The Risks Presented By GBS and Meningitis For Newborns

According to the Center For Disease Control (CDC), Group B Strep is the major prevalent cause of sepsis and meningitis (a severe infection of the fluid of the spinal cord and the fluid surrounding the brain) in newborns. Group B Strep is a bacterial infection that may affect an infant if the mother is is colonized with the bacteria and transmits it during childbirth.

The bacteria normally germinates in the vagina and/or the lower intestine. It is found in about 1 out of every 4 adult women. However, it usually does not lead to an active infection or lead to symptoms. Transmission from expecting mother to the baby generally occurs during labor and delivery. The child may be exposed to group b strep, for instance, if the bacteria moves up from the mother's vagina into the uterus after the membranes (bag of water) rupture. The newborn may also come in contact with GBS while moving down through the birth canal. In this time, the newborn can swallow or inhale the bacteria.

Around 75% of cases of Group b strep in newborns take place during the seven days of life, and the majority show up inside of a few hours following birth. This is called "early onset." The rest develop a GBS infection at anytime from one week to several months after birth. This is called as "late onset." Statistically, approximately fifty percent of instances of late onset can be related to the baby's mother having had the bacteria. In the other cases of late onset, the cause of the infection is unknown.

After the infant is exposed to the bacteria, it may travel to the infant's bloodstream. This may induce sepsis (overpowering infection throughout the body), pneumonia, or meningitis. These are all severe conditions which can progress rapidly and leave the infant with lifelong disabilities or may even cause the newborn's death. Among the typical possible disabilities are: brain damage, cerebral palsy, blindness, deafness, and seizures.

The most common symptoms of meningitis include: a high fever, lethargy, unusual irritability, trouble feeding, stiffness, vomiting, and rashes. Since the infection can advance quickly quick treatment is needed to avoid significant harm to the newborn. For bacterial based meningitis (such as that caused by Group B Strep), treatment calls for the immediate administration of intravenous IV and antibiotics. A diagnosis of meningitis is established through a sample of spinal fluid through a spinal tap and growing the bacteria for correct identification. This is important so as to determine the right antibiotic for use. The outcome of the test might take several hours. In the time it takes for the results, the infection can result in lasting damage or kill the child. Because of the immediacy required, treatment normally begins ahead of a confirmed diagnosis if meningitis is a possible explanation for the baby's symptoms. Penicillin is the most commonly administered treatment.

If an infant died or suffers from permanent disabilities that were avoidable except for the failure on the part of a physician to diagnose GBS meningitis or to provide immediate treatment that doctor might be liable for malpractice. The mothers and fathers of children thus injured by GBS meningitis should consult with a birth injury attorney immediately as the law permits just a limited amount of time to pursue a birth injury claim.

by: Joseph Hernandez

Hyperthermia Nanda Nursing Diagnosis - Dengue Fever

Nanda Nursing Diagnosis for Dengue Fever : Hyperthermia

Dengue hemorrhagic fever is an acute infectious disease manifested initially with fever. Dengue fever is one of the contagious viral diseases spread through the mosquito bite. The female Aedes aegypti mosquitoes thrive in stagnant water of surroundings and become the carriers of the virus. The disease is characterized by mild to high fever, headache, joint and muscle pains and rashes.

Signs and Symptoms

Mild to high fever about 105 F
Severe pain in the bone joints
Intense headache and backache
Loss of appetite
Appearance of rashes all over the body
Nausea followed by vomiting

Home Remedies for Dengue

1. One should reduce the exposure to mosquitoes as far as possible and not venture out in the dawn or dusk, when the mosquitoes are most prevalent.

2. Mosquito nets, mosquito repellant ointments and coils must be regularly used while sleeping at night, to prevent the mosquito bite.

3. Holy basil leaves are very useful in preventing and treating dengue. Drinking a decoction of basil leaves and cardamom powder, adding little salt and milk helps in reducing high fever.

4. Juice extracted from two raw papaya leaves helps in preventing Dengue.

5. Drinking few cups pf herbal tea prepared from basil leaves, ginger and cardamom powder is very effective in reducing the fever.

6. Orange juice is widely used for treating Dengue fever. Drinking orange juice helps in proper digestion to fight against the disease.

