(5)
Expiratory grunting.
(6)
Chin tug.
(7)
Retractions.
(8)
Nasal flaring.
(9)
Cry (feeble, whining, and high-pitched).
(10) Heart rate (usually increased).
(11) Cyanosis (when it occurs, where, relieved by O2, and amount of O2
needed).
(12) Reflexes (gag and swallow).
(13) Prebirth history.
10-5. MAINTENANCE OF BODY TEMPERATURE IN THE PREMATURE INFANT
The lack of subcutaneous fat and poor muscular development make the
premature infant more susceptible to loss of body heat. The absent or minimal flexion
of extremities prevents the premature infant from self-positioning to decrease the
amount of body surface requiring heat. In the absent or poor reflex control of skin
capillaries, there is no shivering to produce heat. Immediately after delivery the baby
should be placed under a radiant heat warmer. He must never be without provisions of
external warmth at any time. It is good practice to keep the baby's head covered
because of the large amount of heat that is lost through the head. The body
temperature of the infant should be maintained at 98o F axillary.
10-6. MAINTENANCE OF ADEQUATE NUTRITION IN THE PREMATURE INFANT
a. The growth rate of the premature infant should parallel the expected
intrauterine growth rate. Most immature neonates have feeble, absent or
unsynchronized sucking and swallowing reflexes. A great deal of patience is needed
when feeding them. A specially made nipple for premature infants may need to be
used.
b. Maintenance of fluid balance also poses a problem. A high proportion of fluid
is excreted from the baby through the urine because the baby is unable to efficiently
concentrate urine. Intravenous fluid is usually initiated within the immediate hours
following birth. Intravenous. glucose is provided to prevent development of
hypoglycemia.
MD0922
10-4