Oko Kumele Ukwazi Ngezibonakaliso Zobunzima
Xa unesana kwi-NICU, uya kuba noqhelana ne symphony yezandi ezihamba nale ndawo. Kulukhuni ukungaxhomekekanga kwaye phantse uqaphele ngeso sihloli njengoko sisisoloko sihlala kwiNICU. Mhlawumbi uye wachazwa ngokutshintshwa kwe-neonatal , yintoni "uBrady" kwaye yiyiphi "intando" kwaye mhlawumbi waqala ukubhekisela kubo "njengeziqephu." Kodwa ngokwenene ukwazi nokuqonda "yintoni" kwaye "kutheni" zonke iifowuni kunye nesantya kunokunceda ukubeka ingqondo yakho lula.
Yonke intsana kwisiko lononophelo olunzulu lwe-neonatal iya kuhlolwa kwizinto ezibizwa ngokuba yi-monitor cardiopulmonary. Ngokwenene, le yinkqubo equkethe iifoni enee electrode ezinamathele kumntwana; ezimbini kwihlangothi zonke zesifuba, kunye nesinye kwisisu esiswini okanye emlenzeni. Ezi electrode ziqhotyoshelwe ngcingo kwaye zibona yonke imisebenzi yentliziyo kwaye ziyithumele kweso sithuthi apho kubhalwa khona kwaye kuboniswe njengendlela yokutshintsha kwesikrini.
Iprogram ibuye isilinganise isantya sokuphefumula, (ukukhawuleza ukuphefumla) kunamandla okurekhoda i-oxygen saturation (i-O2 ehleli) ngaphakathi kwegazi, (ilinganiswe yiprojekti enokuthi iqhotyoshelwe kwisandla okanye unyawo) kwaye iphinda ilingane uxinzelelo lwegazi; mhlawumbi ngokufundwa kwekhafu okanye ngexesha lokwenene lokufunda ngokusebenzisa umthamo kwi-umbilicus, (UAC) isandla, okanye unyawo. Ukufundwa komsebenzi kuguqulwa kwisimo somtsalane onokubonwa kweso siso.
Ukufunda okuqhubekayo rhoqo kwengcinezelo yegazi kusetyenziswa ekuqaleni kweNICU kunye neemeko ezingakumbi.
Uxinzelelo lwegazi
Uxinzelelo lwegazi lubalwa ngamanani amabini, i-systolic kunye ne-diastolic. I-Systolic ingcinezelo xa intliziyo isenza isivumelwano kunye ne-diastolic ingcinezelo xa intliziyo ikhululekile.
Uxinzelelo lwegazi oluqhelekileyo lwentsana edala ngaphambi kwexesha lobudala. Ngokuqhelekileyo kwi-NICU, sifuna uxinzelelo lwegazi oluphakathi (inombolo ephakathi) elinganiswayo phakathi kwe-systolic kunye ne-diastolic, ukuba ibe malunga nobudala bokuzalwa komntwana.
Injongo yokubekwa kwengcinezelo yegazi kwintsana engaphambi kwexesha kukuqinisekisa ukuba ingcinezelo yengcinezelo yegazi ayifuni kakhulu. Uxinzelelo lwegazi oluqhelekileyo luqhelekileyo kwintsana yokuqala emva kokuzalwa kodwa kunokubangelwa ukusuleleka, igazi okanye ukulahlekelwa kwamanzi kunye neminye imichiza. Ukukhulisa ingcinezelo yengcinezelo yegazi kunokuba lula njengoko kunika umthamo owongezelelweyo nge-IV okwandisa umthamo wegazi lomntwana, owenza ngcono umsebenzi wentliziyo. Amachiza abizwa ngokuba yi-vasopressors angasetyenziswa. Amayeza aqhelekileyo asetyenziswayo yi-dopamine, dobutamine, ne-epinephrine. Ezi zonyango zomsebenzi ngokunyusa izinga lentliziyo yengane, ukunqanda imithana yegazi kunye nokunyuka kwegazi kwizitho ezibalulekileyo.
Inqanaba eliqhelekileyo lentliziyo kwintsana engaphambi komntwana iphakathi kwe-120-160 iipilisi ngomzuzu. Akuqhelekanga ukubona intliziyo yesantya yenyuka ifikelele kuma-200 xa ixhala, ilambile, okanye ikhutshwe. Umlinganiselo wokuphefumula oqhelekileyo uphakathi ko-30-60 ukuphefumula ngomzuzu.
