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PHARMACY PRACTICE II > NEONATAL SEPSIS > Flashcards

NEONATAL SEPSIS Flashcards

1
Q

Neonatal sepsis

A

signs and symptoms of infection with or without accompanying bacteremia in the first month of life

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2
Q

Which infections are considered as neonatal sepsis

A

Systemic infections

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3
Q

Systemic infections classified under neonatal sepsis

A

Septicemia
Meningitis
Arthritis
Osteomyelitis
UTIs
Pneumonia

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4
Q

Are superficial infections included in neonatal sepsis

A

NO

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5
Q

Contributing factors to newborn’s susceptibility to infections

A

Immature immune system
Immature skin and mucosal surfaces
Open portal of entry in umbilical cord

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6
Q

Neonatal sepsis mortality rate is higher among……

A

Low birth weight
Pre-term neonates

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6
Q

Risk of sepsis is higher in this population of neonates

A

Prematurity
Low birth weight
Neonate with underlying illness

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7
Q

Gold standard for diagnosis of sepsis

A

Growth of an organism from a sterile site

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8
Q

Danger signs for severe illness in newborns

A

Not feeding well
Convulsions
Fast breathing (60bpm or more)
Severe chest indrawing
Fever (37.5 or more)
Low body temperature (less than 35.5)
Movement only when stimulated or no movement at all

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9
Q

Recommendations on the danger signs

A

Presence of any one of the danger signs is predictive of severe illness
If 1 or more dangers signs, treat immediately
Begin treatment and refer if facility cannot support care of the infant

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10
Q

Classification of neonatal sepsis

A

Early onset neonatal sepsis
Late onset neonatal sepsis

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11
Q

Early onset Neonatal sepsis

A

Presents within 0-3 days of life
Associated with microbes from mother

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12
Q

Late onset Neonatal Sepsis

A

Present after 3 days of life
Associated with care giving environment

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13
Q

Onset of EOS is most rapid in which group of neonates

A

Premature neonates

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14
Q

Pneumonia is common in which type of neonatal sepsis

A

Early onset sepsis

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15
Q

When does 85% of cases of EOS occur

A

Within 24hours of birth

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16
Q

Common organisms associated with EOS

A

Group B streptococcus
E. coli
Coagulase-negative Staphylococcus

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17
Q

Risk factors for EOS

A

Premature birth or LBW
Maternal UTI
Maternal fever >38
Poor prenatal care
Poor maternal nutrition
PROM (<37 weeks)
Prolonged PROM
Prolonged rupture of membranes (18hrs or more)
Intraamniotic infection
Maternal colonisation with group B streptococci

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18
Q

PROM

A

Premature rupture of mebranes (rupture of featl membranes prior to onset of regular uterine contractions, 37 weeks or more)

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19
Q

Infections common in LOS

A

Meningitis
Bacteremia

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20
Q

Common organisms associated with LOS

A

Klebsiella
E coli
Coagulate negative staphylococcus
Staphylococcus aureus

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21
Q

Common organisms associated with both EOS and LOS

A

E. coli
Coagulase negative staphylococcus

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22
Q

Risk factors for LOS

A

Prematurity
Birth asphyxia, meconium staining, stress
Environmental exposure
Procedures (eg. lines, ET-tubes)
Breaks in skin and mucous membranes integrity

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23
Q

Conditions that cause breaks in skin and mucous membranes in neonates

A

Omphalocoele
Meningomylocoele

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24
Q

What percentage of newborn deaths in Ghana is due to neonatal sepsis

A

25-28

25
Q

Maternal risk factors associated with neonatal sepsis in Ghana

A

Parity
Mode of delivery
Bleeding disorder
PROM

26
Q

Neonatal risk factors associated with neonatal sepsis in Ghana

A

APGAR score in the first and fifth minute
Need for resuscitation at birth
Duration of stay in the facility
Neonatal age on admission

27
Q

Most common adverse event in health facilities

A

Hospital acquired infections

28
Q

Signs of local infection

A

Many or severe skin pustules
Umbilical redness extending to peri-umbilical skin
Umbilicus draining pus
Bulging fontanelle
Painfull joints, joint swelling, reduced movement, irritability if these parts are handled
Eye discharge
Abscess

29
Q

Investigations for sepsis

A

FBC, RBS, BUE,
Blood culture
Urine culture
Swab of any leasion or discharge area for C&S
CSF biochemistry and C&S
X-ray
Blood gases
Serum bilirubin
Oxygen saturation

