I need help

Specialties NICU

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Specializes in Labor and Delivery.

I am trying to interpret some labs for a care plan in nicu....PO2 levels are increased, has been on non-invasive ventilator...all other abg levels are within normal range ...why is this? is it because the baby is hyperventilating...help

thanks

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Specializes in Maternal - Child Health.
I am trying to interpret some labs for a care plan in nicu....PO2 levels are increased, has been on non-invasive ventilator...all other abg levels are within normal range ...why is this? is it because the baby is hyperventilating...help

thanks

It would be easier to answer your question if we knew a little more about the patient. What is the baby's gestation and history? For example, is s/he a 32 week preemie, now 4 days old, or a full-term meconium aspiration who has been weaned from the ventilator at 7 days of life?

By non-invasive ventilator, do you mean nasal CPAP? If so, what are the baby's settings: How many mmHG for the CPAP, and what is the FiO2? If the baby is intubated and on a vent, what are those settings, including rate, Pmax/PEEP, and FiO2?

If a baby's pO2 is higher than desired, that generally means that either the FiO2 or CPAP (PEEP) should be decreased. Exposing the baby to excessively high levels of O2 and pressure places him/her at greater risk for lung injury and/or retinopathy of prematurity, so some type of continuous pO2 or O2sat monitoring is indicated.

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Specializes in neonatal, pediatric and hospice.

No, your baby is not hyperventilating. If he/she did so, then you would get a low PCO2. Hyperventilating=washig-out CO2. A low Pco2 can cause brain damage.

In your scenario PO2 is high, so decrease FIO2 given via nCPAP or oxihood. Or decrease PEEP on the nCPAP if FIO2 is 21%. Hope this helps

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Specializes in Labor and Delivery.

Thank you all soooo much it makes more sense to me now...The baby had RDS... and is also on gent and ampicillan do they give that to them prophylactically???? i am just a student and still learning...

Thank you.....

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Specializes in Maternal - Child Health.
Thank you all soooo much it makes more sense to me now...The baby had RDS... and is also on gent and ampicillan do they give that to them prophylactically???? i am just a student and still learning...

Thank you.....

Generally speaking, yes. A baby with RDS is most likely a preemie. And since most cases of prematurity never have an identified cause, it is always prudent to rule out infection. So, these babies get a septic work-up at admission and are started on broad-spectrum antibiotics. After 3 days, if all cultures are negative and the baby shows no clinical signs of infection, then the antibiotics will be discontinued.

Also, the invasive procedures these babies are subjected to increase their risk for infection (intubation, placement of lines, IV sticks and blood draws, etc.). Prophylactic use of antibiotics may help to decrease the risk of infection secondary to these procedures, but meticulous handwashing and sterile technique must always be used!

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Specializes in Labor and Delivery.

THANK YOU, THANK YOU SOOOO MUCH IT IS SOOO MUCH MORE CLEARER NOW.... THIS NEONATE IS ALSO SEPTIC...THE BABY IS ON CAFFIENE I KNOW WHY IT IS USED BUT NEED TO FIND OUT SOME DRUG INFORMATION ON IT...IF YOU HAVE ANY GOOD WEBSITES, FOR INSTANCE USUAL DOSAGE. SIDE EFFECTS AND SO ON THANK YOU THANK YOU THANK YOU......

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Specializes in NICU/Neonatal transport.

I would recommend Lexi-Comp's drug book - that's what we use in my school

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Specializes in Maternal - Child Health.

It is difficult to find on-line drug references for peds. If anyone knows of a good site, please post it!

Go to Google and type in: "Caffeine therapy for neonates" and "Neonatal Ampicillin". I was able to pull up some research articles that gave dosages and indications.

If you have access to the Harriet Lane Handbook, it is also a good reference.

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