7. Plenty of water or diluted fruit juice must be administered to the patient to maintain the required water balance of the body.

Nursing Diagnosis and Interventions for Dengue Fever

Nursing Diagnosis Hyperthermia

related to :

the disease (viremia)

Goal :

Normal body temperature (36-37 C).
Patients were free from fever.

Nursing Interventions and Rational for DHF :

1. Assess the onset of fever.
Rational: to identify patterns of fever patients.

2. Observation of vital signs (temperature, pulse, blood pressure, respiration) every 3 hours.
Rational: vital signs is a reference to determine the patient's general condition.

3. Instruct patient to drink plenty
Rationale: Increased body temperature resulting in increased evaporation of the body so it needs to be balanced with a lot of fluid intake.

4. Give a warm compress.
Rational: With vasodilation can increase evaporation which accelerate the decline in body temperature.

5. Advise not to wear a thick blanket and clothing.
Rational: thin clothing helps reduce the evaporation of the body.

6. Give intravenous fluid therapy and medications according to physician programs.
Rational: infusion of fluids is very important for patients with a high temperature.

Impaired Skin Integrity Nanda Nursing Diagnosis - Stevens-Johnson Syndrome (SJS)

Stevens Johnsons Syndrome is a dangerous problem of the skin. It is thought to be a hypersensitivity complex affecting the skin and the mucous membranes.

Stevens Johnson Syndrome (SJS) is a severe and deadly allergic reaction to certain drugs, some proscription and some over the counter, which causes the severe burning of skin and mucosal membranes from the inside out. 15% of people who develop Stevens Johnson Syndrome will die as a direct result. Many drugs which have been known to cause SJS do not have warning labels notifying users about the very real danger of Stevens Johnson Syndrome.

The skin rash of SJS consists of erythematous (red) papules, vesicles, bullae. There may also be iris lesions. The mucosal lesions include conjunctivitis as well as oral and genital ulcers. The most frequent complications of SJS are keratitis, uveitis, and perforation of the globe of the eye all of which may result in permanent visual impairment.

Nanda Nursing Diagnosis : Impaired skin integrity related to inflammatory dermal and epidermal

Expected Outcomes:

Shows the skin and skin tissue intact.

Intervention:

1. Observation of skin turgor circulation daily notes and sensory as well as other changes that occur.
Rational: determining a baseline by which changes in status can be compared and appropriate intervention

2. Use a thin clothing and soft loom.
Rational: reduce irritation and pressure from the suture line of clothes, leave the incision open to air increases the healing process and reduce the risk of infection

3. Keep loom is used.
Rationale: to prevent infection

Intellectual Disability Causes and Signs

Doctors have found many causes of intellectual disabilities. The most common are:

Genetic conditions. Sometimes an intellectual disability is caused by abnormal genes inherited from parents, errors when genes combine, or other reasons. Examples of genetic conditions are Down syndrome, fragile X syndrome, and phenylketonuria (PKU).
Problems during pregnancy. An intellectual disability can result when the baby does not develop inside the mother properly. For example, there may be a problem with the way the baby’s cells divide as it grows. A woman who drinks alcohol or gets an infection like rubella during pregnancy may also have a baby with an intellectual disability.
Problems at birth. If a baby has problems during labor and birth, such as not getting enough oxygen, he or she may have an intellectual disability.
Health problems. Diseases like whooping cough, the measles, or meningitis can cause intellectual disabilities. They can also be caused by extreme malnutrition (not eating right), not getting enough medical care, or by being exposed to poisons like lead or mercury.

An intellectual disability is not a disease. You can’t catch an intellectual disability from anyone. It’s also not a type of mental illness, like depression. There is no cure for intellectual disabilities. However, most children with an intellectual disability can learn to do many things. It just takes them more time and effort than other children.

Signs of Intellectual Disability

There are many signs of an intellectual disability. For example, children with an intellectual disability may:

sit up, crawl, or walk later than other children;
learn to talk later, or have trouble speaking,
find it hard to remember things,
not understand how to pay for things,
have trouble understanding social rules,
have trouble seeing the consequences of their actions,
have trouble solving problems, and/or
have trouble thinking logically.