Question

Question 3 3. The midwife prepares to receive a term baby after delivery after delivery. The baby’s Apgar score in the 1st and 5th minute were 1 and 3 respectively. The midwife therefore concludes that the baby is asphyxiated and begins resuscitation. A. How would you explain birth asphyxia to a student nurse? (2marks) B. State four causes each of this condition before and after birth C. Outline the immediate care of the baby. (10marks)

Answer 1

1) asphyxia

It is a medical condition in which the brain is not getting enough oxygen rich blood it needs.

Birth asphyxia is the lack of blood flow or gas exchange to or from the fetus, in the period just before, during, or after birth.

Complications are;

. Cerebral palsy

. ADHD

. Vision or hearing problems

. Fetal distress

. Seizure disorder

. Developmental delays

• Cerebral palsy

• ADHD

• Loss of vision or hearing (or other vision / hearing problems

• Seizure disorders

. Hypoxic-ischemic encephalopathy

. Paralysis

. Death

The symptoms which can be seen immediately after birth include;

. Pale or blue skin

. Breathing difficulties, which may cause symptoms such as nasal flaring and abdominal breathing

. Slow heart rate

. Weak muscle tone

2) causes

Before birth

. The delivery lasts too long or is difficult

. An infection affects the mother or the baby

. Inadequate oxygen levels in the mother's blood due to heart or respiratory problems or lowered respiration caused by anaesthesia.

. The mother doesn't get enough oxygen before or during labor.

. The maternal BP is too high or low during labor

. Improperly wraped umbilical cord around the baby

Or compression of umbilical cord that decreases blood flow.

. Inadequate relaxation of the uterus during labor that prevents oxygen circulation to the placenta.

. The placenta separates from the uterus too quickly, resulting in a loss of oxygen.

. Poor placenta function caused by hypertension or post term pregnancy

After birth

. Severe anemia, results in limited oxygen carrying ability of the blood.

. Shock

. Respiratory problems that limit O2 intake

. Heart or lung disease

3) immediate care

. Establish effective ventilation

. Assist circulation if necessary

. Restrict fluid by 20 percent for first two days

.monitor bp and treat hypotension vigorously

. Assess respiratory effort and;

a. Ventilate if baby breathing spontaneously with arterial Co2 tension >7kPa

b. If baby ventilated maintain arterial Co2 tension at 4.5 kPa

. Mannitol, if presented with signs of raised intra cranial pressure

. Anticonvulsants if indicated