Zvaunofanira Kuziva Nezvekukosha Kwechiratidzo
Paunenge uine mwana muNICU, iwe uchange uine ruzivo rwemutauro we symphony wemisero inoenderana nemamiriro aya. Zvakaoma kuti tisava nekutendeseka uye tinenge tichishushikana nechitarisiko sezvo ichi ndicho chinogara chiri muNICU. Iwe zvichida wakamboudzwa mune neonatal tsanangudzo , chii chinonzi "Brady" uye "chidimbu" uye chinogona kunge chakatotanga kutaura kwavari se "zvikamu." Asi kunyatsoziva nokunzwisisa "chii" uye "nei" iyo yose faira uye chekuita zvinogona kubatsira kuisa pfungwa dzako nyore nyore.
Mwana wose muchechecheche yevana neatalatal anochengetedzwa pane chimwe chinonzi cardiopulmonary monitor. Chaizvoizvo, iyi ihurongwa inosanganisira faira ine electrodes inonamatira kumwana; mbiri kune rumwe rutivi rwechifuva, uye imwe pamucheche pasi kana pamakumbo. Aya magetsi anosanganiswa nematairi uye anoona mabasa ese emwoyo uye anoendesa kune chekuona iyo yakanyorwa uye inoratidzwa semufananidzo wekushona.
Nzira yacho inotarisa kuti mwana anofuridzirwa sei, (kukurumidza kufema kufara) ane simba rekunyora kukanganiswa kweokisijeni (O2 akagara) mukati meropa, (yakayerwa neshumo inosungirirwa kuruoko kana rutsoka) uyewo kuenzanisa ropa revana mwana; zvichienderana neketani yekuverenga kana nenguva chaiyo kuverenga kuburikidza neyeri mu umbilicus, (UAC) wrist, kana rutsoka. Kuverenga kwemashoko kunoshandurirwa mu waveform iyo inogona kuonekwa pane chekuita.
Izvi zvinogara zvichiverengwa zvekushandiswa kweropa zvinowanzoshandiswa pakutanga kweNICU kugara uye mumamiriro ezvinhu akaoma.
Ropa rinodzvinyirira
Ropa rekuyeresa rinotaridzwa nemazita maviri, systolic uye diastolic. Systolic inomanikidzwa apo mwoyo unobvumirana uye diastolic inomanikidzwa apo mwoyo wakasununguka.
Kazhinji kuwedzera kweropa kwemwana asati azvarwa kunopesana zvichienderana nemakore ekutenda. Kazhinji muNICU, tinoda ropa remuviri (nhamba yepakati) inotaridzirwa pakati pe systolic uye diastolic, kuti ive yakapoteredza makore ekutakura emwana.
Chinangwa chekuyerera kweropa mucheche asati asvika ndechekuita kuti chirwere cheropa chinenge chisina kupera. Kutsika kweropa kunowanzoonekwa mumwana wekutanga asati aberekwa asi kunogonawo kukonzerwa nehutachiona, ropa kana kurasika kwemvura, uye mamwe mishonga. Kurera ropa revana rinogona kunge rakajeka sekupa huwandu hwehuwandu hwe IV hunoita kuti ropa revana riwedzere, izvo zvinozovandudza kushanda kwemoyo. Mishonga inonzi vasopressors inogona kushandiswa zvakare. Mishonga inowanzoshandiswa ndeye dopamine, dobutamine, uye epinephrine. Iyi mishonga inoshanda nekuwedzera mwana wemwoyo, kuvhara mitsipa yeropa, uye kuwedzerwa kweropa kunopinda kune nhengo dzinokosha.
Iko inowanzoita mwoyo yenguva yevana vasati yasvika iri pakati pe 120-160 beeps neminiti. Hazvisi zvisizvo kuona mwana wemwoyo ichikwira kusvika kusvika mazana maviri kana vakagumbuka, vane nzara, kana kuti vakatsamwa. Chimiro chekufema chinokonzerwa ne preemie chiri pakati pe30-60 kupfutira paminiti.
