Angeles University Foundation Angeles City

T/C NEONATAL SEPSIS

Presented to: Joy Del in !N" #N

Presented $y: Pia $aluyut S%elley Cayanan Lyle Ariane #ariano #ervin Tua&on $SNI'() *!OUP +,

INTRODUCTION Ne-.orns are sus/e0ti.le to in e/tion .e/ause o t%eir underdevelo0ed i11une syste12 Neonatal se0sis also 3no-n as Neonatal Se0ti/e1ia or Se0sis Neonatoru1 is an in e/tion in t%e .lood t%at s0reads t%roug%out t%e .ody and o//urs o a neonate t%at 3ills )"444 ne-ly .orn .a.ies ea/% year .ased on P%ili00ine e50erien/e2 T%e disease /an .e /lassi ied as: /ongenital" early(onset and late(onset2 Congenital neonatal se0sis is -%en t%e /%ild is in e/ted during 0regnan/y .e ore .irt%2 T%e .a.y /an .e in e/ted .y virus t%roug% 0la/enta or .irt% /anal2 6I' 76u1an I11unode i/ien/y 'irus8" sy0%ilis is so1e o t%e viruses t%at /an in e/t t%e /%ild .e ore delivery2 Early( onset neonatal se0sis is -%en t%e in ant is in e/ted" -%ile ta3ing .irt% or soon a ter t%e delivery2 *rou0 $ stre0to/o//us 7*$S8 and Es/%eri/%ia /oli 7E2 /oli8 are /onsidered as /%ie viruses t%at in e/t t%e .a.y" -%ile .irt%2 Early(onset neonatal se0sis is a result o asy10to1ati/ /oloni&ation in t%e intestinal or genital tra/t o t%e 1ot%er2 Coloni&ation is e5isten/e o .a/teria9s/viruses in a .ody 0art2 An in ant is said to .e a e/ted .y late( onset neonatal se0sis" -%en it is in e/ted a e- days a ter delivery2 T%is in e/tion /an .e due to t%e organis1s 0resent in t%e environ1ent o t%e %os0ital2 A ter getting dis/%arged ro1 %os0ital" .a.ies /an get in e/ted due to t%e .a/teria9s 0resent in t%e environ1ent at %o1e2 *$S and E2 /oli are also res0onsi.le or late(onset neonatal se0sis2 Sy10to1s o early(onset neonatal se0sis are o.served 1ostly -it%in ,: %ours o delivery" -%ile t%at o late(onset neonatal se0sis /an .e o.served .et-een )t%();t% days o delivery2 Sy10to1s o.served in in ants su ering ro1 neonatal se0sis are unsta.le .ody te10erature" una.le to su/3 .reast 1il3 0ro0erly" a0nea" ever in rare /ases" vo1iting and diarr%ea" res0iratory distress" redu/ed %eart rate" <aundi/e" .elly area 1ay .e s-ollen2 =6O as o ,44;" an esti1ated ),"444 /%ildren die every year .e ore t%eir i t% .irt%day in t%e P%ili00ines2 6al o t%ese deat%s are related to /o11on in e/tious diseases su/% as diarr%ea" 0neu1onia" neonatal se0sis and 1easles2 In a/t" %al o neonatal deat%s o//ur during t%e irst t-o days o li e2 Progress to /urtail neonatal deat%s is 1isera.le" -it% deat% rates a1ong t%is age grou0 s%o-ing only t%e .arest de/line over t%e 0ast ,4 years2 Current Issues and Trends in Neonatal Sepsis

#il3 Protein Su00le1ent #ay 6el0 Prevent Se0sis In 'ery Lo- $irt%(=eig%t In ants S/ien/eDaily 7O/t2 )" ,44;8 > 'ery lo- .irt%(-eig%t ne-.orns -%o re/eived t%e 1il3 0rotein la/to errin alone or in /o1.ination -it% a 0ro.ioti/ %ad a redu/ed in/iden/e o late(onset se0sis" a//ording to a study in t%e O/to.er ? issue o JA#A2 In e/tions are t%e 1ost /o11on /ause o deat% in 0re1ature in ants and a 1a<or t%reat or 0oor out/o1es"@ t%e aut%ors -rite2 Late(onset se0sis" i2e2" in e/tions arising a ter t%e 0erinatal 0eriod 7i11ediately .e ore and a ter .irt%8" 1ainly o//ur in t%e %os0ital and a e/t ,A 0er/ent o very lo- .irt%(-eig%t 7'L$=B less t%an +2+ l.s8 neonates a//ording to .a/3ground in or1ation in t%e arti/le2 $ovine la/to errin 7$LFB a 1il3 gly/o0rotein8 in%i.its t%e gro-t% o a -ide variety o .a/teria" ungi" and viruses and %as .een s%o-n to e5%i.it even %ig%er in vitro anti1i/ro.ial a/tivity t%an %u1an la/to errin2 =%et%er la/to errin /an redu/e t%e in/iden/e o se0sis is un3no-n2 In ani1al tests" t%e 0ro.ioti/ La/to.a/illus r%a1nosus ** 7L**8 i10roved t%e a/tivity o la/to errin .ut %as not .een studied in in ants2 T%e resear/%ers e5a1ined -%et%er oral su00le1entation -it% $LF alone or in /o1.ination -it% L** redu/es late(onset se0sis in 'L$= neonates2 T%e rando1i&ed trial -as /ondu/ted in AA Italian neonatal intensive /are units and in/luded :?, 'L$= in ants -%o -ere assessed until dis/%arge or develo01ent o se0sis2 In ants -ere rando1ly assigned to re/eive orally ad1inistered $LF alone 7n C AD+8" $LF 0lus L** 7n C ADA8" or 0la/e.o 7n C AE)8 ro1 .irt% until day +4 o li e 7day :D or neonates less t%an ,2, l.s2 at .irt%82 De1ogra0%i/" /lini/al and 1anage1ent /%ara/teristi/s o t%e + grou0s -ere si1ilar" in/luding ty0e o eeding and inta3e o 1aternal 1il32 Forty( ive in ants %ad a irst e0isode o late(onset se0sis2 T%e resear/%ers ound t%at overall" late(onset se0sis o//urred less reFuently in t%e $LF and $LF 0lus L** grou0s 7;/AD+ GD2; 0er/entH and ?/ADA G:2E 0er/entH" res0e/tively8 t%an in t%e /ontrol grou0 7,;/AE) GA?2+ 0er/entH82 T%e de/rease o//urred or .a/terial as -ell as ungal e0isodes2 T%e se0sis(attri.uta.le ris3 o deat% -as signi i/antly lo-er in t%e t-o treat1ent grou0s2 No adverse e e/ts to treat1ent o//urred2 T%e resear/%ers re/o11end t%is study /on ir1ing t%e sa ety and e i/a/y o la/to errin in 'L$= in ants" in/luding 1ore e5tre1ely 0reter1 in ants" .e/ause t%ey 0otentially -ill .ene it t%e 1ost ro1 la/to errin2 Co1.ination strategies" su/% as t%e use o $LF 0lus L** in t%e study s%ould .e 0ursued" and su.stan/es t%at 1ig%t a e/t la/to errin a/tivity" su/% as iron

