Neonatal Respiratory distress syndrome reflective practice...

This assignment describes my own reflective experience while caring for a sick neonate with Respiratory Distress Syndrome (RDS) in the neonatal unit. This has enabled me to explore the meaning and significance of my clinical practice and to recognise the complexities within it. The experience raises a number of issues frequently encountered in daily nursing practice. Within this assignment, I will be discussing a particular pre term baby with RDS and critically analyse the use of nasal continuous positive airways pressure (NCPAP) and surfactant therapy and possible effects on baby’s outcome. Pseudonyms will be used to maintain patient confidentiality in order to keep in with the nursing and midwifery council code of conduct. (NMC 2004)The†¦show more content†¦To understand whether the actions carried out was rational or whether it did more harm or good, it is necessary to review the development of RDS in a preterm baby. Neonatal RDS is a condition of increasing respiratory distress commencing at or shortly after birth (BAPM-2006). It’s the single most important cause of morbidity and mortality in preterm infants (Greenough, et al 2004). Typically RDS affects preterm infants with the incidence being inversely proportional to the gestational age (Stewart 2005) Approximately 60% of those born before 28 weeks gestation are affected (Fraser, et al 2004) Incidence also increases in infants of diabetic mothers those born via elective caesarean section (Fraser, et al 2004) and perinatal asphyxia (Rodriguez, 2003). RDS is characterised by tachypnoea, nasal flaring, intercostal and sub costal in drawing with sternal retraction and a predominantly a diaphragmatic breathing pattern and a characteristic expiratory grunt or moan and cyanosis without oxygen, all persisting within 4-6 hours of delivery. Diagnosis can be confirmed by history, blood gases showing impaired respiratory function and an X-ray film showing ground glass appearance and air bronchograms (Fraser, et al 2004) RDS is caused by a defective or delayed production of surfactant in structurally immature lungs. Surfactant is a complex mixture of phospholipids and proteins secreted by the typeShow MoreRelatedRisk Factors For Gestational Diabetes Mellitus1765 Words   |  8 Pageshigher incidence of GDM than non-Hispanic Caucasian women [Ferrara, 2007; Slocum and Burke Sosa, 2002]), obesity (body mass index [BMI] ≠¥25 kg/m2), high pre-pregnancy fasting blood glucose levels, increased maternal age, parity, polycystic ovarian syndrome, sociodemographic and behavioral attributes, previous adverse pregnancy outcomes, and previous GDM (Gunderson, et al., 2007; Perkins, et al., 2007). King (1998) found that in the absence of risk factors, gestational diabetes is rare (0.6%), and