Iindidi zeenkqubo kwiCandelo loKhathalelo lweNonatal

Umxholo

• Inkxaso yeZondlo
• Ukutya ngeLayini efakwa ngaphakathi (IV)
• Ukondla ngomlomo
• Ezinye iinkqubo eziqhelekileyo zeNICU
• X-ray
• I-Ultrasound
• Uvavanyo lwegazi kunye nomchamo
• IiRhasi zeGazi
• IHematocrit kunye neHemoglobin
• Igazi le-Urea Nitrogen (BUN) kunye neCreatinine
• Iityiwa zeKhemikhali
• Uvavanyo lwegazi kunye nomchamo
• Iinkqubo zokulinganisa iiFluids
• Utofelo-gazi

Ukubeleka yinkqubo entsonkothileyo. Kukho iinguqu ezininzi emzimbeni ezenzeka kwiintsana njengoko zihlengahlengisa kubomi ngaphandle kwesibeleko. Ukushiya isibeleko kuthetha ukuba abanakuphinda baxhomekeke kwi-placenta yomama kwimisebenzi ebalulekileyo yomzimba, njengokuphefumla, ukutya, kunye nokuphelisa inkunkuma. Ngokukhawuleza ukuba iintsana zingene emhlabeni, iinkqubo zemizimba yazo kufuneka zitshintshe kakhulu kwaye zisebenze kunye ngendlela entsha. Olunye lolona tshintsho lukhulu ekufuneka lwenziwe lubandakanya oku kulandelayo:

• Imiphunga kufuneka igcwalise umoya kwaye inike iiseli ioksijini.
• Inkqubo yokujikeleza kwegazi kufuneka itshintshe ukuze igazi kunye nezondlo zisasazwe.
• Inkqubo yokwetyisa kufuneka iqale ngokutya kunye nokukhupha inkunkuma.
• Isibindi kunye namajoni omzimba kufuneka aqale ukusebenza ngokuzimeleyo.

Ezinye iintsana zinobunzima ekwenzeni olu hlengahlengiso. Oku kunokwenzeka ukuba bazalwe ngaphambi kwexesha, oko kuthetha ukuba ngaphambi kweeveki ezingama-37, banesisindo sokuzalwa esisezantsi, okanye banemeko efuna unyango kwangoko. Xa iintsana zifuna ukhathalelo olukhethekileyo emva kokubeleka, zihlala zingeniswa kwindawo yesibhedlele eyaziwa njengeyunithi yonyango olunzulu lweentsana (NICU). I-NICU inezobuchwephesha obuphambili kwaye inamaqela eengcali ezahlukeneyo zononophelo lwempilo ukubonelela ngononophelo olukhethekileyo kwiintsana ezisokolayo. Ayizizo zonke izibhedlele ezine-NICU kwaye iintsana ezifuna ukhathalelo olunzulu zinokufuna ukuba zidluliselwe kwesinye isibhedlele.

Ukubeleka umntwana ngaphambi kwexesha okanye ogulayo kungalindelwanga kuye nawuphi na umzali. Izandi ezingaqhelekanga, ukubonwa, kunye nezixhobo kwi-NICU zinokuba negalelo kwiimvakalelo zoxinzelelo. Ukwazi iintlobo zeenkqubo ezenziwa kwi-NICU kunokubonelela ngoxolo lwengqondo njengoko umntwana wakho efumana ukhathalelo lweemfuno zabo.

Inkxaso yeZondlo

Inkxaso yesondlo iyafuneka xa umntwana enengxaki yokuginya okanye enemeko ephazamisa ukutya. Ukuqinisekisa ukuba usana lusafumana izakha mzimba ezibalulekileyo, abasebenzi be-NICU baya kuzondla nge-intravenous line, ebizwa ngokuba yi-IV, okanye ityhubhu yokondla.

Ukutya ngeLayini efakwa ngaphakathi (IV)

Akuninzi abantwana abasandul 'ukuzalwa okanye abancinci bokuzalwa abanokutya ngexesha leeyure ezimbalwa zokuqala kwi-NICU, kwaye abaninzi abantwana abagulayo abanako ukuthatha nantoni na ngomlomo iintsuku eziliqela. Ukuqinisekisa ukuba umntwana wakho ufumana ukutya okwaneleyo, abasebenzi be-NICU baqala i-IV yokulawula ulwelo oluqukethe:

• amanzi
• iswekile
• isodiyam
• potassium
• ikloride
• calcium
• nemagniziyam
• ifosforasi

Olu hlobo lwenkxaso yesondlo lubizwa ngokuba sisondlo esipheleleyo sabazali (TPN). Umboneleli wezempilo uya kubeka i-IV emthanjeni osemantloko osana lwakho entlokweni, esandleni, okanye kumlenze ongezantsi. I-IV enye ihlala ixesha elingaphantsi kosuku olunye, ke abasebenzi banokubeka ii-IVs kwiintsuku zokuqala. Nangona kunjalo, uninzi lweentsana ekugqibeleni ludinga isondlo ngaphezu kwale mizila mincinci ye-IV inokubonelela. Emva kweentsuku ezininzi, abasebenzi bafaka i-catheter, engumtya we-IV omde, kumthambo omkhulu ukuze umntwana wakho afumane izixa eziphezulu zezakhamzimba.

