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Prapavarin Bunyoung A girl age 14 days Birth date 19 Feb 2019 Diagnosis…

- - - - Diagnosis by
        
        VDRL test = Reactive
        
        RPR test Reactive 1:16
        
        CSF VDRL test from LP = Reactive
      - Clinical manifestation
        
        Hepatosplenomagaly
        
        Liver and spleen
        produce WBC for fetus
        
        Spread of T. Pallidium
        and activate immune respond
        
        Destroy hepatocytes
        
        Cannot conjugate bilirubin (Increased unconjugated bilirubin)
        
        1 more item...
        
        Physical examination
        
        Liver 3 cm BRCM
        
        Abdominal distension
        
        Mild jaundice and pale skin
      - Activate inflammatory process and increase prostagrandin
        
        Prostagrandin stimulate thinning of cervical
        
        Cervix dilate
        
        Preterm birth
        
        Ineffective thermoregulation related to immaturity and low subcutaneous and brown fat.
        
        Assess temperature
        
        Provide incubator
        
        Assess SS of hypo/hyperthermia
        
        Risk for delay development due to preterm birth with maternal VDRL reactive.
        
        . Position the baby to variety of position
        
        Provide pain management
        
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        Provide morning care
      - Low birth weight
        1505 gram
        
        Nutrition imbalance: Less than body requirement due to immature gastrointestinal system.
        
        BM 30 ml + PF 1/2 tsp (24 kcal/oz) 30 ml 8 feed drip in 1 hr via OG
        
        Assess Wt every day, Lt and OFC every week.
        
        Observe SS of feeding intolerance
      - Risk for worsening infection due to congenital syphilis and preterm birth.
        
        Provide Penicilin G inj 5 mu 160,000 v drip in 30 min q 12 hr + 5%D/W 5 ml
        (10 days)
        
        Contact precaution
        
        Monitor V/S q 4 hr
        
        Observe SS of infection