Nursing Interventions for Low Birth Weight Babies

Definition

Low Birth Weight “as one whose birth weight is less than 2500gm irrespective of the gestational age”.
Very low birth infants weight 1500gm or less and
Extremely-low birth infant weight 1000gm or less.

1. Altered breathing pattern dyspnea related to poor lung maturity secondary to respiratory distress.
  • Baby should be positioned with neck slightly extended.
  • Tackling stimulation by sole flaring can be provided to stimulate respiratory effort
  • Do gentle suctioning to remove the secretion,
  • Concentration of oxygen to be maintained to have saO2 between 90 and 95% and paO2 between 60 and 80 mm of Hg.
  • Baby’s respiration rate, rhythm, signs of distress, chest retraction, nasal flaring, apnea, cyanosis, oxygen, saturation, etc. to be monitored at frequent interval.
  • Chest physiotherapy by percussion, vibration and postural drainage may be needed to loosen and remove respiratory secretion.
2. Altered body temperature hypothermia related to immature thermoregulation centre secondary to less subcutaneous fat.
  • Baby should be received in a pre warmed radiant warmer or incubator.
  • Environmental temperature should be maintained according to baby’s weight and age.
  • Alternatively the baby should be managed under radiant warmer with protective plastic cover.
  • The baby as to be placed naked in the warmer
  • The baby cot should be kept warm.
  • Kangaroo mother care can be provided when the baby’s condition stabilized.
  • Baby should be clothed with frock, cap, socks, and mittens while giving kangaroo care.
3. Altered nutrition less than body requirement related to poor sucking reflex.
  • If baby is able to suck encourage breast milk.
  • If baby is unable to suck provide expressed breast milk with help of paladai.
  • If aspiration is evident then give through NG tube.
  • Early enteral feeding should be started as soon as the baby is stable.
  • Monitor the weight of the child every day until baby become stable.
  • Administer 10% glucose through IV.
4. Fluid volume deficit hypovolumia related to poor intake.
  • Administer IV fluids according to the weight of the baby.
  • Monitor I/O chart.
  • Check body temperature to note the way of insensible water loss.
  • Encourage breast feed and increase the frequency of breast feeding.
  • Administer injection vitamin k to prevent blood loss due to hemorrhagic diseases.
  • Provide 15 to 20 ml extra fluids when the child under warmer and phototherapy.
5. High risk for infection related to poor immunity.
  • The baby should be observed for respiration, skin temperature, heart rate and skin color, activity, feeding bahaviour, passage of meconium or stool and urine, condition of umbilical cord, eyes and oral cavity
  • Any abnormal signs like edema, bleeding, vomiting should be noted,
  • Lab values (CRP), biochemical and electronic monitoring should be done.
  • One person as to handle the baby.
  • Wash hand before touching each sick baby.
  • Restrict number of visitors.
  • If baby is not too sick vaccine can be given as like healthy baby.

Source : http://pediabind.blogspot.com/2012/03/nursing-care-of-low-birth-weight-babies.html

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