than one week. "Part of the management of NEC should include removal of UAC if in situ" (McCormick 2000). The baby in this case had a UAC in situ at some point and also had a small PDA. Boxwell (2010) states that blood flow to the gut are compromised by left to right shunting through a PDA. According to Kliegman and Walsh (1992) even if no single organism is consistently associated with NEC, the blood cultures may be positive in more than a quarter of cases. Crawford and Hickson (2002) state that the gas producing bacteria which normally reside in the intestine enters through the damaged intestinal mucosa, and the formula milk if started acts as a food source for the bacteria enhancing the bacterial proliferation. Kleigman et al (1992) states that isolated bacteria are often members of the normal gut flora. ...read more.


The baby in this case was treated conservatively with antibiotics and resumed his feeding slowly with EBM and eventually recovered without surgery and was eventually transferred back to the special care baby unit. He slowly gained weight and managed on demand breast feeding. The parents were very happy about his progress and their trust and confidence was restored as they were prepared to take him home. Sometimes parents feel overwhelmed when speaking to a doctor but generally feel more comfortable to talk about their baby with a nurse. It is also a part of the neonatal nurses' role to recognise the parents requiring emotional, financial or psychological support. From this experience of nursing a baby with NEC I have learnt about the importance of close observation of the babies, in order to recognise the signs and symptoms early. The benefits of breast milk in treatment and the responsibility of nursing staff to ensure that parents are aware of these benefits were also highlighted to me. I feel confident caring in such cases, and have better understanding of NEC, its signs and symptoms, predisposing factors, preventive measures and treatment. I hope that this will enable me to improve my practice and be able to share information with the parents and with new staff who have less experience in nursing infants. ...read more.

The above preview is unformatted text

This student written piece of work is one of many that can be found in our University Degree Nursing section.

Found what you're looking for?

  • Start learning 29% faster today
  • 150,000+ documents available
  • Just £6.99 a month

Not the one? Search for your essay title...
  • Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

See related essaysSee related essays

Related University Degree Nursing essays

  1. This essay will reflect on my first clinical experience during my placement.. Kelvin ...

    both apprehensive about what to expect from each other but I was aware that time was needed to build up a trusting nurse/patient relationship. The best way to build up such relationship is through communication and also listens actively. When I arrived in the patient's room with my mentor, my

  2. HOSPITAL CASE ANALYSIS. This case study takes place at a hospital and is based ...

    no control * N- may not have enough nurses for one floor and too many for another * N- over time people could change their mind causing more problems Training Workshops * P- uniform idea of how the jobs are to be done * P- helps to identify and solve

  1. A case study of a 68 year old patient admitted to undego a bowel ...

    An informed patient is better equipped to make decisions about their care and therefore he will also have received information booklets to enhance his learning (Alexander et al, 2006). The stoma nurse will also look at other practical issues regarding Mr Jones stoma such as the position in which it will lie.

  2. nursing care for older person

    This made her distressed. She never complained about the care delivered on her husband. Whenever she felt things were not done the way she wanted them, she tend to do it herself and often called for assistance. Caring for an older person with mental health problem is more stressful then

  1. Aspect of Care Essay: The Post-Operative Care Following a Hysterectomy and Bilateral Salpingo-oophorectomy.

    and nutrition risk score. Nursing models, like RLT, show relationships between concepts of nursing and provide a framework to explain nursing activities (Roper el al, 1996). Many nursing models assert holistic care principles and moves nursing practice away from a biomedical focus to one that is focused on all factors affecting an individual's health

  2. In this assignment I will reflect upon a neurological assessment I carried out of ...

    Considering it was her first experience of the hospital environment in addition to the impact of her accident, Anna was probably deeply frightened and traumatised by the whole experience and I did not wish to exacerbate her fear and distress.

  1. Ulcerative colitis. The young gentleman I took part in his care had an ...

    In several situations, this condition is always not just limited to pathological changes in the co0lon but also involves systematic degenerations of other parts of the body that involve joints hence resulting in migratory arthritis, ankylosing spondylitis and even sacroileitis (Jill 2008, pg 45).

  2. The focus of this assignment will be on a case scenario of an elderly ...

    A minor injury to this vulnerable area can be very difficult to heal and is classed as a venous ulcer, usually occurring on the lower leg (Porth 2002). Venous leg ulcers are the most common type of leg ulcer; about 100,000 people in the United Kingdom have leg ulcers (Briggs and Closs 2003).

  • Over 160,000 pieces
    of student written work
  • Annotated by
    experienced teachers
  • Ideas and feedback to
    improve your own work