Condition of Prematurity and Associated Disorders: the Causes and Treatment
Condition of Prematurity and Associated Disorders: the Causes and Treatment
1. List the possible causes of congenital anomalies. Describe the condition of prematurity and associated disorders: the causes and treatment. 2. Identify the predisposing factors of disease. Describe the ways in which pathogens may cause disease. Explain the inflammation response to disease. 3. TABLE 4.1: Example of Terms Relating to Research Problems Topic/focus Side effects of chemotherapy Research problem (Problem statement) Nausea and vomiting are common side effects among patients on chemotherapy, and interventions to date have been only moderately successful in reducing these effects. New interventions that can reduce or prevent these side effects need to be identified. Research questions are the specific queries researchers want to answer in addressing the problem. Research questions guide the types of data to collect in a study. Researchers who make predictions about answers to research questions pose hypotheses that can be tested. Many reports include a statement of purpose (or purpose statement), which summarizes the study goals. Researchers might also identify several research aims or objectives—the specific accomplishments they hope to achieve by conducting the study. The objectives include answering research questions or testing research hypotheses but may also encompass broader aims (e.g., developing an effective intervention). Condition of Prematurity and Associated Disorders: the Causes and Treatment.These terms are not always consistently defined in research methods textbooks, and differences among them are often subtle. Table 4.1 illustrates the terms as we define them. Research Problems and Paradigms Some research problems are better suited to qualitative versus quantitative methods. Quantitative studies usually focus on concepts that are fairly well developed, about which there is existing evidence, and for which reliable methods of measurement have been (or can be) developed. For example, a quantitative study might be undertaken to explore whether older people with chronic illness who continue working are less (or more) depressed than those who retire. There are relatively good measures of depression that would yield quantitative information about the level of depression in a sample of employed and retired chronically ill seniors. Qualitative studies are often undertaken because a researcher wants to develop a rich and context-bound understanding of a poorly understood phenomenon. Researchers sometimes initiate qualitative studies to heighten awareness and create a dialogue about a phenomenon. Qualitative methods would not be well suited to comparing levels of depression among employed and retired seniors, but they would be ideal for exploring, for example, the meaning or experience of depression among chronically ill retirees. Thus, the nature of the research question is linked to paradigms and to research traditions within paradigms. Sources of Research Problems Where do ideas for research problems come from? At a basic level, research topics originate with researchers’ interests. Because research is a time-consuming enterprise, curiosity about and interest in a topic are essential. Research reports rarely indicate the source of researchers’ inspiration, but a variety of explicit sources can fuel their interest, including the following: Clinical experience. Nurses’ everyday clinical experience is a rich source of ideas for research topics. Immediate problems that need a solution—analogous to problemfocused triggers discussed in Chapter 2—may generate enthusiasm, and they have high potential for clinical relevance. Quality improvement efforts. Important clinical questions sometimes emerge in the context of findings from quality improvement studies. Personal involvement on a quality improvement team can sometimes lead to ideas for a study. Nursing literature. Ideas for studies often come from reading the nursing literature. Research articles may suggest problems indirectly by stimulating the reader’s curiosity and directly by noting needed research. Familiarity with existing research or with emerging clinical issues is an important route to developing a research topic. Social issues. Condition of Prematurity and Associated Disorders: the Causes and Treatment. Topics are sometimes suggested by global social or political issues of relevance to the health care community. For example, the feminist movement raised questions about such topics as gender equity in health care. Public awareness about health disparities has led to research on health care access and culturally sensitive interventions. Theories. Theories from nursing and other disciplines sometimes suggest a research problem. Researchers ask, “If this theory is correct, what would I predict about people’s behaviors, states, or feelings?” The predictions can then be tested through research. Ideas from external sources. External sources and direct suggestions can sometimes provide the impetus for a research idea. For example, ideas for studies may emerge by reviewing a funding agency’s research priorities or from brainstorming with other nurses. Additionally, researchers who have developed a program of research on a topic area may get inspiration for “next steps” from their own findings or from a discussion of those findings with others.
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Overview
Birth is considered premature, or preterm, when it occurs before the 37th week of pregnancy. A normal pregnancy lasts about 40 weeks.
Those final weeks in the womb are crucial for healthy weight gain and for the full development of various vital organs, including the brain and lungs. This is why premature babies may have more medical problems and may require a longer hospital stay. They may also have long-term health issues, such as learning disabilities or physical disabilities. Condition of Prematurity and Associated Disorders: the Causes and Treatment.
In the past, premature birth was the major cause of infant death in the United States. Today, the quality of care for newborns has improved, as have the survival rates of premature babies. Yet premature birth is still the top cause of infant death worldwide, according to the Centers for Disease Control and PreventionTrusted Source. It’s also a leading cause of long-term nervous system disorders in children.
The cause of a premature birth often can’t be identified. However, certain factors are known to increase a woman’s risk of going into labor early.
