Dehydration fever in newborn

Midwifery-II, minor problems of newborn . Dehydration Fever in newborn, its cause, prevention and management

1. Review 1

2. 2 Guess Today’s topic Hint:- Combination of the following pictures Dehydration fever

3. Midwifery II Dehydration fever BY:- Monika rijal

4. General objective Dehydration fever 4 At the end of the session, B. S c nursing 3 rd year students will be able to explain on dehydration fever.

5. Specific objectives Dehydration fever 5 Introduce dehydration fever Define dehydration fever State the causes of dehydration fever Explain the pathophysiology of dehydration fever List its symptoms Describe its diagnostic evaluations Explain the management of dehydration fever

6. 6 Breast milk is the main nutrient for the growth and development of the infant. Normal neonatal feeding is advocated on demand every 2 hours. The World Health Organization recommends, all infants should be exclusively breastfed for the first 6 months of life. Introduction Dehydration fever

7. Continue Dehydration fever 7 Physiological weight loss in first few days of life is normal. But if the weight loss is more than 10% of the birth weight, most of the times it is associated with breast feeding failure. Dramatic weight loss and dehydration with an increase in serum sodium (Na) concentration related to the insufficient breast milk intake may be observed mostly on the initial days of the infant

8. Definition:- Dehydration fever 8 Dehydration fever is a condition seen in first few days of neonates due to loss of body fluids and inadequate replacement through oral feeding. This leads to ineffective thermoregulation in a neonate’s body resulting in low grade fever to pyrexia.

9. Dehydration fever 9 Causes Chart Options

10. Pathophysiology 10 Dehydration fever

11. Image SLide 11 Dehydration fever Fig:- Body fluid compartments of different age groups

12. Dehydration fever 12 Symptoms Dry oral mucosa Fatigue Tachypnea Lethargy

13. Dehydration fever 13 Symptoms Weight loss greater than 10% of body weight Low urine output

14. Dehydration fever 14 Symptoms Depressed fontanel.

15. Dehydration fever 15 Symptoms Sunken Eyes

16. Dehydration fever 16 Symptoms Decreased skin turgor

17. Dehydration fever 17 Symptoms Temperature rises up to 100-101 F. Rise in temperature are seen on 3 rd to 4 th day of life Tachycardia Irritability Rehydration leads to lysis of fever

18. Diagnosis:- Dehydration fever 18 History Taking:- Birth history, date and time and weight at birth is important in determining dehydration fever. Check maternal health history

19. Physical examination:- Dehydration fever 19 Measurement of temperature, pulse and respiration gives most of the answers Weight comparisons to that of during birth helps to determine the weight loss Check for signs of dehydration. Check if the clothing of baby is appropriate or not.

20. Management:- Dehydration fever 20 Goals of managing dehydration fever are:- Rehydration and proper feeding completely resolves the conditions. Maintaining a thermally safe environment is also important

21. Nursing management:- Dehydration fever 21 Assessment:- Assess the temperature, pulse and respiration of the baby Assess the birth history Assess the Maternal health history

22. Assessment Dehydration fever 22 Assess the mammary gland of mother for infections, inadequate lactogenesis Assess the clothing of the child Assess the surrounding environment for possible hazards that cause fluid loss Assess the breastfeeding technique of mother

23. Nursing Diagnosis:- Dehydration fever 23 Hyperthermia related to fluid volume depletion as evidenced by elevated temperature 100 F Ineffective breastfeeding related to poor knowledge of mother regarding breastfeeding technique as evidenced by improper holding of baby

24. Cont… Dehydration fever 24 Deficient fluid volume related to physiological fluid loss and relatively inadequate intake as evidenced by dry lips Impaired urinary elimination related to fluid volume depletion as evidenced by low urine output

25. Cont… Dehydration fever 25 Imbalanced energy field related to excessive irritability and restlessness as evidenced by lethargy Risk for electrolyte imbalance related to low extracellular fluid volume

26. Cont… Dehydration fever 26 Risk for ineffective peripheral tissue perfusion related to depletion of intravascular volume Risk for dry mouth related to dehydration

27. Nursing Intervention Dehydration fever 27 For hyperthermia:- Rehydration with breast milk is the best way to subside the hyperthermic state Extra clothing , that causes sweating should be removed The child should not be kept near fire or in sun for a longer period of time

28. Cont… Dehydration fever 28 Sponge bath with luke warm water helps to maintain the temperature within normal range Maintain humidity. Put on light clothes on newborn Monitor temperature every 4 hourly and more frequently if required.

29. To maintain effective Breastfeeding:- Dehydration fever 29 Provide adequate knowledge Encourage feeding on demand.

30. For volume maintenance:- Dehydration fever 30 Monitor Intake and output of the child strictly Watch for concentrated urine and other sign that indicates dehydration Monitor body weight and nutritional status of the child Watch for depressed fontanel and sunken eyes or change in skin texture that indicates worsening in the condition.

31. .To eliminate the risk of electrolyte imbalance:- Dehydration fever 31 One main complication could be hyponatrimia , routine blood examination for sodium level and potassium level is important

32. Dehydration fever 32

33. Assignment:- Dehydration fever 33 Write fluid requirement in newborn

34. References:- Dehydration fever 34 TuiTui , R. (2007). Manual of Midwifery III, (4 th ed.). Kathmandu, Nepal: Vidyarthi Pustak Bhandar ( pg ). Sherpa, M. (2074). Essential textbook of Midwifery Nursing part-III. Kathmandu, Nepal: Samiksha publication pvt.ltd , ( pg ). Hassan, M. , Ardash E . ( jan 10, 2019 ). Clinical profile of dehydration fever in neonates. Name of journal. http://dx.doi.org/10.18203/2349-3291.ijcp20190716

35. Dehydration fever 35 R E APPLETON and C K Foo Child Health Unit,Princess Mary Maternity Hospital, Dehydration fever in the neonate-a common phenomenon? A case report. https :// www.ncbi.nlm.nih.gov / pmc /articles/PMC1792028/ pdf /archdisch00674-0129b.pdf MD, Koyfman,nov 12, 2018, Pediatric Dehydration, https://emedicine.medscape.com/article/801012-clinical The Editors of Encyclopaedia Britannica,December 7 , 2017,Dehydration, https://www.britannica.com/science/dehydration-physiology

36. THANK YOU Monika Rijal BNS 2 nd year CMC WOODGROVE BANK