I-Catheters inokufakwa kwi-umbilical artery kunye ne-vein ukuba umntwana wakho mncinci kakhulu okanye uyagula. Ulwelo kunye namayeza zinokunikezelwa ngokusebenzisa i-catheters kwaye igazi linokutsalwa kwiimvavanyo zaselebhu. Olunye ulwelo lwe-IV oluxineneyo lunokunikwa ngale migca yeembilical, ukuvumela umntwana ukuba afumane isondlo esingcono. Ukongeza, imigca yeembilili igcina ubuncinci iveki enye ukuba zincinci ii-IVs. Imigca ye-umbilical arterial lines inokuqhagamshelwa kumatshini oqhubeka ngokulinganisa uxinzelelo lwegazi lomntwana.

Ukuba umntwana wakho ufuna i-TPN ngaphezulu kweveki enye, oogqirha bahlala befaka olunye uhlobo lomgca, obizwa ngokuba ngumgca ophakathi. Umgca ophakathi unokuhlala endaweni kangangeeveki ezininzi de umntwana wakho angabe esayifuna i-TPN.

Ukondla ngomlomo

Ukondla ngomlomo, okwaziwa ngokuba kukutya ngaphakathi, kufuneka kuqalwe ngokukhawuleza. Olu hlobo lwenkxaso yesondlo lukhuthaza iphecana lesisu somntwana wakho (GI) ukuba likhule kwaye liqale ukusebenza. Usana oluncinci kakhulu kunokuqala lufune ukondliwa ngombhobho omncinci weplastiki ohamba ngomlomo okanye ngempumlo kwaye ungene esiswini. Inani elincinci lobisi lwebele okanye ifomula inikwa ngale ityhubhu. Kwiimeko ezininzi, umntwana unikwa indibaniselwano ye-TPN kunye nokutya okungena ngaphakathi ekuqaleni, njengoko kunokuthatha ixesha ukuba iphecana le-GI liqhele ukutya.

Usana ludinga malunga neekhalori ezili-120 ngosuku ngalunye lweepawundi ezi-2.2, okanye ikhilogremu enye yobunzima. Ifomula rhoqo kunye nobisi lwebele luqukethe iikhalori ezingama-20 ngeewunce. Usana olunobunzima bokuzalwa obuphantsi kakhulu kufuneka lufumane ifomula ekhethekileyo okanye ubisi lwebele oluqinisiweyo oluqukethe ubuncinci beekhalori ezingama-24 ngeyuniyure nganye ukuqinisekisa ukukhula okwaneleyo. Ubisi lwebele kunye nefomula inezinto ezininzi ezinokucolwa ngokulula ngumntwana onobunzima bokuzalwa.

Kungathatha ixesha ngaphambi kokuba zonke iimfuno zesondlo somntwana zifezekiswe ngokutya okunesondlo. Amathumbu wosana oluncinci awanakho ukunyamezela ukwanda ngokukhawuleza kwenani lobisi okanye ifomula, ke ngoko ukonyuka kokutya kufuneka kwenziwe ngononophelo kwaye ngokuthe ngcembe.

Ezinye iinkqubo eziqhelekileyo zeNICU

Abasebenzi be-NICU banokwenza nezinye iinkqubo ezahlukeneyo kunye neemvavanyo zokuqinisekisa ukuba ukhathalelo lomntwana luhlala kwindlela.

X-ray

IX-reyi yenye yezona mvavanyo ziqhelekileyo zenziwa kwi-NICU. Bavumela oogqirha ukuba babone ngaphakathi komzimba ngaphandle kokwenza ukusikwa. Kwi-NICU, ii-X-ray zihlala zisenziwa ukuvavanya isifuba somntwana kunye nokuvavanya ukusebenza kwemiphunga. I-X-ray yesisu nayo inokwenziwa ukuba umntwana unengxaki yokutya ngaphakathi.