su00le1entation" s%ould .e investigated2 T%e e e/t o la/to errin on %e1ato/rit Gt%e 0ro0ortion o .lood t%at /onsists o 0a/3ed red .lood /ells s%ould .e 1onitored" and t%e e e/ts o la/to errin on neurodevelo01ental out/o1e" %os0ital lengt% o stay" and /osts s%ould .e studied2 Reasons for choosing the study An in(de0t% study a.out Neonatal Se0sis is e5tensively i10ortant or a nurse 1ost es0e/ially i t%e nurse is -or3ing in t%e 0ediatri/ -ard or neonatal Intensive Care Unit or t%e NICU de0art1ent2 A nurse s%ould .e 0ro0erly edu/ated regarding t%e /ause o t%e neonatal se0sis" %o- it is a/Fuired and 0revented" and its /o10li/ations to 0revent t%e o//urren/e o late(onset neonatal se0sis2 $eing a.le to o.tain 3no-ledge a.out neonatal se0sis /an give t%e student nurses in or1ation t%at /ould %el0 t%e1 in t%eir %ealt% tea/%ings to 0atients a.out a/tors t%at /ould 0redis0ose an individual to t%is disease2 $eing t%e %ealt% /are 0rovider o t%e 0atient 1eans t%at student nurses %ave t%e res0onsi.ility to 0revent" treat and %el0 in t%e re%a.ilitation o 0atients a e/ted .y t%e disease2 A ter t%e /o10letion o t%e study" a nurse s%all .e a.le to: Identi y and di erentiate t%e ty0es o Neonatal Se0sis $e u0dated -it% t%e latest trends in t%e treat1ent o Neonatal Se0sis Per or1 a /o10re%ensive assess1ent o Neonatal Se0sis Enu1erate t%e di erent signs and sy10to1s o Neonatal Se0sis List do-n t%e di erent diagnosti/ 0ro/edures t%at -ould %el0 in t%e diagnosis o Neonatal se0sis2 For1ulate nursing /are 0lans utili&ing t%e nursing 0ro/ess2 For1ulate /on/lusions .ased on t%e indings and enu1erated re/o11endations /on/erning t%e disease Nurse Centered O.<e/tives: S%all %ave /riti/al t%in3ing ne/essary or 0roviding sa e and e e/tive nursing /are2

 S%all %ave a /o10re%ensive assess1ent and i10le1ent /are .ased on t%eir 3no-ledge and s3ills o t%e /ondition2 S%all %ave a1iliari&ed -it% e e/tive inter(0ersonal s3ills to e10%asi&ed %ealt% 0ro1otion and illness 0revention2 S%all %ave an a00ro0riate 1anage1ent and treat1ent to t%e 0atient and utili&e it2

II. Nursing Assessment A2 Personal Data $a.y Se0sis is a , days old .a.y .oy -%o -eig%s ,2E3g" %e is a /at%oli/" a Fili0ino" and lives in Angeles City2 6e -as .orn on July ;" ,4A4 in t%eir %ouse via NSDB %e -eig%ed ,2E l.s" and -as .orn ull ter12 A day a ter %is .irt% %e %ad <aundi/e" %e -as t%en rus%ed in one o t%e %os0itals in Angeles City and t%ere %e -as /on ined -it% a diagnosis" T/C Neonatal Se0sis2

6istory o Past Illness $a.y Se0sis is only t-o days old -%en %e -as ad1itted" and sin/e t%en %e %as not e50erien/ed any illnesses2 6istory o Present Illness =%en $a.y Se0sis -as only , days old" %e .egan to %ad <aundi/e and %ad a ever o +;oC %e -as t%en rus%ed in one o t%e %os0itals in Angeles City2 *ro-t% and Develo01ent a2 Eri3 Eri3son9s Psy/%oso/ial Develo01ent T%eory: Trust vs2 #istrust Develo01ental tas3 is to or1 a sense o trust versus 1istrust2 C%ild learns to love and .e loved2 T%is -as e5%i.ited .y $a.y Se0sis -%en t%e student nurse -as %olding %i1" %e 3e0t idgeting and started to /ry" -%ile -%enever %is 1ot%er tou/%es %i1" %e 3ee0s /al12 T%is 0roves t%at %e /an di erentiate .et-een %is 1ot%er9s tou/% and a stranger9s tou/%" %e /ries .e/ause %e is un a1iliar -it% t%e student nurse and so %as not yet

esta.lis%ed trust2 It -ould .e i10ortant or t%e student nurse to 0rovide a 0ri1ary /are giver" 0rovide e50erien/es t%at add to se/urity" su/% as so t sound and tou/%" 0rovide visual sti1ulation or a/tive /%ild involve1ent2

.2 Sig1und Freud9s Psy/%ose5ual Stage: Oral Stage T%e /%ild e50lores t%e -orld .y using %is 1out% es0e/ially t%e tongue2 $a.y Se0sis 1ani ested t%is t%roug% %is eagerness to su/3 on %is 0a/i ier and %is instant rea/tion o /al1ing do-n on/e %e .egins su/3ing on a 0a/i ier2 It -ould do good to 0rovide oral sti1ulation .y giving 0a/i iers" not dis/ouraging t%u1. su/3ing2 /2 Jean Piaget9s T%eory o Cognitive Develo01ent: Sensori1otor Stage $a.ies relate to t%e -orld t%roug% t%eir senses" using only re le5 .e%aviour2 Sti1uli are assi1ilated into .eginning 1ental i1ages2 T%is -as evident ro1 $a.y Se0sis -%en %is re le5es -ere tested su/% as rooting re le5" su/3ing re le5" s-allo-ing re le5" 0lantar gras0 re le5" .a.ins3i re le5" and 1agnet re le52 P%ysi/al E5a1ination July ,A " ,4A4: Ast NPI 'S TC +D2,oC PC A4, .01 !C +: .01 6ead: dry lips with lesions around the mouthB yello- s/leraB yello- /on<un/tivaB -it%out s/arsB -it%out 0erior.ital ede1a2 S3in: yellow in color B with purple ruises on Right arm and leg! B poor s"in turgorB s3in -ar1 to tou/%B so t s3inB no lesionsB no s/ars2 Nails: /a0illary re ill o I+se/B s1oot% 0ail nail .edsB /o10lete set o ingers and toesB no s/arsB no -oundsB no dis/olorationsB no ede1a2

Ne/3: 1idlineB no distentionB no s-elling ly10% nodesB no lesionsB no s/arsB no tendernessB no ede1a2 C%est: sy11etri/ lung e50ansionBB no use o a//essory 1us/lesB no sternal retra/tionsB -it%out ralesB -it%out -%ee&esB no -oundsB no ras%esB no s/ars2 A.do1en: a.do1en not distended no eryt%e1aB no tendernessB no s/arsB no -oundsB no ras%esB2 E5tre1ities 7U00er and Lo-er8:B I# insertion wounds on on upper and lower e$tremities2 oth armsB purple ruises

#. The %atient and his Care A. &edical &anagement &edical &anagement Treatment Date Ordered ' (DO)* Date +eneral %erformed (D%)* Date Description Change (DC)

