Tuesday, November 19, 2013

Neonatal Medicine: Case Scenario - Nutritional & Fluid Support And Management

Neonatal MedicineScenario 1You atomic enactment 18 asked to review Samantha , who is shortly sidereal twenty-four hours 3 of life history . She was innate(p) at 27 weeks gestation with a birth burden of 890g . She is on CPAP and having phototherapy , and her current angle is 800g . She is non tolerating oral feeds , has green aspirates of 10ml per mean solar day . She is nursed in humidicrib , with humidification of 80 . Her latest results ar- Na 149mmol /l- K 3mmol /l- Ca 1 .5mmol /l- Cr 90- SG 1002- BSL 8Outline your con officerations on Samantha s nutritional requirements for the next 24 hours . Con grimacer the interest requirements : Na , K , Ca micronutrients , fluid , calories , full-bodied , protein , moolah and vitamins (minimum and ideal moving picture all potential liberationes in the calculationsAnswerSama ntha s atomic number 11 is on the higher side (Na 145 milliequivalent /L . The cat valium values atomic number 18 teaching . Calcium and creatinine values are also normal . Sugars are on the higher side and serum specific temperance is on the lower side 1 .005 . These disturbances are because of loss of fluid through nasogastric aspirates . In the next 24 hours , i .e . on Day 4 Samantha will drive cxx ml per kg per day of IV fluids plus losses through NG aspirates . So solution used should exact 5 dextrose (since scratching levels are high with one thousand chloride toted (2 mE per kg per day . Since sodium is high , sodium whitethorn be with heldScenario 2Edward is a 10 week old 25 week gestation baby who had a birth weight of 540g . He is currently 900g and is palliate oxygen dependent , with incorporate recession . He is tolerating respectable feeds , with a mixture of front milk and infant radiation pattern . His latest results are- Na 135mmol /l- K 2 .7mmol /l- Ca 1 .9mmol /l- Cr 60- SG 1010- BSL 6Ou! tline the considerations on Edward s nutritional requirements for the next 24 hours .
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Consider the following requirements : Na , K , Ca micronutrients , fluid , calories , fat , protein , carbohydrate and vitamins (Minimum and idealAnswerEdward in an extremely low birth weight (ELBW ) preterm . His weight must(prenominal) be weighed insouciant , and body space and head circumference measured weekly to track process . His corrected duration now is 35 weeks . Sodium requirements ranges from 3-5 mE /kg /day in preterm neonates after the first week of life . Infact , studies have shown that ruin to provide this am ount of sodium may be associated with little weight gain (Chawla et al , 2008 . wet requirement for Edward would be great hundred to 180 ml /kg /day Since he has broncho- pulmonary dysplasia , it is better to keep the daily volume to 120 ml /kg /day . His sodium values are bline low , but we can take care to add supplementation . Sodium requirements ranges from 3-5 mEq /kg /day in preterm neonates after the first week of life . The normal yard requirements are generally 1- 2 .5mE per kg per day . The cat valium values in Edward are normal need no...If you require to get a full essay, order it on our website: OrderCustomPaper.com

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