I-oksigen saturation values eziqhelekileyo ziyahlukahluka ngokususelwa kuminyaka yobubele bomntwana. Isilinganiselo senhliziyo esinyanisekileyo singabonakalisa ukukhulelwa kwegazi, ukwehla kwamaseli obomvu (amangqamuzana egazi abomvu enza i-oksijini kwizitho ezibalulekileyo zomzimba).
Isilathisi sinemigqaliselo esetyenziswe kwi-alamu ukuba iinombolo ziwela ngaphantsi okanye ngaphezu kwezinto ezilindelekileyo. Akuqhelekanga ukuba i-alarms yobuxoki xa usana luhamba, okanye ukuba i-electrodes iyanqandwa. Kubalulekile ukungena kumkhwa wokujonga umntwana wakho kwaye uqaphele umbala wakho wesikhumba kunye nokunyakaza, kwaye xa bekwenza kwaye bahambelani ne-alamu zamehlo kunye neendlela zokutshintsha.
Yintoni iBradycardia & Kutheni Kuyenzeka?
I-Bradycardia kukunciphisa intliziyo. Xa intliziyo yomntwana iqalisa ukukhawuleza, kuncipha ukuhamba kwegazi kumaphaphu kunye ne-oksijini kumathambo ehla. I-Bradycardia kwintsana engaphambi komntwana ichazwa njengesantya senhliziyo esingaphantsi kwe-100 beats ngomzuzu. I-Bradycardia yinto eqhelekileyo ekulindeleke ukuba iguqulwe kwangaphambili ngenxa yokuba inkqubo ye-nervous is old. Intliziyo ilawulwa yinxalenye yenkqubo ye-nervous system ebizwa ngokuba yinkqubo ye-nervous autonomic (ANS). Kwiimeko ezininzi, asiyazi ngokusebenza kwe-ANS kuba isebenza ngendlela engabonakaliyo, ingenangqiqo kwaye ingekho ekulawuleni kwethu.
I-ANS ihlukaniswe kwisistim se-nervous and system syndrome. Inkqubo yesantya evelwano isebenzisa ukulwa okanye ukuphendula kwendiza kwaye kwandisa uxinzelelo lwegazi, kwaye intliziyo iyabetha ngokukhawuleza. Inkqubo ye-neasympathetic ye-nervous isebenza ukugcina amandla kunye nokunciphisa uxinzelelo lwegazi kunye neentliziyo zibetha ngokukhawuleza. Kwimimandla ye-nervous evuthiweyo, le mi sebenzi isebenza kwi-cadence, evumela ukuba izinga lokuphefumula kunye nexinzelelo lwegazi libe lomelele. Kwintsana engaphambi komntwana, inkqubo ye-nervous is immature, kwaye ke, ezi nkqubo zikwazi ukuphuma kwishythm esibangela ukungabikho kwimeko engayikhokelela kwibradycardia.
Iintsana ezinokuqala zingabangela ukuba zibe neengqayi ze bradycardia. Ukuvuselela okulula, ukutya, ukufaka ityhubhu yokutya, kunye ne-reflux inokubangela ukuba i-preemie ibe nengqungquthela ye-bradycardia. Ngokuxhomekeka kwimbangela yeBrady iya kuxhomekeka kwongenelelo. I-premie bradycardia ngamanye amaxesha isenokuzixazulula xa isistim se-nervous sishukumisekile ukuba siphumelele. Ukuba oku kungenzeki, umntwana uya kufuna ukuvuselela, mhlawumbi ngokuchukumisa ukukhanya okanye ukukhupha ngamandla kweenyawo okanye ukuxubha umva. Kwezinye iimeko, umntwana uya kufuna i-oxygen okanye ukwanda kwe-oksijeni. I-caffeine yimiyeza esetyenziswayo xa i-bradycardia ibangelwa yi-apnea (ikhefu lokuphefumla). Ngamanye amaxesha uBrady uyimpawu esilumkisa ukuba into ethile ingaba yinto engafanelekanga njengokwenyango. Kwiimeko ezininzi, njengoko umntwana ekhula kwaye inkqubo yeentlanzi ikhula, iya kukhula kuyo.
