Intervention measures for premature babies, premature babies come to this world in advance, and their body organs are not fully developed, so they are prone to infection, and the higher the probability of various complications, it will also affect their future growth and development. So what are the interventions for premature infants?
Intervention measures for premature infants 1 What exactly is early intervention?
Early intervention refers to organized and purposeful educational activities that enrich the environment. Used for children with abnormal development or possible abnormality before 5-6 years old. Through this measure, it is expected to improve these children's physique, sports, intelligence, language and behavior, or catch up with the development level of normal children.
Early intervention for premature infants is a treatment method with the main purpose of promoting the development of various energy areas of premature infants and avoiding their development risks.
It should be noted that there are two levels of "early stage": First, early intervention should be given to premature infants as soon as possible (before the age of 0-2), because the brain of infants develops fastest and the compensatory ability of brain cells is strongest at the age of 0-2, so early intervention at this stage is the best. The second is to intervene early when the child has not found any abnormality.
How to do early intervention for premature infants?
In fact, early intervention is also a means of preventive medicine, aiming at minimizing the risk of children's development and preventing problems before they happen. Just like why babies should be vaccinated, it is mainly to prevent possible diseases in the future.
What is the main content of early intervention for premature infants?
1, sports training:
According to the characteristics of the disease, the patient's clinical manifestations and functional status, with the help of therapeutic instruments, techniques and the patient's own participation, the treatment method of improving local or overall function and improving physical fitness in an active or passive way. This training is mainly aimed at premature infants aged 0-3 who are backward in sports and have abnormal muscle tone.
2. Fine sports training:
Operation training of upper limb dysfunction and backward hand function caused by abnormal muscle tension of upper limb. This kind of training is mainly aimed at premature infants with fine motor retardation aged 0-3.
3. Sensory training:
By stimulating children's vision, hearing, smell, taste and touch, we can promote the harmonious and effective operation of the body and improve children's communication and learning ability. This training is aimed at premature infants aged 0- 12 years.
4, intelligence training:
Comprehensive training for children with mental retardation includes attention, cognition, language and hand operation ability training. This training is mainly aimed at premature infants from 6 months to 3 years old.
5, collective function class:
Promote the development of all energy areas of premature infants through physical movement, fine movements, language, cognition, social ability and parent-child relationship. This course is mainly aimed at premature infants from 6 months to 6 years old.
Interventions for premature infants 2 Main nursing measures for premature infants:
Main nursing problems:
1, ineffective thermoregulation is related to poor thermoregulation function, less heat production and more heat dissipation.
2. Failure to maintain spontaneous breathing is related to the immature development of respiratory center and respiratory organs.
3. Dysphagia is related to poor sucking, swallowing, digestion and absorption functions.
4. The risk of infection is related to immature immune system.
Main nursing measures:
(1) Immediately after birth, put the child on the preheated radiotherapy table, remove the mucus in the mouth and nose in time, and keep the respiratory tract unobstructed.
(2) Put the baby in an incubator, keeping the room temperature at 24℃-26℃ and the relative humidity at 55%-65%. Measure your body temperature every 4 hours and keep it at 36.5-37.5℃.
(3) Observation of illness: Closely observe the changes of children's complexion, breathing and heart rate. Pay attention to the occurrence of scleredema and report to the doctor in time if any abnormality is found.
(4) Maintain effective breathing: raise the shoulder about 2-3cm, and the bedside 15-30 to keep the respiratory tract unobstructed. If apnea or hypopnea occurs, immediately stimulate the soles of the feet and hold the back to stimulate breathing, and promptly report to the doctor and record.
(5) Feeding by special personnel. After feeding, tilt your head to one side to prevent vomiting. Weigh yourself 1 time every day, and accurately record the 24-hour urine volume and stool frequency.
(6) Prevention of infection: Strictly implement the protective isolation system and strengthen hand hygiene. Strengthen the care of the mouth, navel, buttocks and skin, give head braking and reduce children's activities.
Intervention measures for premature infants 3 What special care do premature infants need?
First, keep warm.