Indication or %urposes

Clients Response to Treatment

DA4 = D44 // in Date Ordered: soluset 5 + /y/les July AA" ,4A4 J A

Date Per or1ed: July AA K A:" ,4A4

Isotoni/ /rystalloid Solution -%i/% /ontains 1ulti0le ele/trolytes in roug%ly t%e sa1e /on/entration ound in 0las1a2 A+4 1EF o Sodiu1 7Na8 ion A4; 1EF o C%loride 7Cl8 ion2 ,) 1EF o La/tate : 1EF o Potassiu 17L8 ion

To 0rovide a .alan/ed solution o luids and ele/trolytes or t%e 0atient2 T%e 0atient 1aintained good s3in integrity2 For 0arenteral re0la/e1ent o e5tra/ellular losses o luid and ele/trolytes as reFuired .y t%e /lini/al /ondition o t%e 0atient2 To 0rovide as a 0assage or intravenous 1edi/ations o t%e 0atient2 T%is solution also 0rovided 1odest /alories o A?4 3ilo/alories2

Date C%anged: July A:" ,4A4

Date Ordered:

July A)" ,4A4 DA4 = +44 // 5 ?( )ugtts/ 1in2 J , Date Per or1ed: July A) ( A; ,4A4

+ 1EF o Cal/iu17 Ca8

Date C%anged: July A;" ,4A4 DA4 = D44 // 5 ?( )ugtts/ 1in2 J + Date Per or1ed: July ,4 ( ,A" ,4A4

PNSS D44 // 5 Date Ordered: L'O July A;2 ,4A4

Date Per or1ed: July A;" ,4A4

Date /%anged:

6y0otoni/ It is used or $T2 solution /ontaining a lo/on/entration o solute relative to anot%er solution2 =%en a /ell is 0la/ed in a %y0otoni/ solution" t%e -ater di uses into t%e /ell" /ausing t%e /ell to s-ell and 0ossi.ly e50lode2

T%e /lient didn9t e50erien/e any allergi/ rea/tion2

DD 42+ NaCl D44// Date Ordered: 5 A4ugtts/ 1in July A:" ,4A4

Date Per or1ed: July A:" ,4A4

Date C%anged: July A)" ,4A4

7s%i ted to DA4 = +44 // le tover8

Nursing Responsi ilities %reparation for Administration (Use aseptic techni,ue) Close lo- /ontrol /la10 o ad1inistration set2 !e1ove /over ro1 outlet 0ort at .otto1 o /ontainer2 Insert 0ier/ing 0in o ad1inistration set into 0ort -it% a t-isting 1otion until t%e set is ir1ly seated2 NOTE: See ull dire/tions on ad1inistration set /arton2 Sus0end /ontainer ro1 %anger2 SFuee&e and release dri0 /%a1.er to esta.lis% 0ro0er luid level in /%a1.er2 O0en lo- /ontrol /la10 and /lear air ro1 set2 Close /la102 Atta/% set to veni0un/ture devi/e2 I devi/e is not ind-elling" 0ri1e and 1a3e veni0un/ture2 !egulate rate o ad1inistration -it% lo- /ontrol /la102

-efore. C%e/3 t%e Do/tor9s order2 C%e/3 t%e la.el o t%e I'F2 C%e/3 or t%e 0aten/y o t%e line2 La.el t%e I'F on t%e date and ti1e started and on t%e in usion rate2 Pla/e on t%e Larde5 t%e luid ty0e

During. C%e/3 or t%e 0aten/y o t%e line2 A2 C%e/3 t%e in usion rate2 ,2 #onitor or t%e level o t%e luid2

After. A2 !egulate and 1onitor I' lo,2 Assess or t%e .ulging o t%e site2

&edical &anagement Treatment

Date Ordered ' (DO)* Date +eneral %erformed (D%)* Date Description Change (DC)

Indication or %urposes

Clients Response to Treatment

O5ygen T%era0y

Date Ordered O5ygen t%era0y and Per or1ed: is used to treat 'ia nasal /annula %y0o5ia2 It /an regulated ,(+ LP# July MA+ ( ,A" .e dis0ensed ,4A4 ro1 a /ylinder" 0i0ed(in(syste1" liFuid O, reservoir or O, /on/entration2

O5ygen t%era0y is indi/ated to t%e T%e /lient -as -ell o5ygenated 0atient to 0rovide adeFuate -it%out signs o %y0o5ia and o5ygenation and relieve res0iratory distress res0iratory di i/ulty2

Nursing Responsi ilities. $e ore: /%e/3 do/tor9s order /%e/3 availa.ility o nasal /annula" or 1as3 During: ensure rig%t regulation o o5ygen liters 0er 1inute ensure 0ro0er a00li/ation o nasal /annula or 1as3 A ter: o.serve res0iratory e ort rate" de0t% and r%yt%1 1onitor vital sign &edical Date Ordered &anagement ' (DO)* Date +eneral Treatment %erformed (D%)* Date Description Change (DC) P%otot%era0y Date ordered

Indication or %urposes

Clients Response to Treatment

P%otot%era0y is P%otot%era0y -as indi/ated to t%e T%e /lient still %as <aundi/e and t%e use o lig%t 0atient to 0%otoiso1eri&e un/on<ugated .iliru.in 1ore into -ater( or1s t%at are solu.le and /an t%e .e/ause do/tor o o.served i/teri/ s/lera a ter 0%otot%era0y as i/teri/ s/lera and <aundi/e -%i/% diagnosed %y0er.iliru.ine1ia2

and 0er or1ed: July A+" ,4A4

.e ra0idly -it%out

e5/reted .y t%e

liver and 3idney glu/uronidation2 It 0rovides o de initive treat1ent neonatal %y0er.iliru.ine1 ia 0revention 3erni/terus2 and o

Nursing responsi ilities -efore. asses 0atients s3in /olor re/ord vital signs 0re0are eye and genitalia /over /%e/3 0atients %ydration status re1ove all /lot%ing instru/t so not to 0ut and lotions or oils in t%e 0atient9s s3in

During. 1onitor 'ital signs es0e/ially te10erature /%e/3 I' luid After. .reast eed t%e .a.y a ter 0ro/edure to ensure adeFuate %ydration re1ove eye and genitalia /over and /lot%e t%e .a

&edical &anagement Treatment

Date Ordered ' (DO)* Date +eneral %erformed (D%)* Date Description Change (DC) tu.e Date ordered O*T 0ro/ess 0la/ing 0lasti/ t%roug% a is

Indication or %urposes

Clients Response to Treatment

Oro(gastri/ insertion

t%e A oro(gastri/ tu.e is dire/t ito t%e o so t lavage2 On t%e

T%e /lient -as a.le to tolerate O*T eeding2 T%e 0atient

sto1a/% -%i/% ena.le gastri/ -%en giving

and 0er or1ed: July AE" ,4A4

days o nurse didn9t e50erien/e as0iration2

tu.e 0atient intera/tion O*T is used to a deliver 1il3 or1ulas to t%e .a.y9s

0atientNs 1out%" sto1a/% 0ast t%e 0%aryn5 and a do-n t%e eso0%agus into

0atientNs sto1a/ %2 Oro( tu.es inserted deliver su.stan/es dire/tly into t%e sto1a/%" or to re1ove su.stan/es ro1 t%e sto1a/% or as a 1eans o testing sto1a/% un/tion /ontents2 or gastri/ are to

Nursing responsi ilities -efore. C%e/3 or t%e do/tors order Assess /lient9s need $e ore 0re0are t%e a00ro0riate 0ara enalias or t%e 0atient and .e sure t%at 0ro0er %and -as%ing is 1aintained During.

