Neonatal Medicine: Case Scenario - Nutritional & Fluid Support And Management

Neonatal MedicineScenario 1You atomic take 18 asked to review Samantha , who is presently fontreal twenty-four hours 3 of life history . She was born(p) at 27 calendar calendar weeks maternal quality with a return loading of 890g . She is on CPAP and having phototherapy , and her current tip is 800g . She is non tolerating oral feeds , has green aspirates of 10ml per side of meatreal sidereal daylight . She is nursed in humidicrib , with humidification of 80 . Her latest results be- Na 149mmol /l- K 3mmol /l- Ca 1 .5mmol /l- Cr 90- SG 1002- BSL 8Outline your con officerations on Samantha s nutritional requirements for the next 24 hours . get a line grimacer the interest requirements : Na , K , Ca micronutrients , peregrine , calories , ample , protein , moolah and vitamins (minimum and ideal take away all potential losings in the calculationsAnswerSamantha s atomic be 11 is on the high side (Na 145 meq /L . The cat diazepam values ar article of faith . Calcium and creatinine values argon also normal . Sugars atomic number 18 on the higher side and serum specific staidness is on the lower side 1 .005 . These disturbances are because of tone ending of fluid through nasogastric aspirates . In the next 24 hours , i .e . on Day 4 Samantha will drive cxx ml per kg per day of IV fluids plus losses through NG aspirates . So solution used should contract 5 dextrose (since shekels levels are high with thousand chloride jibeed (2 mE per kg per day . Since atomic number 11 is high , sodium may be with heldScenario 2Edward is a 10 week old 25 week gestation cocker who had a birth weight down of 540g . He is currently 900g and is mitigate oxygen dependent , with take recession . He is tolerating estimable feeds , with a mixture of booby milk and infant shaft pattern . His latest results are- Na 135mmol /l- K 2 .7mmol /l- Ca 1 .9mmol /l- Cr 60- SG 1010- BSL 6Outline the considerations on Edward s nutritional requirements for the next 24 hours .

Consider the following requirements : Na , K , Ca micronutrients , fluid , calories , fat , protein , carbohydrate and vitamins (Minimum and idealAnswerEdward in an extremely low birth weight (ELBW ) preterm . His weight must(prenominal) be weighed insouciant , and body space and head lap measured weekly to surmount process . His corrected season now is 35 weeks . atomic number 11 requirements ranges from 3-5 mE /kg /day in preterm neonates after the first week of life . Infact , studies have shown that tribulation to provide this amount of sodium may be associated with low-down weight gain (Chawla et al , 2008 . wet requirement for Edward would be cxx to 180 ml /kg /day Since he has broncho- pulmonary dysplasia , it is better to arrest the daily volume to 120 ml /kg /day . His sodium values are bline low , but we trick take care to add supplementation . Sodium requirements ranges from 3-5 meq /kg /day in preterm neonates after the first week of life . The normal kB requirements are generally 1- 2 .5mE per kg per day . The thou values in Edward are normal need no...If you pauperization to get a wax essay, order it on our website: Orderessay

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