Neonatal Sepsis – Newborn Complications (Nursing)

00:01 Next, let's talk about Newborn Neonatal Sepsis.

00:05 Sepsis is just a fancy way of saying infection.

00:09 Risk factors for neonatal sepsis include Prenatal infections in the birthing person.

00:15 Two of the most common infections would be group Beta strep or E coli.

00:19 But there can also be other infections that may lead to neonatal sepsis.

00:23 A preterm infant may experience things like a prolonged rupture of membranes, or maybe they're preterm because of an infection like group Beta strep.

00:33 Someone who experiences a long labor can also have a baby that's at risk for neonatal sepsis.

00:38 Think about the things that happened during a prolonged labor, multiple vaginal exams being a number one reason.

00:45 So we know from research studies that anytime more than seven exams are performed.

00:50 That increases the risk of infection in the birthing person, which can translate to infection in the neonate.

00:57 Also, when someone is in labor for a long time, they may also experienced prolonged rupture of membranes, where we have rupture of the membranes longer than 24 hours.

01:06 We lose that protective sack that keeps the infection from getting to the baby.

01:13 Symptoms of neonatal sepsis include poor tone.

01:16 So a baby that's flaccid as opposed to well flexed.

01:20 The baby may also lose that healthy color and experience paler, so they look maybe more pale.

01:26 They may also experience respiratory distress or poor feeding.

01:30 Does this sound familiar? Depending on how far into the shock cascade, the baby has gone, they may experience tachycardia.

01:38 Along with an infection, along with a fever, or they may experience bradycardia.

01:44 They may have temperature instability, and they may have persistent or recurrent hypothermia, where the baby comes up to a normal temperature, but they have difficulty maintaining that temperature, and then they develop a fever.

01:57 So these are all possibilities of ways that the baby could present with neonatal sepsis.

02:02 In terms of our assessment, we want to check our vital signs, we're going to look for labs specifically trying to indicate which type of infection is at work, because when we begin our next part, which is our treatment, we have to know that particular organism that we're dealing with.

02:18 We will also get a CBC with differential and we'll also check the electrolytes to see where the baby is.

02:24 So treatment for neonatal sepsis is going to include IV antibiotics and IV fluids.

02:31 We also want to offer nutritional support, because the baby has to have a way to fight off this infection.

02:37 It's also important to provide thermoregulatory support.

02:41 Again, remember, if one system is not doing well, it affects every other system.

02:47 And finally, as with every other complication, making sure that we decrease the stimuli so the baby has enough energy to fight off this infection.

02:56 Can we prevent neonatal sepsis? Absolutely.

02:59 One of the major ways we do this is getting birthing persons into prenatal care.

03:05 It allows us to test and look for any pre-existing signs of any type of infection prior to giving birth, and maybe avoid a preterm birth to begin with.

03:15 Let's talk about prevention during labor.

03:18 Around 35-36 weeks, every client will receive an opportunity to have a Group Beta strep test.

03:24 For the clients who test positive, we will treat that Group Beta strep prophylactically in labor.

03:30 So they may not show symptomatic signs of having group beta strep, just have the organism on board.

03:36 We'll also review records for any sort of risk factors that may not have been picked up during the prenatal visit.

03:42 We also want to make sure that we perform pericare.

03:46 Remember that E-coli? Anything that may be dragged into the vagina, and thus into the uterus and to the baby during exams, we want to minimize. So pericare will help with that.

03:57 But also, if we just minimize the number of vaginal exams that we do, that could also go a long way.

04:03 Once the water breaks, we want to make sure that we are assessing for signs of infection.

04:07 This is specifically related to the amniotic fluid.

04:11 Once it's broken, we want to check every two hours for the temperature of the birthing person.

04:16 And we want to look at the fluid to make sure that it remains clear because it can show signs of infection later on in the process.

04:24 We also want to do the very basic of washing our hands as we interact with the client, and encouraging the client to wash their hands and all the other support persons to do that as well.

04:34 We want to monitor for illness in the visitors.

04:37 So whomever comes to visit with the birthing person, we want to make sure they're infection free as well.

04:43 And we want to maintain asepsis.

04:45 So when we think about procedures that we may do, including and putting in internal leads, or using an indwelling catheter, or an epidural, or anything else, we want to make sure that we're using sterile technique.