 C%e/3 0aten/y o 4*T O.serve 0atient rea/tion to gastri/ lavage After. C%e/3 lavage su.stan/e Note and do/u1ent any unto-ard rea/tion

a2: $lood Trans usion

#EDICAL #ANA*E#ENT/T!EAT#ENT

DATE O!DE!ED DATE PE!FO!#ED DATE C6AN*ED

*ENE!EAL DESC!IPTION

INDICATION7S8 O! PU!POSE7S8 7Patient(Centered8

CLIENT !ESPONSE TO T6E T!EAT#ENT

$lood Trans usion 7.lood ty0e $O8

:4

// DO: July A)" ,4A4

A .lood trans usion is a To solve t%e 0ro.le1 T%e student nurses didn9t regarding t%e a.nor1al results see t%e /lient during t%is sa e" /o11on 0ro/edure in 6e1atology li3e ane1ia" 0ro/edure2 in -%i/% .lood is given to lue3o0enia and you t%roug% an t%ro1.o/ytooenia2 intravenous 7I'8 line in

DP: July A;" ,4A4

one

your

.lood

vessels2 $lood trans usions are done to re0la/e .lood lost during surgery or due to a serious in<ury2 A trans usion also 1ay .e done i your .ody /anNt 1a3e .lood 0ro0erly .e/ause o an illness2 During trans usion" a a .lood s1all

needle is used to insert an I' line into one o your .lood vessels2 T%roug% t%is line" you re/eive %ealt%y .lood2 T%e 0ro/edure usually ta3es A to : %ours" de0ending on %o- 1u/% .lood you need2

Nursing Responsi ilities Prior: Note /urrent drug t%era0y .e ore 0ro/edure2 C%e/3 t%e 0%ysi/ian9s order2 Identi y t%e /lient2 Pre0are t%e needed 1aterials2 E50lain t%e 0ro/edure" its 0ur0ose and %o- it is done2 In or1 t%e 0atient/SO t%at t%ere are no ood or luid restri/tions2 !ig%t 0atient a ter ty0ing and /ross1at/%ing .y t%e la.2 t%is is done .y /%e/3ing t%e lot" serial nu1.ers" .lood ty0e" and e50iration date -it% anot%er nurse or Fuali ied la. 0ersonnel2 t%en t%e unit o .lood2 *et /onsent or1s signed .y t%e 0atient or a Fuali ied re0resentative o t%e 0atient =as% %ands2 During: 'ital signs 1ust .e /%e/3ed a ter AD 1inutes" t%en +4 1inutes ro1 t%en" t%en at one %our2 t%en vital signs 1ust .e /%e/3ed every %our2 Ta3a note any rea/tion o t%e .lood I any rea/tion" STOP T6E INFUSION OF $LOOD" 1aintain in usion o NSS and noti y 0%ysi/ian Start t%e saline solution" atta/% t%e .lood tu.ing 0ri1ed -it% NSS to t%e intravenous /at%eter Invert t%e .lood .ag gently several ti1es to 1i5 /ells -it% t%e 0las1a" 0ull t%e ta. and s0i3e t%e P set In use slo-ly or Ast AD 1inutes at A4gtts/1 #aintain ase0ti/ te/%niFue2 A ter:

A ter trans usion" o0en nor1al saline and in use u.til tu.ing is /lear

Disregard all t%e 1aterials used2 Continue to note t%e rea/tion o t%e .lood2 Pro0er Do/u1entation =as% %ands2 DRU+S

Name of Date Drugs! +eneric Ordered Name Date -rand Name Ta"en' +i/en Date Changed' D'C

Route of Administrati on* Dosage 0 1re,uency of Administrati on

+eneral Action 1unctional Classification

Indication(s ) or

Client2s Response to the &edication with actual side effects

&echanism of %urpose(s) Action

*eneri/ na1e: Para/eta1ol +4 1g I' F: or +?2)

Date +4 1g I' F: Anti 0yreti/ Fever Ordered: or +?2) !edu/es ever July AE" .y a/ting ,4A4 dire/tly on t%e %y0ot%ala1i/ $rand Na1e: %eat K A/eta1ino0%en regulating /enter to /ause vasodilation and s-eating" -%i/% %el0s dissi0ate %eat2

T%e /lient didn9t e50erien/e ever or te10 o +?2)C2

*eneri/ na1e: Date +4 1g I' FA, Ce tria5one Ordered: Sodiu1 July AE" ,4A4 $rand Na1e Date !o/e0%in: Per or1ed: July AE K ,A" ,4A4

Anti.ioti/

$a/teri/idal: In%i.its synt%esis o 1i/roorganis1 ound on %is .a/terial /ell /ulture" 1a3ing it e e/tive as -all" /ausing #eningitis a treat1ent or %is /ondition2 /ell deat%2 Caused .y 62 in luen5&ae/ Ce0%alos0orin so1e /ases rd 7+ generation82 /aused .y S2 0nue1oniae

Se0ti/e1ia T%e /lient didn9t e50erien/e /aused .y E2 any allergi/ rea/tion2 /oli" T%e drug is sensitive to t%e

NU!SIN* !ESPONSI$ILITIES FO! D!U* T6E!APP: %rior to the procedure. 'eri y do/tor9s orders Identi y t%e drug" reFuen/y" dosage and route o ad1inistration C%e/3 drug or any /loudiness and e50iration date2 Pro0er dilution s%ould .e /arried out Identi y t%e 0atient E50lain to t%e 0atient t%e 0ro/edures and reasons or giving t%e drug2 Per or1 %and-as%ing During the procedure.

 C%e/3 or I'F 0aten/y/ .a/3 lo Assess /lient9s vital signs .e ore ad1inistration Ase0ti/ te/%niFue s%ould .e 1aintained at all ti1es during t%e 0ro/edure C%e/3 or .u..les in t%e syringe After the procedure. #onitor or any adverse e e/ts a ter ad1inistration o drug Note 0atient9s res0onse to t%e drug2 Do not re/a0 needle Dis0ose any unne/essary ite1s Do/u1ent t%e 1edi/ation given Per or1 %and-as%ing DI3T T4%3 O1 DI3T DAT3 ORD3R3D DAT3 START3D DAT3 C5AN+3D +3N3RA6 D3SCRI%TION INDICATION(S) OR S%3CI1IC %UR%OS3(S) 1OODS TA73N C6IN3T2S R3S%ONS3 AND8OR R3ACTION T53 DI3T

TO

NPO 7Not%ing Per Ore18

Date Ordered and No ood and luid is Food is 0ro%i.ited None Started 0assed t%roug% t%e a ter every lu1.ar July AA" ,4A4 ali1entary /anal 0un/ture to 0revent s0inal %eada/%e Date C%anged and vo1iting2 July A+" ,4A4

