RNSG 2262 | Pediatrics

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Gestational Issues that Affect the Fetus

There are many complications that may occur during pregnancy and these may have adverse effects on the developing fetus. This program examines a number of these gestational issues including hyperemesis gravidarum, Rh negative disease, diabetes, pregnancy induced hypertension, a range of infections, and uterine complications. Maternal lifestyle issues are also addressed including the impact of recreational drugs, tobacco, and physical trauma. Finally, the program emphasizes the role ultrasound and other prenatal tests play in identifying congenital anomalies.

OBJECTIVES

Upon completion of this series, the learner will be able to:

-Define hyperemesis gravidarum and identify pharmacologic and not pharmacologic interventions.
-Understand how Rh-negative disease develops whether the condition may require admission to the NICU.
-Explain the screening process related to gestational diabetes and discuss the physiologic processes that may result in complications.
-Describe pregnancy induced hypertension and the potential complications that may develop.
-Provide an overview of the range of infections that may present during pregnancy and discuss their symptoms and interventions.
-Discuss the negative impacts of some maternal lifestyle choices including the use of drugs and tobacco.
-Provide an overview of the potential congenital anomalies that may arise in the neonate.

Directed by Sean Harrigan, Jim Harrigan, Narrated by Siobhan Doherty, Produced by Classroom Productions, In Patient Care in the NICU (Cypress, CA: Medcom, 2019)

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Ongoing Care of the Compromised Infant

Neonates who require care in the NICU present unique challenges. This program provides a detailed overview of those challenges. It begins by describing the four major levels of NICU care. Next, specific areas of care are discussed including post resuscitative care, complications of resuscitation, feeding difficulty, and temperature management. The program concludes with a broad view of common pathologies present in the NICU with a focus on neurologic pathologies.

OBJECTIVES

Upon completion of this series, the learner will be able to:

-Differentiate each of the four levels of care.
-Describe post resuscitative care, the need for such intervention and the specific medical responses required.
-Define persistent pulmonary hypertension of the newborn, pneumothorax, acidosis, hypotension and hypoglycemia.
-Explain the complications and subsequent interventions recommended for feeding difficulties in the newborn.
-Provide descriptions of the challenges that may be encountered if the neonate has poor temperature control.
-Identify the common pathologies in the NICU.
-Recognize the major neurologic pathologies that may present in the NICU.
-Discuss the symptoms and treatment for neonatal abstinence syndrome.

Directed by Sean Harrigan, Jim Harrigan, Narrated by Siobhan Doherty, Produced by Classroom Productions, In Patient Care in the NICU (Cypress, CA: Medcom, 2019)

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Pathologies in the NICU

The fourth program in the NICU series presents identification and management of pathologies. It begins with an overview of respiratory pathologies and a discussion of a wide variety of specific challenges. The second area of presented focuses on cardiovascular anomalies. Common cardiac defects seen in the NICU are outlined, highlighting both symptoms and treatment. The program concludes with a discussion of sepsis and gastrointestinal defects.

OBJECTIVES

Upon completion of this series, the learner will be able to:

-Describe the most common respiratory pathologies seen in the NICU including meconium aspiration, persistent pulmonary hypertension and Robin Syndrome.
-Outline the purpose and nature of ECMO (extra corporeal membrane oxygenation).
-Identify a wide range of cardiovascular anomalies, noting the symptoms and treatment.
-Understand the specific characteristics of coarctation of the aorta and tetralogy of fallot.
-Highlight the symptoms and management of sepsis.
-Discuss the range of gastrointestinal defects including omphalocele, gastroschisis and imperforate anus.

Directed by Sean Harrigan, Jim Harrigan, Narrated by Siobhan Doherty, Produced by Classroom Productions, In Patient Care in the NICU (Cypress, CA: Medcom, 2019)

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Death of a Neonate

The neonatal period is between birth and 28 days of life. In the United States, about 19,000 newborns die each year. Healthcare professionals must be prepared to address this loss — both in themselves and in the family connected to the loss. This program addresses this difficult situation. First, decision making issues related to life-saving interventions are addressed with a presentation of the “Code of Ethics for Neonatal Resuscitation.” This is followed by a discussion of how staff can support the family during this difficult time. In the event that the decision to remove of life-support equipment is made, the program examines the challenges and issues. If the family would like their child to die at home, the option of hospice care is presented. The program concludes with a discussion of how important it is that the staff’s needs are also addressed during this challenging time.

OBJECTIVES

Upon completion of this series, the learner will be able to:

-Understand the survival prospects and possible causes of neonatal death.
-Describe the decision-making process involved in life-saving interventions and when such measures should be suspended.
-During the decision-making process, identify the steps that should be taken to provide the family-appropriate support.
-When life-support equipment is removed, provide general and specific approaches that the healthcare professional might take in informing and supporting the parents.
-Discuss the option of hospice care if parents would like to take their child home.
-Recognize the needs of the staff in the event of the death of the neonate.

Directed by Sean Harrigan, Jim Harrigan, Narrated by Siobhan Doherty, Produced by Classroom Productions, In Patient Care in the NICU (Cypress, CA: Medcom, 2019)

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Discharge Planning for the NICU Patient

This program explains that discharge planning for any inpatient actually begins at admission. For the NICU patient, the process is both challenging and complex. Before infants can be discharged, a number of physiologic milestones should be met. This program discusses general guidelines and specific criteria. A wide range of needs are outlined including specialized equipment, nutritional needs, and tracheostomy care. Attention is paid to preparing the family for discharge and teaching specific skills.

OBJECTIVES

Upon completion of this series, the learner will be able to:

-Describe the criteria for discharge including the general guidelines and criteria dictated by the special needs of the baby.
-Identify appropriate measures and equipment employed to address the nutritional needs of some babies released from the NICU.
-Understand how oxygen therapy is employed in specific airway malformations.
-Discuss the major components of the home care plan and which healthcare professionals should participate in its development.
-Outline the major components of parent teaching, beginning with the simple, moving to the complex.
-Highlight the significant respiratory issues that may exist for the baby who is discharged from the NICU.
-Provide an overview of the unique care options that might be available for families with significant patient care needs.

Directed by Sean Harrigan, Jim Harrigan, Narrated by Siobhan Doherty, Produced by Classroom Productions, In Patient Care in the NICU (Cypress, CA: Medcom, 2019)