Yintoni i-Apnea?
I-Apnea lixesha lokungaphefumli okanye ukuyeka ukuphefumula kwaye kuqhelekile kwiintsana ezingekafiki. Ngaphambi kokubeleka umntwana, amathuba amakhulu ukuba i-apnea iya kwenzeka. I-Apnea yokuqhawuka kwangaphambili idlalwa yinkqubo yesantya esingaqhelekanga. Amaziko alawula ukuphefumula awanakuliswa ngokupheleleyo kwaye anokungathembeki. Nangona kunjalo, i-apnea spells ingabangela ezinye izizathu kwaye ingabonisa:
- Ukuba umntwana usenokufumana isifo.
- Ukuqhawula okanye ukulimala kweethambo kwintliziyo.
- iingxaki zesisu ezifana ne-reflux. (Xa isisu sesisu siphindela kwi-oophagus.)
- Amanqanaba amancinci okanye aphakamileyo kakhulu kumachiza emzimbeni, afana ne-glucose okanye i-calcium.
- Ukukhuthazwa kweengcamango ezinokubangela i-apnea ezifana nezibilini zokutya okanye ukutshisa, kunye nokushisa okungaqinisekiyo.
Xa i-apnea iyenzeka, ukuvuselela ngokugubha umqolo okanye unyawo kunokunceda ukhumbuze umntwana ukuba aphinde aphefumule. Uninzi lweintsana ezingaphaya kwexesha luya kuphuma i-apnea ye-prematurity ngokuqhelekileyo ngelixa lifikelela kumaviki angama-36. Iiphambanzana ezimfutshane azilimazi kwi-preemie kodwa ukuba zenzeka rhoqo, umntwana uya kufakwa kwiyeza (ngokuqhelekileyo i-caffeine) ukunceda ukuvuselela inkqubo ye-nervous central.
Abagadi bayingxenye enkulu yeNICU njengoko babonisa ulwazi oluqhubekayo malunga neempawu ezibalulekileyo zezingane. Zonke iintsimbi kunye neengqungquthela ziyakunceda kakhulu ekuqaleni. Kodwa ukwazi ukuba yintoni i-alamu nganye kwaye ithetha ntoni kunokukunceda uzive ukhululekile kunye nosana lwakho. Abahloli bahlala beba ngumthombo obalulekileyo kakhulu olwazi kubazali, kwaye kunokuba kunzima ukuba ulungele ukungabikho kwabo xa ukhutshwa ekhaya. Inokuba yinto enomdla kakhulu kwaye iyantyantya ngexesha elifanayo ekugqibeleni ibe nomntwana ongenazintambo, ongenazintambo.
> Imithombo:
> Apnea kunye neBradycardia. (nd). Ukufunyanwa kwi-http: //www.pediatrics.emory.edu/divisions/neonatology/parent_info3.html
> Iingxaki zengcinezelo yegazi - i-neonates: i-ehandbook ye-neonatal - iSebe lezeMpilo kunye neNkonzo zoLuntu, iVictoria, eAustralia. (nd). Kubuyiselwa kwi-http: //www.health.vic.gov.au/ebennerhandbook/procedures/blood-pressure.htm
> Uxinzelelo lwegazi luhlala kwiintsana ezingaphambi kwexesha. I. Iiyure zokuqala zobomi. - I-PubMed - NCBI. (nd). Ukufunyanwa kwi-http: //www.ncbi.nlm.nih.gov/pubmed/8151481
> I-epidemiology ye-Apnea neBradycardia isigqibo kwiintsana ezandulela. (nd). Ukufunyanwa kwi-http: //pediatrics.aappublications.org/content/128/2/e366
> I-Neonatal Hypertension. (nd). Kubuyiselwa kwi-http: //emedicine.medscape.com/article/979588- ukubukela kwakhona
> Ukubonwa kwe-Neonatal, I-Layer eyongezelelweyo yoNonophelo-RT: KubaSebenzi beZigqibo zokuNakekelwa koPhephelo. (nd). Ifunyenwe kwi-http: //www.rtmagazine.com/2013/10/ononatal-monitor-an-extra-layer-of-care/
> Xa umntwana wakho e-NICU. (nd). Ukufunyanwa kwi-http: //kidshealth.org/parent/system/ill/nicu_caring.html