A pregnant woman with any of the following conditions is more likely to have a premature birth:
- diabetes
- heart disease
- kidney disease
- high blood pressure
Pregnancy-related factors associated with premature birth include:
- poor nutrition before and during pregnancy
- smoking, using illegal drugs, or drinking too much alcohol during pregnancy
- certain infections, such as urinary tract and amniotic membrane infections
- premature birth in a previous pregnancy
- an abnormal uterus
- a weakened cervix opening early
Pregnant women also have an increased chance of delivering early if they are younger than 17 or older than 35.
The earlier a baby is born, the more likely they are to have medical problems. A premature infant may show these signs soon after birth:
- trouble breathing
- low weight
- low body fat
- inability to maintain a constant body temperature
- less activity than normal
- movement and coordination problems
- difficulties with feeding
- abnormally pale or yellow skin
Premature infants may also be born with life-threatening conditions. These can include:
- brain hemorrhage, or bleeding in the brain
- pulmonary hemorrhage, or bleeding in the lungs
- hypoglycemia, or low blood sugar
- neonatal sepsis, a bacterial blood infection
- pneumonia, an infection and inflammation of the lungs
- patent ductus arteriosus, an unclosed hole in the main blood vessel of the heart
- anemia, a lack of red blood cells for transporting oxygen throughout the body
- neonatal respiratory distress syndrome, a breathing disorder caused by underdeveloped lungs
Some of these problems can be resolved through proper critical care for the newborn. Others can result in long-term disability or illness.
Doctors perform various tests on premature infants soon after childbirth. These tests help reduce the risk of complications. Doctors also monitor infants continuously during their hospital stay. Condition of Prematurity and Associated Disorders: the Causes and Treatment.
Common tests include:
- chest X-ray to evaluate heart and lung development
- blood tests to assess glucose, calcium, and bilirubin levels
- blood gas analysis to determine blood oxygen levels
Doctors often try to prevent a premature birth by giving the mother certain medications that can delay delivery.
If premature labor can’t be stopped or a baby needs to be delivered prematurely, doctors then prepare for a high-risk birth. The mother may need to go to a hospital that has a neonatal intensive care unit (NICU). This will ensure the infant receives immediate care after birth.
In the first few days and weeks of the premature baby’s life, hospital care focuses on supporting vital organ development. The newborn may be kept in a temperature-controlled incubator. Monitoring equipment tracks the baby’s heart rate, breathing, and blood oxygen levels. It may be weeks or months before the baby is able to live without medical support.
Many premature babies can’t eat by mouth because they can’t yet coordinate sucking and swallowing. These babies are fed vital nutrients either intravenously or using a tube inserted through the nose or mouth and into the stomach. Once the baby is strong enough to suck and swallow, breast-feeding or bottle-feeding is usually possible.
The premature baby may be given oxygen if their lungs aren’t fully developed. Depending on how well the infant can breathe on their own, one of the following may be used to deliver oxygen:
- ventilator, a machine that pumps air into and out of the lungs
- continuous positive airway pressure, a treatment that uses mild air pressure to keep the airways open
- oxygen hood, a device that fits over the infant’s head to supply oxygen
Generally, a premature infant can be released from the hospital once they can:
- breast-feed or bottle-feed
- breathe without support
- maintain body temperature and body weight
Premature infants often require special care. This is why they usually begin their lives in an NICU. The NICU provides an environment that limits stress to the baby. It also provides the warmth, nutrition, and protection needed for proper growth and development.
Due to many recent advances in care for mothers and newborns, survival rates for premature infants have improved. Condition of Prematurity and Associated Disorders: the Causes and Treatment. A study published by JAMATrusted Source found that the survival rate for babies born before 28 weeks, which is considered extremely premature, increased from 70 percent in 1993 to 79 percent in 2012.
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Even so, all premature infants are at risk of long-term complications. Developmental, medical, and behavioral problems can continue through childhood. Some may even cause permanent disabilities.
Common long-term problems associated with premature birth, especially extreme prematurity, include:
- hearing problems
- vision loss or blindness
- learning disabilities
- physical disabilities
- delayed growth and poor coordination
Parents of premature infants need to pay careful attention to their child’s cognitive and motor development. This includes the achievement of certain skills, such as smiling, sitting, and walking.
Speech and behavioral development also are important to monitor. Some premature infants may need speech therapy or physical therapy throughout their childhood.
Getting prompt and proper prenatal care significantly reduces the chances of having a premature birth. Other important preventive measures include:
Eating a healthy diet before and during your pregnancy. Make sure to eat lot of whole grains, lean proteins, vegetables, and fruits. Taking folic acid and calcium supplements is also highly recommended.
Drinking lots of water every day. The recommended amount is eight glasses per day, but you’ll want to drink more if you exercise.
Taking aspirin daily starting in the first trimester. If you have high blood pressure or a history of premature birth, your doctor may recommend you take 60 to 80 milligrams of aspirin each day.
Quitting smoking, using illegal drugs, or overusing certain prescription drugs. These activities during pregnancy may lead to a higher risk of certain birth defects as well as miscarriage.
Talk to your doctor if you’re concerned about having a premature birth. Your doctor may be able to suggest additional preventive measures that can help lower your risk of giving birth prematurely. Condition of Prematurity and Associated Disorders: the Causes and Treatment.