T%e /lient re/eived not%ing 0er ore1 and did not e50erien/e e0isodes o vo1iting2

Date started: July A? " ,4A4 Q$a/3 to eeding #ILL

Date started: July A;" ,4A4 7$T8

#ILL FO!#ULA Date Ordered and It is designed to =IT6 ST!ICT Started: si1ulate %u1an ASPI!ATION July A+" ,4A4 1il32 It is P!ECAUTION individuali&ed or Date C%anged: t%e in ant and is July A?" ,4A4 deter1ined in s0e/i i/ a1ounts .y Q$a/3 to NPO /onsidering t%e reFuire1ents or /alories" C6ON" Date started: vita1ins and July A) " ,4A4 1inerals2 It is 0re0ared in t%e Q$a/3 to NPO 1ost sterile 1anner 0ossi.le and ed to t%e .a.y de0ending on %is %unger2 Nursing Responsi ilities. -efore. C%e/3 0%ysi/ian9s order a.out t%e diet2

It used -%en .reast eeding is /ontraindi/ated" 1ot%ers e10loyed outside t%e %o1e" .reast 1il3 0rodu/tion is inadeFuate" si/3ly 1ot%er" in.orn errors o 1eta.olis1 -%erein .a.ies la/3 ne/essary en&y1es to digest or utili&e 1il3 and or so1e 0ersonal reasons

T%e /lient a.le to tolerate %er 1il3 and didn9t e50erien/e as0iration2

 Identi y 0atient" instru/t SO or 0atient -%en diet is /%anged Provide /o1 ort 1easures su/% as o ering e5tra /lot% and na03in -%en eating2 During. *ive oods in s1all reFuent 1eals to /%e/3 or toleran/e2 Assist 0atient -%en eating2 O.serve or as0iration 0re/aution2 After. En/ourage t%e 0atient to ollo- t%e diet regi1en2 En/ourage ver.ali&ation o eelings a.out t%e diet2 Involve t%e 0atient in t%e 0re0aration o t%e 1enu a//ording to t%e 0atient9s 0re eren/es2 Assess or 0atient9s /ondition" %o- s%e res0onds to t%e diet2 $e sure t%at t%e 0atient is ta3ing or eating ood s%e /an tolerate

NURSIN+ &ANA+3&3NT 9.NURSIN+ CAR3 %6AN Pro.le1 no2A 6y0ert%er1ia

Assessment

Nursing Diagnosis 6y0ert%er1ia related to in la11atory 0ro/ess/ %y0er1eta.oli/ state as eviden/ed .y an in/rease in .ody te10erature" -ar1 s3in

Scientific 3$planation Due to t%e 0resen/e o an in e/tious agens" sti1ulation o t%e 1ono/ytes triggers t%e release o t%e 0yrogeni/ /yto3ines t%at sti1ulate anterior %y0ot%ala1us -%i/% results in elevated t%er1oregulatory set 0oint t%at leads to an in/reased %eat /onservation 7'aso/onstri/tion8 and in/reased %eat 0rodu/tion -%i/% results to Fever2

%lanning

Inter/ention

Rationale

3$pected Outcome S%ort ter1:

S( O( T%e 0atient 1ani ested t%e ollo-ing: ( Te10erature a.ove nor1al level 7+) oC8 ( S3in -ar1 to tou/% ( dia0%oreti/ ( a00ears -ea3 ( lus%ed s3in

Short:term. A ter A(, %rs o nursing intervention t%e 0atient -ill 1aintain nor1al /ore te10erature as eviden/ed .y vital signs -it%in nor1al li1its 6ong Term. A ter + days o NI" 0t -ill still 1aintain nor1al /ore te10erature as eviden/ed .y nor1al vital signs

Independent A2 #onitor neonate9s /ondition2 A2 To deter1ine t%e need or intervention and t%e e e/tiveness o t%era0y2 ,2 To %ave a .aseline data +2 6el0s in lo-ering do-n t%e te10erature

T%e 0atient s%all 1aintain nor1al /ore te10erature as eviden/ed .y nor1al vital signs

,2 #onitor 'ital signs +2 Provide TS$

6ong Term. A ter + days o NI" 0t s%all 1aintain nor1al /ore te10erature as eviden/ed .y nor1al vital signs

Interdependent :2 Ensure t%at all eFui01ent used or in ant is sterile" s/ru0ulously /lean2 Do not s%are eFui01ent -it% ot%er in ants Dependent D2 Ad1inister Anti(0yreti/s as ordered D2 aids in lo-ering do-n te10erature :2 t%is -ould 0revent t%e s0read o 0at%ogens to t%e in ant ro1 eFui01ent

P!O$LE# ,: Ine e/tive T%er1oregulation r/t I11aturity and Illness Assess1ent SRo OR 0t2 #ani ested ( <aundi/e (i/teri/ s/lera ( .ruises on ar1s and legs (/ut do-n -ounds on an3les ( lu/tuations in.ody te10erature a.ove and .elonor1al .ody te10erature (0oor s3in turgor (/a0illary re ill o I+se/ Diagnosis Ine e/tive T%er1oregulation Illness S/ienti i/ E50lanation $ody te10erature re0resents t%e %eat generation and %eat loss 0ro/esses2 T%e s3in" -it% its" a.ility to alter t%e rate o %eat loss" is t%e 1a<or 0oint o regulation o .ody te10erature2 T% erate o %eat loss de0ends 0ri1arily on t%e sur a/e te10erature o t%e s3in" -%i/% is inturn a un/tion 6ong:term. A ter + days o nursing interventions t%e 0atient -ill Re10%asi&e R to avoid /ross /onta1ination and O.<e/tives Short:term. A ter + %ts o nursing interventions and %ealt% R assess tea/%ings" t%e /ondition 0atient -ill .e R1onitor a.le e50erien/e te10erature and -ill .e a R loosen /lot%es nor 1al +?oC Rdis/ourage tig%t /lot%ing R 0er or1 TS$ R to 0revent %eat .uild u0 R to 0ro1ote sur a/e /ooling to re/ord 'S a Rregulate 1onitor I'F Nursing Interventions Resta.lis% ra00ort !ationale Rto gain /lient9s trust and /o10lian/e R to o.tain gen .aseline data R to o.tain and .aseline data Rto se/ure and adeFuate I'F loR to 0ro1ote /ooling 6ong:term. A ter nursing interventions" t%e 0atient s%all %ave 1aintained /ontrolled te10erature +?2DoC -it% o t%e O.<e/tives Short:term. A ter nursing interventions and %ealt% tea/%ings" t%e 0atient s%all %ave e50erien/ed a non( lu/tuating and te10erature +?2DoC

r/t I11aturity and .alan/e .et-een

s%all .e a nor1al

non( lu/tuating

(/ 'S o TC+?2?oC PC A:4 .01 !C D4 .01 R 0t2 #ay 1ani est ( ta/%y/ardia (/ool s3in (1oderate 0allor (1ild s%ivering (0iloere/tion (/yanoti/ nail .eds ( in/reased res0iratory (sei&ures (slo- /a0illary re ill

o t% es3in9s .lood lo-2 $ut sin/e neonates are 0oi3ilot%er1i/ t%ey are easily a e/ted .y t%e te10erature o t%eir surroundings -%i/% 1a3e t%eir te10eratures lu/tuate2