Oxygen saturation tsika dzakasiyana uye dzinowirirana zvichienderana nemakore ekugwinya kwemucheche. Kakawanda kuwedzera kwemoyo yemutengo kunogona kuva chiratidzo chekushaya ropa, kuderera kwemasero matsvuku eropa (masero matsvuku eropa anotakura okisijeni kune nhengo dzomuviri dzinokosha).
Izvo zvinotarisa zvine zviyero zvakagadzirirwa kuvhenekera kana nhamba dzichiwa pasi kana kupfuura izvo zvinotarisirwa. Hazvisi zvisingazivikanwi kuva nemanyepo ekunyengera kana mwana achifamba, kana kuti magetsi anosvibiswa. Zvakakosha kupinda mumutsika wekutarisa mwana wako uye kuziva chivara chako chemuvara wepreemie nekufamba, uye kana pavanoita uye vasingatauriki nemapurisa ekucherechedza uye mavara.
Chii Chinonzi Bradycardia & Nei Zvichiitika?
Bradycardia ndiko kunonoka kwemwoyo. Apo mwoyo wemwana unotanga kunonoka, kune kuderera kweropa kunopinda kumapapu uye oksijeni kune madonhwe ematope. Bradycardia mucheche asati azvarwa anotsanangurwa sehutano hwemwoyo huri pasi pe 100 kurohwa paminiti. Bradycardia ndiyo inotarisirwa kuita chikamu chekushanda kwepakutanga nokuti chirwere chetsitsi hachina. Mwoyo unotungamirirwa nechikamu chegadziriro yenzwa inonzi autonomic nervous system (ANS). Mune mamiriro ezvinhu akawanda, hatizivi nezvekushanda kweASS nokuti inoshanda nenzira isingaiti, inofungidzira uye iri kunze kwekutonga kwedu.
IAS inoparadzaniswa muhurongwa hwekutya netsitsi uye chirongwa chinoshungurudza chinotyisa. Tsitsi dzinotyisa dzinoshandisa kurwisana kana kupindura kwemauto uye kunowedzera kuwedzera kweropa, uye mwoyo unorova nokukurumidza. Izvo zvinoshungurudza zvirwere zvinoshandiswa kuponesa simba uye kuderedza kushanda kweropa uye mwoyo unorova zvishoma. Mune manzwiro emagetsi akakura, izvi zvinoshanda mumhepo, zvichibvumira kuporesa uye kupemha kweropa kuti zvigadzikane. Mumwana asati asvika, chirwere chetsitsi hachina kufema, uye izvi zvigaro, saka, zvinogona kubva kunze kwechimiro zvichikonzera kusagadzikana izvo zvinogona kutungamirira ku bradycardia.
Vana vasati vasvika vanogona kuita kuti zvive zvinokonzera kuti vave nezvikamu zveBradycardia. Kukurudzira kwakadzika, kudya, kuisa chikwata chokufudza, uye reflux inogona kuita kuti preemie ive nechiitiko che bradycardia. Zvichienderana nechikonzero cheBrady chichatsigira nekupindira. Kazhinji preemie bradycardia dzimwe nguva inogona kuzvigadzirisa kana chirwere chetsitsi chichikonzerwa kuti chime mukati. Kana izvi zvisingaitiki, mwana achange achida kukurudzirwa, zvichida nekubata kwechiedza kana kukurumidza kufema kwetsoka kana kubvisa shure. Mune mamwe mamiriro ezvinhu, mwana achada oksijeni kana kuwedzerwa mumhepo yakakisi. Caffeine imishonga inoshandiswa kana bradycardia inokonzerwa nepnea (pause in breathing). Dzimwe nguva Brady's anonyevera zviratidzo zvekuti chimwe chinhu chinogona kuva chakaipa sechipatara chakadai sehutachiona. Muzviitiko zvakawanda, apo mwana anowedzera uye urongwa hwekutya hunokura, huchakura huri.
