A Foundation for Neonatal Care
A Multi-Disciplinary Guide
This authoritative guide offers a vital overview including the recent fundamental changes in the care of newborn babies. As well as medical staff, key roles are now played by senior nurses, clinical nurse specialists, pharmacists, advanced neonatal nurse practitioners, nurse consultants, midwives, dieticians, physiotherapists and speech therapists. The involvement of such a diverse range of professional cultures in such a rapidly developing area often leads to competing priorities, complicated by a lack of established guidelines. There is also the added challenge of fetal medicine - an important emerging allied specialty new to many healthcare professionals. This book assists all professionals involved in the provision of neonatal care in understanding the genetic, physiological and biochemical mechanisms which have either led to or are associated with the clinical conditions affecting their patients. With comprehensive chapters on fetal medicine, genetics, inherited biochemical disorders, fundamental physiological concepts, the cardiovascular, renal and respiratory systems, bacterial and transplacental infections, pharmacokinetics, nutrition, and an overview of haemostasis, A Foundation For Neonatal Care aids understanding of the continuum of developmental physiology and pathology which is now required of neonatal care providers.
Table of Contents
Preface. About the authors. Acknowledgements. Fetal medicine. The placenta and implantation. Hypertensive disorders of pregnancy. Maternal disorders affecting the fetus. Fetal Investigations and their interpretation. Multiple pregnancies. Fetal infections. Blood group antibodies. Fetal therapies. An overview of genetics. DNA, the genetic code and alterations. Mutations. Mitochondrial DNA. Patterns of inheritance. Autosomal Dominant (AD) inheritance. Autosomal recessive inheritance. X-linked inheritance. Mitochondrial inheritance. Chromosomes. Chromosome morphology. Cell division. Chromosomal abnormalities. Key points for practice. Inherited biochemical disorders. Examples of inherited enzyme defects. Congenital adrenal hyperplasia. Galactosaemia. Inherited organic acid disorders. Inherited urea cycle defects. Non-ketotic hyperglycinaemia (NKH). Other disorders causing severe seizures. Diagnosis of inherited metabolic disorders. Good samples for biochemistry tests. Key points for practice. Fundamental physiological concepts. Body fluid compartments. Movement of substances across cell membranes. Membrane potentials. Cell to cell communication mechanisms. Acid-base balance. Autonomic nervous system. The cardiovascular system. Anatomy of the fetal and neonatal circulations. Cardiac muscle. Control of cardiac output. The baroreceptor reflex. Capillary function. The renal system. Glomerular filtration. Reabsorption in the kidney tubule. Tubular secretion. The respiratory system. Carriage of gases in blood. Respiratory control mechanisms. Pulmonary mechanics. Bacterial and transplacental infections. Bacterial structure and classification. Antibiotic structure and mechanism of action. Bacterial resistance. Antibiotic choice in neonatal units. Routes of infection. Early-onset sepsis. Late-onset sepsis.Transplacental infections. Summary. Key points for practice. Pharmacokinetics. Drug movement through the body. Absorption. Distribution. Elimination. Conclusion. Nutrition. An overview of haemostasis. Introduction. Normal haemostasis. Assessment of haemostasis. Disorders of the haemostatic system. Haemostasis in the neonate. Implications for diagnosis. Haemorrhagic disease of the newborn. Key points for practice. Clinical decision making. Introduction. Defining clinical decision-making. The nature of decision analysis. Summary. Key points for practice.