Nursing Care for Infants in Incubator

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Incubator

• Is an equipment to provide optimal condition of temperature, humidity and oxygen for survival of preterm, low birth weight or high risk infants.

• Is important to delay or to prevent cold stress that produces additional hazards to the newborn as hypoxia, hypoglycaemia and metabolic acidosis.

• Neutral thermal environment is one that permits the infants to maintain normal core temperature, with minimum oxygen consumption and caloric expenditure.

• Consumption of oxygen is minimal at abdominal temperature ‘36-36.5º C’, So when abdominal skin temperature is increased or decreased ,oxygen consumption increases.

The Isolette Infant Incubator

Functions

– Control temperature

– Humidity and oxygen concentration

– It provides high degree of isolation through slight

– It maintains positive pressure by air circulation.

– A client probe to the abdominal skin as a guide in controlling the heater output of unit.

Parts of Incubator

• Incubator lights

• Temperature indictor meter

• Thermostat knob

• Patients prob

• Control point adjust button

• Red line adjust button

• Oxygen inlet

• Ice chamber

• Humidity control

• Humididty chamber

• Portholes and plastic sleeves

• weighing facility

• Thermometer

• Plexyglass porthole

• Plastic bar

• Storage cabinet

Note:

1.The microfilter pad of the air filter at the rear of the incubator
should be changed every three months.

2. Alcohol should never be used to wipe the plexyglass hood.

 

Nursing Care of Infants in Incubator

PRINCIPLES NURSING RESPONSIBILITIES
General use

• Physician order should indicate amount of humidity, liter flow of Oxygen and its concentration.

• Observe and record the infant’s responses. And notified if cyanosis, retraction, grunting respiration, or hypothermia.

• Nurse may use her judgment in placing a new born who weighs less than 5 pound 8 ounces in an incubator until doctor arrives

• At least one vacant incubator should be kept ready.

• Don’t place incubator on direct sunlight or near radiator.

It is necessary to take body temperature of the infant to determine the amount of external heat required. • Nurse should record infant temperature every hour until stabilized and then every four hours.

• If temperature is elevated or subnormal, the temperature dial of the incubator should be adjusted.

• Abrupt changes in the incubator temperature can cause untoward metabolic responses in the newborn that may result in apnea. • Prewarming to 36.5-37oC for infants less than 1500 g and to 34-36.1 to infants above 1500 g

• The normal range of body temperature for a newborn is not always an exact reading of 98.6oF/37oC

•Monitor body temp. and respirations

• To maintain the atmospheric conditions constant, need not to open during routine care. • No need of using masks and gowns for caring of infant in incubator.

• Use the port holes of the incubator for providing care

• Expose the chest for effective observation of respiration • Infant need not be fully clothed, incubator provides stable atmospheric conditions during routine care.
Oxygen

Oxygen therapy is more effective when interruptions in the oxygen administration are kept to a minimum.

• When the oxygen supply is not centrally located, the oxygen tank must be changed at intervals to ensure continuous therapy.

• When the pressure gauge reading falls below 100 lb, the oxygen technician should be notified.

• Low oxygen concentration-hypoxia-cause brain damage. • The oxygen concentration should be checked every hour
• Excessive oxygen concentration damage the optic nerve. Incubator care requires organization of nursing care activities to prevent loss of oxygen, warmth and humidity
Weaning

Should be gradual process to avoid chilling due to the change from incubator temperature to room temperature.

• Dress and wrap the infant and open all the portholes.

• After the incubator cooled, the infant may be removed and placed in a regular basinet.

Terminal cleaning

• Stagnant water harbors virulent pathogens. Thorough cleansing of the unit and removal of the water will prevent the spread of infection.

• When infant is removed from incubator, the unit should be cleaned before reuse. All water should be removed from reservoirs.
• Alcohol ,ether, or acetone will dissolve plastic. Alcohol, ether, or acetone should not be used to clean plastic parts

 

1. Maintaining temperature:

• Pre-warming the incubator up to the desired temperature before placing the infant in it.

• For infant weighing less than1500 gm the incubator pre-warmed to 34- 36.1º C.

• For infants weighing more than 1500 gm the incubator pre-warmed to 34- 35º C.

• When infant removed from incubator should be well wrapped in blankets to conserve heat.

 

2. Feeding:

• The nurse can feed infant inside the incubator through porthole.

• Lift the baby to semi-sitting position for feeding, burp the baby after feeding and then place the baby on prone position or on left side after feeding to facilitate getting out of air and to avoid abdominal distension.

 

3. Bathing:

• Daily skin care involve using of clean water only. Soiled linen is stripped of from the top slowly slipped down to the bottom. It is removed through the porthole at the foot end of the incubator. Clean linen is placed inside via the porthole at the head end and should be tucked well under the mattress.

• When infant is removed from incubator, the unit should be cleaned before reuse. All water should be removed from reservoirs

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