Chii Chinonzi Apnea?
Apnea ishoko rokuti kusafema kana kumbomira mukufema uye zvakajairika mumaana asati avapo. Kana nguva isati yasvika mwana wacho, yakawanda mikana yokuti apnea ichaitika. Apnea of ​​prematurity inowanzokonzerwa nehutachiona hwemutambo weshuga. Nzvimbo dzinodzora kufema hazvigadziri zvakakwana uye dzinogona kutendeseka. Zvisinei, apnea spells inogona kukonzerwa nezvimwe zvikonzero uye inogona kuratidza:
- Kuti mwana angave ari kutora utachiona.
- Kusveta kana kuora kwemasu muuropi.
- Matumbo emakwenzi akadai se reflux. (Apo dumbu racho riri mukati maro rinopinda mudenga.)
- Zvishoma pasi kana zvakanyanya kukwirira kwemakemikari mumuviri, zvakadai seglucose kana calcium.
- Kukurudzirwa kwezvirwere zvinogona kukonzera apnea zvakadai sekudyisa mabhesi kana kunwa, uye kushambidzika kusingachinji.
Apo apnea inowanzoitika, kukurudzirwa nekubvisa musana kana rutsoka kunogona kubatsira kukuyeuchidza mwana kuti atange kufema zvakare. Vazhinji vana vasati vasvika vachabvisa apnea yekufananidza kwevakawanda kazhinji kana vachizosvika mavhiki makumi matatu nemasere. Iyo pfupi pfupi haisi kukuvadza ku preemie asi kana ichiitika kakawanda, mwana achaiswa pamishonga (kazhinji caffeine) kuti abatsire kusimbisa hutano hwepamusoro.
Vakatarisa vari chikamu chikuru cheNICU sezvavanoratidzira ruzivo runopfuurira pamusoro pezviratidzo zvinokosha zvevana. Zvose mabhero uye bongu zvinogona kunge zvisinganzwisisiki pakutanga. Asi kuziva kuti alamu imwe neimwe ndeyei uye zvinorevei zvinogona kubatsira kuita kuti unzwe wakasununguka nemwana wako. Vatariri vanowanzova chituko chinokosha chemashoko kuvabereki, uye zvingangove zvakaoma kugadzirisa kusavapo kwavo kana iwe uchisunungurwa kumba. Inogona kuva inofadza zvikuru uye inotyisa panguva imwecheteyo pakupedzisira iine cordless, wireless baby.
> Sources:
> Apnea uye Bradycardia. (nd). Kudzorerwa kubva ku http://www.pediatrics.emory.edu/divisions/neonatology/parent_info3.html
> Kuwedzerwa kweropa ropa - neonates: Neonatal ehandbook - Department of Health and Human Services, Victoria, Australia. (nd). Kudzorerwa kubva ku http://www.health.vic.gov.au/neonatalhandbook/procedures/blood-pressure.htm
> Dambudziko reRopa rinotarisana nevana vasati vasvika. I. Maawa okutanga ehupenyu. - PubMed - NCBI. (nd). Yakadzorerwa kubva ku http://www.ncbi.nlm.nih.gov/pubmed/8151481
> Epidemiology yeApnea neBradycardia Kugadziriswa muMucheche Makana. (nd). Kudzorerwa kubva ku http://pediatrics.aappublications.org/content/128/2/e366.full
> Neonatal Hypertension. (nd). Yakadzorerwa kubva ku http://emedicine.medscape.com/article/979588-overview
> Neonatal Monitoring, Chimwe Chinyorwa Chekuchengetedza - RT: Nevatongi Vagadziro muHupfu Hwenyama. (nd). Kudzorerwa kubva ku http://www.rtmagazine.com/2013/10/neonatal-monitoring-an-extra-layer-of-care/
> Apo Mwana Wenyu ari muNICU. (nd). Kudzorerwa kubva ku http://kidshealth.org/parent/system/ill/nicu_caring.html