.e

a.le

to i10ortan/e o reFuent 0ro0er SO R1edi/ations given as ordered

ger1 s0read

%el0 o t%e SO

e50erien/e /ontrolled te10erature o +E2D(+?2DoC

and 1aintain a %and-as%ing to Rto /o10ly -it% treat1ent regi1en

P!O$LE# +: I10aired S3in Integrity r/t #e/%ani/al Fa/tors Assess1ent SR o OR 0t2 #ani ested ( <aundi/e (i/teri/ s/lera ( .ruises on ar1s and legs (/ut do-n -ounds on an3les (0oor s3in turgor (/a0illary re ill o I+se/ (/ 'S o TC+?2?oC PC A:4 .01 !C D4 .01 R 0t2 #ay 1ani est (it/%ing (0ain Diagnosis I10aired S3in Integrity r/t #e/%ani/al Fa/tors S/ienti i/ E50lanation =ounds are o0enings in t%e s3in /aused .y trau1a" s%ar0 o.<e/ts or 0ur0ose ully 1ade to e5a1ine t%e inside o t%e .ody2 It /loses .y itsel or it to %eal" alt%oug% even i it %as /losed it still serves as a good entry-ay or .a/teria to in iltrate t%e .ody and /ause in e/tion2 So it is i10ortant to aid t%e .ody or ti1ely -ound 6ong:term. A ter : days o Nursing Interventions" t%e O.<e/tives Short:term. A ter + %rs o Nursing Interventions and 0atient9s dressed 0ro0erly SO %ygieni/ 0ra/ti/es .e o.served2 R assess 6ealt% /ondition re/ord 'S and 1onitor I'F R advise t%e SO and /%ange t%e 0atient9s -ound -ill dressings Radvise SO o regular -ound /leaning or 0atient R3ee0 t%e -ound dry" R to o0ti1al %ealing R to in e/tion Nursing Interventions Resta.lis% ra00ort !ationale Rto gain /lient9s trust and /o10lian/e gen R to o.tain .aseline data and R to o.tain .aseline data and Rto se/ure adeFuate I'F loR to 0ro1ote ti1ely %ealing and 0revent in e/tion O.<e/tives Short:term. A ter nursing interventions and %ealt% tea/%ings t%e 0atient9s -ounds s%all %ave .een dressed and 0ro0erly /leaned .y t%e SO ad 6ygieni/ 0ra/ti/es s%all %ave .een 0revent o.served 6ong:term. a ter nursing interventions" t%e 0ro1ote 0atient9s -ound s%all %ave dis0layed ti1ely %ealing -it%out

Tea/%ings t%e R1onitor -ounds -ill .e Rregulate

/leaned .y t%e to regularly

0atient9s /lean and

(invasion o .ody stru/tures (nu1.ness o a e/ted surrounding (eryt%e1a on a e/ted area

%ealing2

-ould -ill .e /are ully a.le to dis0lay dressed ti1ely %ealing R li1it/ avoid use -it%out any o 0lasti/ 1aterial su/% as 0lasti/ .ed linens Ruse 0a0er ty0e o dressings R straig%ten -rin3les on .ed R 1edi/ations given as ordered R an in ant9s s3in is very sensitive R to avoid 0ressure .uild u0 on an area o s3in R to /o10ly -it% treat1ent regi1en /o10li/ations R 1oisture 0otentiates s3in .rea3do-n

any /o10li/ations2

P!O$LE# :: !is3 or Furt%er In e/tion r/t InadeFuate Pri1ary De enses

Assess1ent SRo OR 0t2 #ani ested ( <aundi/e (i/teri/ s/lera ( .ruises on ar1s and legs (/ut do-n -ounds on an3les (0oor s3in turgor (/a0illary re ill o I+se/ (/ 'S o TC+?2? C PC AE? .01 !C D; .01 R (s3in tou/% ( lus%ed s3in (%y0ert%er1ia 0t2 -ar1 #ay to 1ani est
o

Diagnosis !is3 or Furt%er In e/tion r/t InadeFuate Pri1ary De enses

S/ienti i/ E50lanation Not all -ounds %eal in a ti1ely 1anner or stay %ealed2 $ot% intrinsi/ and e5trinsi/ a/tors delay -ound %ealing2 =it% i10ro0er %andling and un%ygieni/ 0ra/ti/es a -ound /an .e a sour/e o in e/tion" .e/ause it serves as an o0ening or oreign agents to enter t%e .ody2 On/e t%ese .a/teria enter t%e .ody t%roug% t%e -ound" t%e

O.<e/tives Short:term. A ter +%rs o nursing interventions .e a.le

Nursing Interventions Resta.lis% ra00ort R assess

!ationale Rto gain /lient9s trust and /o10lian/e gen R to o.tain .aseline data and R to o.tain .aseline data and Rto se/ure adeFuate I'F loR to 0ro1ote ti1ely %ealing and 0revent in e/tion R to

O.<e/tives Short:term. A ter nursing interventions t%e 0atient s%all %ave o.served ne/essary 0re/autions avoid to urt%er t%e t%e

t%e 0atient -ill /ondition to R1onitor t%e re/ord 'S Rregulate o.serve ne/essary avoid in e/tion t%roug% 6ong:term. A ter + days o Nursing Interventions %el0 o t%e SO

0re/autions to 1onitor I'F urt%er R advise t%e SO to regularly t%e /%ange t%e 0atient9s -ound dressings Radvise SO o regular -ound /leaning or

in e/tion t%roug% t%e %el0 o SO 6ong:term. A ter nursing

0revent interventions t%e 0atient s%all %ave dis0layed -ound ti1ely %ealing any

in e/tion

t%e 0atient -ill 0atient %ave dis0layed R3ee0 t%e ti1ely any /o10li/ations -ound -ound dry" /are ully dressed %ealing -it%out /lean and

to

0ro1ote -it%out /o10li/ations

o0ti1al %ealing

t%roug% t%e use o -ound R to %ygieni/ /leaning

0revent and 1aintenan/e

(ta/%y/ardia (in/reased =$Cs (.rady0nea

in la11atory 0ro/ess o t%e .ody -ill .e triggered and t%en in e/tion -ill soon set in2

t%roug% -ound /leaning 0ra/ti/es SO

t%e Radvise t%e SO 0ro0er and %and-as%ing R en/ouraged regular s0onge

.a/terial and s0read R to

gro-t% assisted .y t%e SO2 gro-t% 0revent

use o %ygieni/ o reFuent

.a/terial and s0read

1aintenan/e

R to /o10ly -it% treat1ent regi1en2

assisted .y t%e .at%s R1edi/ations given as ordered //o NOD

Pro.le1 D: De i/ient Fluid 'olu1e r/t Failure o !egulatory #e/%anis1 Assess1ent SRo Diagnosis De i/ient Fluid S/ienti i/ E50lanation Fluid volu1e O.<e/tives Short:term. Nursing Interventions Resta.lis% !ationale Rto gain /lient9s O.<e/tives Short:term.

