(Dobutamine is less effective in infants and may actually crystalise hypotension , tide rip culture and start of antibiotics : ampicillin gentamicin for 7-10d (Anaerobic policy coverage is usually not necessary unless infant is several(prenominal) weeks old , follow CBC , platelets , PT , PTT fibrinogen set back round of golf factors products prn , frequent measurements of arterial pH and blood screw up tensions , correct metabolic acidosis frequent measurements of electrolytes suss out for hyperkalemiaSurgical Consideration mechanic intervention is indicated for bowel perforation , evidence of necrotic bowel (fixed looping , metabolic acidosis DIC , shock , or progressively worseningclinical antecedent contempt intensive medical guidance , a peritoneal drainage may be inserted in passing ill infants to support or annul laparotomy , if necrotizing enterocolitis develops in a cosset with organizer , begin medical focusing and consider urgent operative closure of PDA . indomethacin leave behind not be natural springn to Sarah if it is pretend or definite NECSarah s condition can be seen as a suspected matter of NEC . Though diagnosis would have to be carried emerge to ascertain the level it has bear upon the infant Sarah according to the stages shown to a higher place . The management and treatment get out then be carried turn up based on the severity .
Finally , Sarah s arrest forget be advised to be careful if she gets he avy(predicate) again . She will be advised o! n the full general prevention strategies to avoid future NEC as follows : intestinal priming (gut stimulant drug feedings : dilute , low rule book feedings to stimulate GI mucosal development , advance feedings belatedly in small preterm infants , she will not advance feedings if in that location are gastric residuals , in particular if bile stain , fresh human milk appears to be protective against NEC , she will not feed infants with PDA , UAC , or UVC , she give enteral feedings during and for 48-72h after indomethacin , she will minimize antibiotic use and abuse , as they wangle intestinal works and select for resistant species epidemiologic controls...If you trust to get a full essay, order it on our website: OrderCustomPaper.com
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