Submission of An Evidenced Based Analysis of a Clinical Competency: fluid and electrolyte balance of the neonate - Essay Example

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EVIDENCE-BASED ANALYSIS OF A CLINICAL COMPETENCY (name) (professor) (subject) (date) Evidenced Based Analysis of a Clinical Competency: Fluid and Electrolyte Balance of the Neonate Introduction Clinical competency in the fluid and electrolyte balance of the neonate is an important clinical skill to develop in paediatric care…
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Submission of An Evidenced Based Analysis of a Clinical Competency: fluid and electrolyte balance of the neonate
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Download file to see previous pages Evidence in this research was able to establish that the newborn kidney has a very limited capability of excreting excess water and sodium; therefore, the overload of sodium during the first week can result in necrotizing enterocolitis and patent ductus arteriosus (Aggarwal, et.al., 2001, p. 2). Different trials have shown that remedies like using transparent barriers, caps, and socks on neonates have been effective in reducing water loss (Aggarwal, et.al., 2001, p. 2). In effect, this study has shown the importance of applying effective skills in fluid and electrolyte balance. In order to improve the health outcomes of neonates, the development of skills in fluid and electrolyte balance have to be enhanced and targeted. Clinical competency in fluid and electrolyte balance in the neonate is therefore an important clinical skill; and building knowledge in support of such skill can help ensure improved health outcomes for the neonate. Discussion Background In evaluating fluid and electrolyte balance among neonates, it is important to first consider the physiology of the newborn and how such make-up affects the management of his fluids and electrolytes. A discussion seen in the website Anaesthesia.uk. points out that the extracellular fluid compartment of neonates is expanded and their total body water covers 85% of their body weight; and 75% of the body weight of term babies is water. This is in contrast to the 60% body weight of adults (Anaesthesia.uk, 2007). The website further emphasizes that the expanded extracellular fluid compartment is caused by the higher volume of distribution from commonly prescribed drugs and higher dose requirements in these drugs, regardless of their increased sensitivity (Anaesthesia.uk, 2007). It is also important to understand that the contraction of the extracellular fluid compartment and the weight loss during the first several days following birth is part of the normal bodily processes of the neonate – caused by dieresis, induced by atrial naturetic peptide (ANP) and sometimes by the higher pulmonary blood flow and stretch of the left atrial receptors (Anaesthesia.uk, 2007). When the state of negative water and sodium balance in the neonate’s system stabilizes, the water and sodium elements would increase and match the elements needed by the growing baby. It is therefore important to restrict fluids until the postnatal weight loss has become manifest. Studies have indicated that high fluid intake in the first few days after birth has been associated with negative patient outcomes among premature infants (Anaesthesia.uk, 2007). For these infants, fluid needs often gradually increase from the first day of their life at 60mL/kg/day to 150mL/kg/day at their 1st week of life (Anaesthesia.uk, 2007). The competence in evaluating the changes needed in the neonate’s feeding and fluid management is therefore a crucial competency for the health professionals to acquire. For immature neonates with respiratory distress syndrome, there is usually a delay in the acute contraction of the extracellular compartment. Before surfactants were used, this incident was marked by the natriuresis or diuresis which was seen when the respiratory functions were being improved (Modi, 2004, p. 109). For healthy newborn children who were able to receive surfactants, the diuresis often occurs at a lower degree. For the healthy newborns, only about 10% of the total body water is ...Download file to see next pagesRead More
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