30
Q

Managing abdominal distention in neonates

A

NIL orally, Gastric aspiration 2 hourly until no distension

31
Q

Supportive treatment for SEPSIS

A

Ensure ABC
IV fluids as required
Maintain temperature
O2 as required
Manage seizure
Introduce feeding asap
Manage metabolic problems
Manage abdominal distension

32
Q

If sepsis is not improved in ——– hours, refer to higher center

A

12 hours for neonatal sepsis
48 hours for cord sepsis

33
Q

Treatment for neonatal sepsis

A

IV/IM Ampicillin + IV/IM Gentamycin
or
IV/IM Ampicillin + IV Cefotaxime

34
Q

Treatment for cord sepsis

A

IV/IM Flucloxacillin + IV/IM Gentamycin

35
Q

Treatmment for sepsis when meningitis is suspected or proven

A

IV Ampicillin + IV Gentamycin

36
Q

Diagnosis of meningitis

A

WBC in the CSF 20/mm3 or more for babies<7days or 10/mm3 or more for babies 7days old or more

Culture or Gram stain of CSF is positive

37
Q

Duration for treatment of sepsis with meningitis

A

If baby’s condition improve after 48 hours
Continue for 14 to 21 days or for 7 days after signs of improvement are first noticed

38
Q

Dose of ampicillin for sepsis

A

50mg/kg/dose 12 hourly for <7days

50mg/kg/dose 8hourly for 7 days old or more

39
Q

Dose of ampicillin for meningitis

A

100mg/kg/dose 12 hourly for babies < 7 days

100mg/kg/dose 8 hourly for babies more or equal to 7 days old

40
Q

Dose for flucloxacillin for cord sepsis

A

50mg/kg/dose 8 hourly

41
Q

Dose of Gentamicin for both sepsis and meningitis

A

<2Kg- 4mg/kg once daily

2Kg or more- 5mg/kg once daily

42
Q

Dose of Cefotaxime for sepsis

A

<7days- 50mg/kg/dose 12 hourly
7 days or more- 50mg/kg/dose 8 hourly

43
Q

Cefotaxime for meningitis

A

50mg/kg/dose
8hourly for <7days old
6hourly for 7 days old or more

44
Q

Chain of infection

A

Infectious agent
Reservoir host
Portal of exit
Route of transmission
Portal of entry
Susceptible host

45
Q

Route of transmission of infections

A

Air
Ingestion
Direct or indirect contact

46
Q

What is IPC

A

Procedures and practices used to reduce the risk of spreading infections esp in healthcare facilities

47
Q

What are standard precautions

A

Basic level infection control precautions which are to used as a minimum in the care of all patients

48
Q

12 components of standard precautions

A

1.Proper hand hygiene
2. Appropriate use of PPE
3. Patient placement and transportation
4. Effective processing of used patient care equipment
5. Proper environment cleaning and disinfection
6. Appropriate sharps management
7. Proper healthcare waste management
8. Safe injection practices
9. Occupational health and bloodborne pathogens
10. Appropriate handling of textiles, line and laundry
11. Proper management of clinical specimen
12. Respiratory hygiene/Cough etiquette

49
Q

Transmission Based Precautions

A

Used when the route of transmission cannot be completely interrupted using standard procedures

50
Q

When is transmission based precaution used

A
  1. Patients in isolation
  2. Outbreaks of highly infectious diseases
  3. Infections of epidemiological importance
51
Q

Categories of TBP

A
  1. Contact precautions
  2. Droplet precautions
  3. Airborne precautions
52
Q

Contact precautions

A

Gloves and Gown

53
Q

When is contact precautions employed

A

Pemphigus neonatarium
Cholera
Scabies
Herpes simplex

54
Q

Face shield and Face mask

A

Droplet precautions

55
Q

Droplet precautions are employed in

A

Whooping cough
Meningitis
Influenza

56
Q

Airborne precautions

A

N95 Mask

57
Q

Airborne precautions are employed in

A

Tuberculosis
Measles
Chicken pox

58
Q

The five cleans

A

Clean hands
Clean surfaces and linen
Clean and dry cord
Clean cut and tie
Sterile instruments

59
Q

Preventive elements of essential newborn care

A

1.Early and exclusive breastfeeding
2.Cord care
3. General hygiene
4. Thermal care

PHARMACY PRACTICE II (17 decks)

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