OR 0t2 #ani ested ( <aundi/e (i/teri/ s/lera ( .ruises on ar1s and legs (/ut do-n -ounds on an3les (0oor s3in turgor (/a0illary re ill o I+se/ (s3in -ar1 to tou/% ( urine out0ut o D(: dia0ers a day or (dry li0s (in/reased 0ulse rate (dry s3in (/ 'S o TC+?2? C PC AE? .01
o

'olu1e r/t Failure o !egulatory #e/%anis1

de i/it" or %y0ovole1ia" o//urs ro1 a loss o .ody luid or t%e s%i t o luids into t%e t%ird s0a/e one a/tor in/ludes a ailure o t%e regulatory 1e/%anis1 o t%e ne-.orn s0e/i i/ally %y0ert%er1ia

A ter + %ours o nursing intervention t%e 0atient -ill .e a.le to start 1aintaining luid volu1e at a un/tional level as eviden/ed .y t%e 0ra/ti/e o te/%niFues to 0ro1ote adeFuate luid volu1e2 6ong Term. A ter + days o nursing interventions t%e 0atient -ill .e a.le to 1aintain luid volu1e at a

ra00ort R assess

trust and /o10lian/e gen R to o.tain .aseline data and R to o.tain .aseline data and Rto se/ure adeFuate I'F loRTo assess -%at a/tor /ontri.utes to luid volu1e de i/it t%at 1ay .e given 0ro10t intervention2

A ter nursing interventions t%e 0atient s%all %ave started to 1aintain luid volu1e at a un/tional level as eviden/ed .y t%e 0ra/ti/e o te/%niFues to 0ro1ote adeFuate luid volu1e2 6ong Term. A ter nursing interventions t%e

/ondition R1onitor re/ord 'S Rregulate 1onitor I'F R Note or t%e /ausative a/tors t%at /ontri.ute to luid volu1e de i/it

R To de/rease te10erature and RProvide TS$ i 0atient %as ever R To 0revent in<ury ro1 0rovide /o1 ort

0atient s%all %ave 1aintained luid volu1e at a un/tional level AE$ individually adeFuate urinary out0ut" sta.le

!C D; .01 R 0t2 #ay 1ani est: (sun3en eye.alls ( dry 1u/ous 1e1.rane (in/reased 6/t (in/reased .ody te10 nor1al ( lus%ed s3in (s3in tou/% -ar1 to a.ove

un/tional level AE$ individually adeFuate urinary out0ut" sta.le vital signs" 1oist 1u/ous 1e1.ranes" good s3in turgor and 0ro10t /a0illary re ill2

RProvide oral /are .y 1oistening li0s S s3in /are .y 0roviding daily .at% RAd1inister I' luid re0la/e1ent as ordered

dryness

vital signs" 1oist 1u/ous 1e1.ranes" good s3in turgor

R re0la/es luid losses

and 0ro10t

R to redu/e .ody R Ad1inister anti0yreti/ drugs i 0atient %as ever as ordered te10erature

;. ACTUA6 SOA%I3 July ,A ,4A4 SC OC!e/eived .a.y on .assinette under .ililig%t -it% ongoing I'F J+ DA4= D44// T :4 // level draining via soluset T D: // level regulated T : ugtts/1in in using -ell on le t %and -it% 4, t%era0y via nasal /annula T , LP# -it% O*T o0en draining 1ini1al /o ee ground se/retions" <aundi/e noted" i/teri/ .ul.ar /on<un/tiva" 0in3is% 0al0e.ral /on<un/tiva" -it% dried .lood seen on li0s -it% %e1ato1a o.served over .a.y9s e5tre1ities and .utto/3s" -it% a.sen/e o a0nei/ e0isodes and sei&ure atta/3s 0atient re1ain ree ro1 signs o /yanosis -it% good strong /ry" -it% good s3in turgor" -it% 0resen/e o 1ilia on %is nose -it% C!T o , se/ -it% good /ry -it% 0resen/e o .a.ins3i" rooting" and 1ori re le5" -it% 0resen/e o dried .lood on t%e u1.ili/al /ord -it% ede1a 0resent on %is 0enis and s/rotu12 =it% 'S ta3en and re/orded as ollo-s T(+D2, C C!( A4, .01 !!( +: /01 ACIne e/tive tissue 0er usion r/t a.nor1al .lood 0ro ile AE$ 0latelet /ount E4 5 A4; and de/rease O, sat )E2?U PC a ter + %ours o Ni t%e .a.y -ill de1onstrate a.sen/e o signs o in<ury AE$ a.sen/e o .leeding e0isodes2 IC R Assessed gen /ondition R1onitored and re/orded 'S Rregulated I'F ro1 : ugtts to ?() ugtts/1in R0rovided /ont .ililig%t -it% eye and genitalia 3e0t /overed R.ililig%t turned o T )a1 Rdressed t%e .a.y a ter .ililig%t turned o R3e0t t%er1oregulated R3e0t O*To0en R3e0t .a/3 dry

R0rovided reFuent 0osition /%anges R0rovided an environ1ent /ondu/ive or resting R3e0t envt /lean R1onitored 05 or a0nei/" sei&ure" and /yanoti/ e0isodes RAs/ertained 0ro0er ase0ti/ te/%niFue -%en %andling t%e .a.y Rneeds attended Rdue 1eds given #u0iro/in oint1ent T )a1 Ce ota5i1e ,D41g TA4a1 !anitidine ,2D 1gTA4a1

?a1 seen on rounds .y dra2 Cadi& -it% orderts 1ade and /arried out R/ont 1eds R/ont .ililig%t Rre er EC *oal 1et AE$ t%e .a.y de1onstrated a.sen/e o signs o in<ury AE$ a.sen/e o .leeding e0isodes2

'I2 A2Client9s Daily Progress C%art Days Nursing Pro.le1s A2 6y0ert%er1ia ,2Ine e/tive T%er1oregulation I11aturity and Illness +2I10aired S3in Integrity r/t #e/%ani/al Fa/tors :2 !is3 or Furt%er In e/tion r/t InadeFuate Pri1ary De enses D2 De i/ient Fluid 'olu1e r/t Failure o !egulatory #e/%anis1 'ital Signs T P ! #edi/al #anage1ent A2 O*T ,2 O, +2DA4 -ater D2PNSS Drugs A2 Ce uro5i1e ,2 *enta1i/in +2 Ce tria5one :2 'ita1in L D2Furose1ide Diet: NPO #II. Conclusion and Recommendation 6earning Deri/ed (((( ((( ((( +D2,oC A4, .01 +: .01 Q Q r/t Ad1ission Q Q Q Ast NPI

