Hypothermia occurs when a body's temperature drops below 36.5 degrees Celsius. The document discusses risk factors for hypothermia in newborns such as prematurity, low birth weight, and improper care immediately after birth. It outlines signs of hypothermia like cold feet and weak crying. If left untreated, hypothermia can cause complications including death. The nurse's role is to prevent heat loss and maintain normal body temperature through immediate drying, skin-to-skin contact with the mother, and covering with blankets.
2. Hypothermia occurs when the body
temperature drops below 36.5degree
Celsius (97.7 degree F), the lower
limit of normal range of 36.5 - 37.5
degree Celsius (97.8-99.5 degree
Fahrenheit).
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3. Distribution and incidence
Neonatal cold injury occurs throughout
the world, even in warm climates. In one
hospital during an 8-year study in
Ethiopia, 67% of low birth weight and
high-risk infants admitted to a special
care unit from outside were hypothermic.
In a large series of births in the provinces
in China the incidence of sclerema was 6.7
per thousand. High - risk factors were
prematurity and low birth weight
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4. General Risk Factors
> Incorrect care of the baby immediately after
birth.
> Separation of mother from baby after birth.
> The weight and gestational age of the infant.
> The place of the delivery and environmental
conditions.
> Inadequate warming procedures before and
during transport of the infant.
> Asphyxia, hypoxia, other illness of the baby,
> Inadequate warming procedure during
resuscitation.www.drjayeshpatidar.blogspot.in
5. Signs of Hypothermia
Early clinical signs which should arouse
suspicion of cold stress due to hypothermia
are:
(1) The feet are cold to the touch and
become cold before the body is cold;
(2) Weak sucking ability.
(3) Reduction in activity-lethargy; and
(4) A weak cry.
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6. If hypothermia persists:
(1) there is a risk of neonatal cold injury
(2) the infant usually becomes lethargic, with
slow, shallow and irregular respiration and a
slow heart rate (bradycardia) corresponding
to the degree of fall in body temperature.
(3)Hypoglycemia and metabolic acidosis may
develop.
(4) There is a real risk of death
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7. (5) The face and extremities may have a
bright red color while the rest of body
is pale; central cyanosis may be present.
(6) Sclerema, a hardening of the skin,
associated with reddening and edema is
seen mainly on the back and the limbs
but may cover the whole body.
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8. Loss of Heat
There are four ways a newborn may
lose heat to the environment:-
(1) Radiation
(2) Convection
(3) Conduction
(4) Evaporation
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9. Role of a Nurse
An important objective of appropriate
care of the newborn is to avoid
hypothermia from the moment of
birth, by using procedures that will
prevent heat loss and maintain the
temperature within the normal
range, thus conserving the infant’s
energy for growth and development.
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10. Hypothermia can be prevented by
(1) drying the infant immediately after
birth,
(2) placing indirect skin-to-skin contact
with mother,
(3) Covering both (mother & baby) with
heavy and clean blanket.
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11. warm chain
The “warm chain” is a concept
introduced to describe a set of interlinked
procedures, which will minimize the
likelihood of hypothermia. Failure to
implement any one of them will break the
chain and increase the possibility of
undesirable cooling of the infant.
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12. The link in the “warm chain” includes:
(1) Warm delivery room
(2) Immediate drying
(3) Skin-to-skin contact
(4) Breast-feeding
(5) Postpone bathing and weighing of the
newborn
(6) Appropriate clothing and bedding
(7) Keeping mother and baby together
(8) Warm resuscitation
(9) Training and awareness
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13. Conclusion
If all newborn infants, including preterm and small
infants are carefully dried and given to their mother in
skin-to-skin contact immediately after delivery, the risk
of hypothermia is greatly reduced.
There is sufficient evidences to conclude that
immediate post delivery hypothermia is harmful to
newborn, increasing the risk of morbidity and
mortality.
The information presented here provides a basis from
which managers and health care providers can develop
their own plans and procedures for the prevention and
management of hypothermia in the newborn
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