(b) Observe for signs of respiratory distress (grunting, flaring,
retractions, apnea, and cyanosis).
(c)
Monitor input and output (I&O), daily weights, and head
circumference.
(d) Prevent hypothermia by maintaining thermal stability.
(e) Assess hematocrit according to local policy.
(f)
Support the parents by listening to their concerns and answering
questions.
b. Large for Gestational Age. Large for gestational age (LGA) infants are
those whose birth weight places them above the 90th percentile of normal for their
gestational age.
(1)
Conditions that occur frequently in the LGA infant are:
(a) Hypoglycemia. This is related to hyperinsulinism following birth.
(b) Hypocalcemia. This is associated with prematurity or asphyxia.
(c)
Polycythemia. This is a complicated factor of decreased
extracellular fluid.
(d) Hyperbilirubinemia. This may be influenced by decreased
extracellular fluid and birth trauma hemorrhage.
(e) Respiratory distress syndrome. This is associated with premature
delivery.
(f)
Congenital anomalies.
(2)
Nursing care considerations.
(a) Monitor the infant's respiratory and temperature status.
(b) Monitor the infant's levels of glucose, calcium, bilirubin, and
hematocrit and hemoglobin per physician's orders.
(c)
Employ measures to prevent infection.
MD0922
11-4