Neonatal Hypothermia

A Method to Provide Neuroprotection After Hypoxic Ischemic Encephalopathy

Katherine M. Newnam, MS, RN, CPNP, NNP-BC; Donna L. DeLoach, MS, RN, CPNP, NNP-BC

Disclosures

NAINR. 2011;11(3):113-124. 

In This Article

Developmental Considerations

Although many medical journals address the long-term developmental outcomes of the infant after hypothermia treatment of HIE, one must turn to the nursing literature for guidance in developmental care of the infant during the hospital stay. Careful prioritization is required of the bedside registered nurse to ensure that critical interventions as well as needed therapy are provided in a clustered format to reduce unwarranted stress on the infant. Increasing stress has been shown to increase metabolic rates, resulting in the risk for temperature elevation.[4] Premedication before care may be necessary. Gentle repositioning of the infant is frequently needed and can be accomplished by providing developmentally appropriate care through the use of positioning aids to support hands to the midline and knees aligned with the shoulders.[29] The infant must be positioned to avoid prolonged tissue pressure and potential shearing forces over the bony prominences. This intervention affords the nurse the opportunity to examine the skin closely for changes, intervening at the first sign of skin breakdown.

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