Essay about Neonatal Respiratory distress syndrome reflective practice

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This assignment describes my own reflective experience while caring for a sick neonate with Respiratory Distress Syndrome (RDS) in the neonatal unit. This has enabled me to explore the meaning and significance of my clinical practice and to recognise the complexities within it. The experience raises a number of issues frequently encountered in daily nursing practice. Within this assignment, I will be discussing a particular pre term baby with RDS and critically analyse the use of nasal continuous positive airways pressure (NCPAP) and surfactant therapy and possible effects on baby’s outcome. Pseudonyms will be used to maintain patient confidentiality in order to keep in with the nursing and midwifery council code of conduct. (NMC 2004)The …show more content…
Due to the lack of adequate surfactant in miniature lungs the alveoli collapses and cause inadequate gaseous exchange with hypoxemia and hypercarbia, resulting acidosis. In some babies pulmonary vasoconstriction leads to persistent hypertension and right to left shunts resulting more severe hypoxemia. (Rodriguez 2003)
Management of RDS include both prevention and active management before during and after birth. Prevention of preterm delivery is very important as the vast majority of babies who develop RDS do so because they are born preterm. Late or lack of antenatal care, smoking, alcohol consumption, illegal drug use, domestic violence, lack of social support, high levels of stress and long working hours with lengthy periods of standing can all increase the risk of premature birth( Johnson et al, 2003). Current medical approaches to preventing preterm labour include the use of tocolytic drugs, antibiotic treatment and cervical cerclage. Tocolytic drugs such as ritodrine can delay the progress of preterm labour in the short term which may allow enough time to give the women antenatal steroids or to arrange her transfer to a perinatal centre with neonatal intensive care facilities if needed (Murphy et al, 2004). A systematic review of randomised controlled trials (including large ORACLE 1 trial,) indicated that the antibiotics for preterm pre-labour membrane rupture prolong pregnancy and reduce the incidence of neonatal infection