Transient Tachypnoea of the Newborn.

 Instructions In this assignment you are to explain the pathophysiology of a complex neonatal condition from the scenario below, develop a plan of care for this, as well as undertake a literature review for one aspect of care. Detailed instructions for completing this assignment are provided below. Study the ISBAR handover provided and respond to each assignment instruction (Part A, B & C) in your essay. Please note: This essay requires an introduction (100 words) and a conclusion (100 words). Referencing is to adhere to the Harvard system. Part A: The pathophysiology Choose ONE complex neonatal issue from the scenario; either Transient Tachypnoea of the Newborn (TTN) or Neonatal Abstinence Syndrome (NAS). Describe the pathophysiology of this condition, including the risk factors, prevalence, signs and symptoms, treatment and outcomes, with reference to clinical resources and literature to support your explanation. (900 words) Part B: The plan of care Devise a care plan for this infant in response to the Recommendation component of the ISBAR. (700 words) Part C: Literature review Provide a literature review to support any component of neonatal care outlined in the ISBAR or any care that Mia would have received that was not stated in the ISBAR. (1200 words) Scenario Identify Mia Arnold (B/O Kylie Arnold), UR 24659921 Situation Mia is now 24 hours of age on postnatal, in an open bassinet and having 3 hourly bottle feeds of formula. Background Mother Kylie is a 25 years of age, a primagravida (P1+0) who was induced for cholestasis or pregnancy. Her membranes were artificially ruptured 2 hours prior to delivery and she was GBS negative. She failed to progress during the second stage of labour, and fetal distress was diagnosed on CTG. She went to theatre for an emergency lower segment cesarean section. Mia was born at 38 weeks gestation. Apgar’s of 4 at 1 minute and 8 at 5 minutes were given. She was born with a heart rate of 60 bpm, required stimulation and positive pressure ventilation at delivery. After 30 seconds of delivered breaths, she cried and her heart rate increased to 150 bpm. Once spontaneous breathing was established, intercostal recession and nasal flaring were noted. Kylie’s partner Craig was present for the birth. A birth weight of 2.8 kilograms was recorded. Kylie is on the Methadone Program. She has a history of 5 years of heroin use. She did not attend many of her antenatal appointments. Social work has provided ongoing support to Kylie and Craig throughout her pregnancy when possible and planned to conduct more assessments once the baby was born. Mia received 25% oxygen for the first 3 hours and a diagnosis of TTN was made. Her blood sugar level at 1 and 4 hours were within normal limits. She had two bottles of term formula (15 mLs 3 hourly) (40 ml/kg/day) after her respiratory distress resolved and was subsequently weaned to an open cot. Kylie gave consent for formula as she is unsure whether to breast feed or not. She then roomed in with her mother during the first night and commenced 4 hourly Finnegan scoring as the night duty Midwife noted her to be very unsettled.