I-Ultrasound

I-Ultrasound lolunye uhlobo lovavanyo lokucinga olunokwenziwa ngabasebenzi beNICU. Isebenzisa amaza esandi ahamba ngesantya esiphezulu ukuvelisa imifanekiso eneenkcukacha zezakhiwo zomzimba ezahlukeneyo, ezinje ngamalungu, imithambo yegazi, kunye nezicubu. Uvavanyo alunabungozi kwaye alubangeli zintlungu. Zonke iintsana ezinobunzima bokuzalwa ngaphambi kwexesha kunye nobuncinci zivavanywa rhoqo kusetyenziswa uvavanyo lwe-ultrasound. Ihlala isetyenziselwa ukukhangela ukonakala kwengqondo okanye ukopha kukhakhayi.

Uvavanyo lwegazi kunye nomchamo

Abasebenzi be-NICU banoku-odola uvavanyo lwegazi kunye nomchamo ukuvavanya:

IiRhasi zeGazi

Iigesi egazini zibandakanya ioksijini, icarbon dioxide, kunye neasidi. Amanqanaba erhasi egazi anokunceda abasebenzi ukuba bavavanye indlela esebenza kakuhle ngayo imiphunga kunye nokuba lungakanani na uncedo lokuphefumla olunokudingeka. Uvavanyo lwegesi yegazi ihlala ibandakanya ukuthatha igazi kwi-catheter yomthambo. Ukuba umntwana akanayo i-catheter ye-arterial endaweni, isampuli yegazi inokufumaneka ngokuhlaba isithende somntwana.

IHematocrit kunye neHemoglobin

Olu vavanyo lwegazi lunokubonelela ngolwazi malunga nokuba ioksijini kunye nezondlo zisasazwa njani emzimbeni wonke. Iimvavanyo zeHematocrit kunye nehemoglobin zifuna isampulu yegazi. Le sampuli inokufunyanwa ngokuhlaba isithende somntwana okanye ngokususa igazi kwi-catheter ye-arterial.

Igazi le-Urea Nitrogen (BUN) kunye neCreatinine

Amanqanaba egazi urea nitrogen kunye ne-creatinine abonisa indlela ezisebenza kakuhle ngayo izintso. I-BUN kunye nemilinganiselo ye-creatinine inokufumaneka kuvavanyo lwegazi okanye kuvavanyo lomchamo.

Iityiwa zeKhemikhali

Ezi salts zibandakanya isodiyam, iglucose, kunye ne potassium, phakathi kwezinye. Ukulinganisa amanqanaba eetyiwa zekhemikhali kunokubonelela ngolwazi olubanzi malunga nempilo yomntwana iphela.

Uvavanyo lwegazi kunye nomchamo

Olu vavanyo lwegazi kunye nomchamo lunokwenziwa rhoqo kwiiyure ezimbalwa ukuqinisekisa ukuba iinkqubo zomzimba womntwana kunye nemisebenzi iyaphucuka ngokuthe chu.

Iinkqubo zokulinganisa iiFluids

Abasebenzi be-NICU balinganisa lonke ulwelo umntwana aluthathayo kunye nawo onke amanzi ampompoza umntwana aphuma kuwo. Oku kuyabanceda ukuba babone ukuba amanqanaba e-fluid ahambile na. Baphinde balinganise usana rhoqo ukuvavanya ukuba lungakanani ulwelo olufunwa ngumntwana. Ukulinganisa umntwana yonke imihla kukwavumela abasebenzi ukuba bavavanye ukuba umntwana uqhuba kakuhle kangakanani.

Utofelo-gazi

Iintsana kwi-NICU zihlala zifuna ukumpontshelwa igazi nokuba kungenxa yokuba amalungu abo enza igazi akakakhuli kwaye avelisi iiseli ezibomvu zegazi okanye kuba banokulahlekelwa ligazi elininzi ngenxa yenani leemvavanyo zegazi ekufuneka zenziwe.

Ukufakwa kwegazi kuzalisa igazi kwaye kunceda ekuqinisekiseni ukuba umntwana uhlala esempilweni. Igazi linikwa umntwana ngokusebenzisa umgca we-IV.

Kuqhelekile ukuba uzive ukhathazekile ngomntwana wakho ngelixa bekwi-NICU. Yazi ukuba basezandleni ezikhuselekileyo kwaye abasebenzi benza konke abanako ukuphucula imbonakalo yomntwana wakho. Musa ukoyika ukuvakalisa izinto ezikuxhalabisayo okanye ukubuza imibuzo malunga neenkqubo ezenziwayo. Ukubandakanyeka kukhathalelo lomntwana wakho kunokunceda ekunciphiseni naluphi na uxinzelelo onokuba uziva ngalo. Inokukunceda ukuba ube nabahlobo kunye nabathandekayo kunye nawe ngelixa umntwana wakho eseNICU. Banokubonelela ngenkxaso kunye nesikhokelo xa usidinga.