As uture nurses" our duty is to 0rovide /are to our 0atients and %el0 t%e1 to re/over ro1 t%eir illness2 In order to do t%is" -e s%ould %ave enoug% 3no-ledge and s3ills2 =e %ave to utili&e t%ese 3no-ledge and s3ills to 0rovide t%e1 -it% %ealt% tea/%ings to 0revent diseases2 Neonatal se0sis is very .road disease" s0e/i i/ally re ers to t%e 0resen/e o a serious .a/terial in e/tion 7su/% as 1eningitis"0neu1onia" 0yelone0%ritis" or gastroenteritis8 a//o10anied .y ever2 #any /o10li/ations arise ro1 t%is disease es0e/ially our 0atient is also diagnosed -it% TO!C6 and 1eningitis2 T%e grou0 learned t%at t%is disease is due to no sterile te/%niFue a00lied during t%e delivery o t%e .a.y and t%at disease is a/Fuired to 1ot%er or during t%e delivery .e/ause t%e ne-.orn %as still -ea3 i11une syste1 and i11ature /ells to ig%t su/% in e/tion2 T%ere ore" -e s%ould 0ra/ti/e sterile te/%niFue and %ave a regular 0renatal /%e/3u02 And or neonates sus0e/ted o se0sis" -e s%ould %ave /losed -at/% t%e /ondition o t%e 0atient" .e/ause t%is 1ig%t lead to serious deat% i not /ured or solved2 As a student nurse" t%e grou0 /a1e u0 -it% reali&ations essential to t%e uture 0ra/ti/e o our 0ro ession2 T%e 3no-ledge" s3ills and attitudes -e 0ossess s%ould .e en%an/ed and i10roved a//ordingly to 0ro0erly address t%e 1edi/al and nursing needs o t%e /lient2 =e are endo-ed -it% res0onsi.ility o 0roviding t%e .est 0ossi.le /are to our 0atient and assisting t%e1 attain to-ards t%e a/%ieve1ent o o0ti1u1 %ealt%2 Su i/ient understanding o t%e disease /ondition and t%e t%era0euti/ regi1en involve in t%e /ourse o treat1ent -ill allo- us to 0er or1 our duties and res0onsi.ilities -it%in t%e 1a5i1u1 /riteria2 Co10re%ension o t%e 0atient9s distin/t needs -ill urnis% t%e Fuality o /are or our 0atient and -ill ena.le us to a00ly individuali&ed nursing /are to our 0atient and -ill strengt%en or 0ro essional relation to our 0atient2 $ut to to0 it all" t%e .est 0art /ondu/ting a /ase study is t%e sense o ul il1ent -e elt 3no-ing t%at in one -ay or t%e ot%er -e %ave tou/% one9s li e .y e5tending a %and and a %eart -%en t%ey needed it 1ost2 T%is /ase study %el0s our grou0 in understanding t%e disease 0ro/ess o t%e 0atient2 $y identi ying t%e 0ri1ary needs o t%e 0atient -it% Neonatal se0sis2 It -ill %el0 our grou0 to urt%er learn t%e /urrent trends to t%e disease /ondition" t%e rig%t nursing intervention" 0ro0er drug ad1inistration" t%e 0reventive as0e/ts or t%e 0ur0ose o %ealt% tea/%ing to 0atients and t%e rationale .e%ind t%e /lini/al 1ani estations2 E e/tive 1anage1ent o

t%e 0ro.le1s identi ied -ill %el0 t%e 0atient to re/over aster and 1aintain a %olisti/ sense o -ellness even -%ile in t%e %os0ital2 T%is /ase study %ad also eFui00ed t%e grou0 -it% 3no-ledge" s3ill and attitude on %o- to 1anage uture 0atients -it% t%e sa1e or si1ilar disease2 And gave us an overvie- o t%e /on/e0ts -e9ve studied .e ore so -e /ould a00ly it to our day to day e50osure to di erent individuals and to t%e %os0itals and /o11unities2 During t%e /ourse o 1a3ing t%is reFuire1ent in !LE t%e grou0 %as learned a lot a.out t%e disease se0sis -%i/% /ould a e/t neonates due to t%eir -ea3 i11une syste1 and .odily res0onse to in e/tion2 T%e /ase gave us an o00ortunity to study 1ore a.out t%e /ertain a/tors t%at lead to t%e o//urren/e o t%e disease t%e 1ani estations t%at it -ould s%o- and also t%e 0ossi.le out/o1es i it -ould not .e treated i11ediately2 T%e %u1an .ody %as uniFue -ays to ig%t o any oreign 1aterial in t%e /ir/ulation and t%roug% t%e %el0 o t%is /ase study not only us t%e resear/%ers -ould .ene it ro1 it .ut also to ot%ers -%o 1ay 1a3e t%is 0resentation as a .asis in urt%er understanding t%e disease /ondition2 T%e en/ounter or %andling o t%is /ertain 0atient -ould %el0 us nurses in t%e 0ursuit o t%e 0ro ession to .e a.le to a00ly our 3no-ledge to t%e su//eeding 0atients %aving t%e sa1e /ondition and .e a.le to 0rovide ne/essary 1easures to /ontrol or 1anage t%e 0ro.le12 Recommendations. To t%e P%ili00ine *overn1ent" t%at t%ey 1ay 3no- t%e latest studies and resear/% .eing done in order to i10rove t%e Fuality o li e o every 0eo0le2 T%ey s%ould 0ut 1ore attention to 0u.li/ %ealt% to i10rove t%e out0ut a /iti&en /an 0rovide t%is /ountry" none t%e less it -ould also .e .etter and .ene i/ial i t%ey t%e govern1ent -ould also t%e edu/ation standards o t%e Fili0ino /iti&ens so t%at in any o//urren/e o /risis t%ey o0t to ind solution and re1edies t%at -ould %el0 to alleviate t%eir 0ro.le12 To t%e De0art1ent o 6ealt%" t%at t%ey 1ay i10le1ent 0ro<e/ts or se1inars in order to give adeFuate 3no-ledge to t%e general 0u.li/ a.out t%e latest studies in su/% disease in order to in or1 t%e1 a.out its 0ro0er 0reventive -ays as -ell as t%e .ene its and ris32 To t%e 6ealt% Care Providers" 0arti/ularly 0%ysi/ian and nurses" t%at t%ey 1ay i10art t%eir 3no-ledge to t%e 0u.li/ in order to 0revent t%e o//urren/e o urt%er

/o10li/ations" and t%e grou0 -ould also re/o11end to t%e1 t%at t%ey -ould o0t to do t%eir duties -it% out1ost 0er e/tion in t%e -ay t%at t%ey /an to alleviate t%e /ir/u1stan/e o t%eir 0atients and /lients2 To t%e #edi/al Interns and Student Nurses" t%at t%ey 1ay .e/o1e a-are o t%e /urrent trends" studies" resear/%ers and issues in .ot% 1edi/ine and nursing ields" and t%ey o0t to 0ra/ti/e t%eir duties to t%e .est t%at t%ey /an so t%at in t%e uture t%ey -ould .e 0ra/ti/ing t%e out1ost /are to t%eir 0atients and /lients2 To t%e Fili0ino 0eo0le s0e/i i/ally to t%e 0atient" t%at t%ey 1ay %ave t%e .a/3ground regarding t%e latest studies .eing done to i10rove Fuality o li e2 T%e 0atient s%ould also -at/% or a/tors t%at /ould again aggravate t%eir %ealt%2 T%eir %ealt% is in t%eir %ands so t%ey s%ould try to 0ra/ti/e -ays and te/%niFues on %o- to avoid /o10li/ations su/% as t%is disease in our /ase study2