what nursing care does a 24 week old fetus require?

Question

Describe the various body systems in the preterm infant of 24 weeks and over and how it influences their ability to cope with extrauterine life?specifically,respiratory;cardiovascular;thermoregulation;gastrointestinal;;renal;hepatic;hematologic;immunologic;neurologica dn reactivity and behaioural states..any help really appreciated...I've been an ER/flight nurse and paramedic for 30 years and am preparing to emigrate and need to complete some extra OBGYN courses...which are doing my head in....I've bought 13 books incl the 2 resommended texts but just cant find the answers to some of the questions...and cos I'm still working in ER,nobody here knows!!

This is a technical question and I am looking for the technical and non-obvious answers probably from an NICU RN or MD,related to the really very specific developemental states of the (just viable) 24 week old fetus/infant.
-hopefully looking for a site or book or journal article that describes the various body systems and their ability to cope with extrauterine life- specifically the respiratory ;cardiovascular;GI;immunologic;renal;;hepatic;neurologic; ...Thank you for your help if you can offer any

Answer 1

OK-> the lungs of the premature infant are collapsed at the start since they have not yet used oxygen , they are also stiff, and do not produce enough surfactant thus cannot facilitate breathing. Usually corticosteroid medication are given to help prepare the fetus's lungs prior to birth. Such treatment is the most effective and least risky intervention available for improving the infant's chances of surviving a premature birth between 24 and 34 weeks of gestation.
Because the lungs interact closely with the heart and the kidneys, problems in one organ system can cause problems in the other. What goes on in the heart of a neonate has an effect on respiration. (Normally, the neonate's heart has shunts between pulmonary and systemic circulation, and when an infant is born at the normal time, or close to it, those shunts begin to close with the first breaths, and this closing process is completed at about 2 months of age. A 24-week neonate needs artificial respiration, and under artificial respiration those shunts might not close like they are supposed to. The problem that results from this is that oxygenated and deoxygenated blood mix in the infant's heart, less oxygenated blood goes out to the body than should be bringing up problems to the rest of the body systems.
A premature newborn is at risk of complications when many of the organs-especially the heart and lungs-are not ready to function on their own after birth. The less mature an infant is at birth, the greater the risk of serious medical complications.
The nursing care required for a 24 week old infant would generally follow the care of a premature newborn, though a 24 week old needs more extra care as they are more fragile and are more risky and has high mortality rate.
Check the attached link for your reference, it includes nursing management and nursing diagnosis of a premature infant, and respiratory care.

http://www.abac.edu/nursing/tdennis/nurs2208/pdf/Lecture%20Fourteen%20High%20Risk%20Infant.pdf
http://www.sunysb.edu/healthed/premature.html

You may also search by entering premature infant and you will get various results. Good luck!

Answer 2

1st: a "fetus" is technically still in the uterus...chose "infant" next time
2nd: at 24 weeks the infant would be a whole 3 months premature. developmentally speaking there could be respiratory problems, digestion problems, perhaps others.

i would suggest simply looking at an infant of 24 weeks, determining the systems that are underdevleoped (see above) then drawing some logical conculuions about how this would influence their ability to survive and cope... (eg: respiratory problems = ventilator = feeding tube) Also, birth weight would be low, which most likely means the infant is inside an incubator for warmth...

these seem like simple places to start, especially since you've been a nurse for 30 years!!!

Answer 3

i haven't a clue what your on about sorry but that looks like a different language to me :-S