The suitable room temperature for premature infants is 24 ~ 28℃ and the relative humidity is about 60%. The body temperature should be kept at 36.5 ~ 37℃, and those with low body weight below 2000g should be kept warm in a warm box. If you don't have an incubator, you can use a hot water bottle, a salt water bottle, a burnt brick, etc. Before using the incubator, it must be electrified and preheated. Generally, it takes about 2 hours to stabilize the temperature of the incubator, and the newborn can be put in after the temperature of the incubator is stabilized.
The temperature in the box is adjusted according to birth weight, body temperature, birth days and vitality. All nursing operations should be carried out in a warm box, and the body temperature should be measured every 4 to 6 hours, and the temperature and humidity of the box should be paid attention to. When the weight increases to more than 2000g, the body temperature is stable, and the feeding and general conditions are good, you can consider moving out of the incubator, but you should still closely observe and pay attention to the general conditions such as body temperature, weight gain, sucking and breastfeeding.
Second, oxygen supply.
Premature babies are prone to irregular breathing, and small babies have a history of intrauterine asphyxia. Therefore, it is very important to keep the respiratory tract unobstructed and give oxygen inhalation after birth. Intermittent oxygen supply is suitable for relieving cyanosis, and oxygen inhalation is not needed for a long time, preferably no more than 3 days. Oxygen concentration should be controlled at 30 ~ 40%, and arterial oxygen partial pressure should be maintained at 50 ~ 80 mmhg.
Premature infants with cyanosis during breastfeeding can take oxygen for a few minutes before feeding. Premature infants below 1000g, if the oxygen concentration is as high as 50 ~ 60%, will easily lead to posterior lens fibrosis and chronic bronchopulmonary dysplasia; Excessive oxygen can accelerate the destruction of red blood cells and aggravate jaundice and anemia, which should be paid attention to.
Third, feeding
In order to prevent hypoglycemia, early feeding is advocated. Generally, feed sugar water 4 hours after birth, and start breastfeeding according to the sucking ability 6 ~ 8 hours after birth. Those who are weak can be given intravenous drip 10% glucose solution first. Breast milk is the most ideal dairy product for low birth weight infants. If the sucking power is good, breast milk can be directly fed or bottle fed.
If the sucking force is poor and swallowing is good, you can feed it with a dropper or spoon; If it is difficult to swallow, you can use a stomach tube made of soft silica gel or insert it into the jejunum to feed it once every 1 1/2 ~ 3 hours according to your personal situation. Breast-feeding people don't have to calculate the amount of milk rigidly, so that children can sleep quietly after breast-feeding every time and get a satisfactory weight.
If there is no breast milk, you can feed milk with the concentration of1:1or 2:1. The daily milk intake varies greatly from individual to individual, and should not be forcibly unified. The standard is to gain weight. Milk intake can be roughly estimated as: 40ml/kg of body weight the next day, 80ml/kg on the third day, 120ml/kg on the fourth day, 150ml/kg on the fifth day, and then increase by 10ml/kg every day until the day after 10.
Fourth, supplement vitamins.
From the first day after birth, vitamin K 1 and 1 ~ 3 mg were injected intramuscularly every day for 3 days to prevent bleeding, and then vitamin C 50 ~ 100 mg was taken orally every day. Vitamin D 400 ~ 600 IU was given daily from the second week.
In order to prevent hemolytic anemia caused by vitamin E deficiency in premature infants, vitamin E50mg can be injected intramuscularly on the second day after birth, or vitamin E 10 ~ 20 mg/d can be supplemented on the10 day after birth. For very low birth weight infants, the oral dose can be increased to 20 ~ 30 mg/kg/d for 2 ~ 3 months.
Five, correct hypoglycemia and acidosis
Anyone who is suspected of hypoglycemia should be given 2 ~ 4 ml/kg of 25% glucose solution as soon as possible, and then given 10mg/kg of glucose solution at a rate of 10% per minute, and the blood sugar should be maintained for 24 hours before oral administration. If acidosis still exists 4 hours after birth, 5ml/kg of 5% sodium bicarbonate and 10% glucose solution can be used after intravenous dilution.
Intransitive verbs to prevent infection
The premature room and bedstead should be disinfected and cleaned. Medical staff must strictly abide by the aseptic system, and anyone suffering from influenza, skin infection, diarrhea or carrier must be temporarily transferred from this room. If patients with suspicious infectious diseases are found, they should be isolated as soon as possible to prevent cross-infection. The use of antibiotics as a means to prevent infection is generally discouraged.