Exam 2: NEC Flashcards
What is NEC?
Inflammatory disease of the bowel
Period of ischemia (decreased blood flow and o2, leads to necrotic injury of GI tract
Most common acquired infection in pre-term infant
What is the mortality rate of NEC?
50% mortality rate
What are the predisposing factors for developing NEC?
Decreased immune response
Prematurity
Increased permeability of bowels from inflammation
Decreased peristalsis causing bowel stasis
Hypoxia
Pathophysiology of NEC
Multifactorial
Bacterial or viral infection (first 2 weeks of life)
Period of low perfusion, low O2
Body diverts blood to vital organs (brain, heart & lungs)
-starves portion of GI tract & kidneys from receiving O2
PDA
Opening between aorta and pulmonary artery
What is apnea or bradycardia in infants?
<60 BPM
What are the signs and symptoms of NEC?
Abdominal distention
Poor feeding
Irritability
Vomiting
Low o2
Decreased temperature
Bradycardia
Hypotension
Decreased gastric emptying
Heme positive stool
Change in metabolism
What are the nursing interventions to prevent NEC?
Slow feedings
NG or OG tubes
Increase feeds slowly (human milk preferred)
Check residual before feeding
Measure abdominal girth
What do you do if NEC is suspected?
STOP ENTERAL FEEDINGS
IV to restore fluid balance
TPN to maintain nutrition
Gastric decompression
Antibiotics
Monitor I&O
How is NEC diagnosed?
Abdominal X-Ray (Dilated loops of bowel)
Abnormal gas pattern
Pneumotosis (gas in bowel wall - marbles/grapes)
If bowel perforates - gas escapes
What are signs and symptoms of sepsis from NEC?
Hypotension
Temperature instability (often low)
Irregular breathing
Elevated WBCs
Bleeding from perforated bowels
What are the nursing interventions for neonatal sepsis from NEC?
Careful monitoring of VS
Temperature instability (Infant warmer, isolette)
Venous access for blood draw (CBC with diff)
Inspect diapers - heme test
Antibiotics as prescribed
What is the treatment of NEC?
Rest bowels - NPO
TPN
Central venous line or PICC
Antibiotics (sometimes 2-3)
Decompress abdomen
Surgery
