Overview of the patient's diagnosis
Bronchopulmonary dysplasia is a disease that has been recorded to be affecting or leads to high mortality rates of newborns. The disease is associated with birth weight and the gestational age. Bronchopulmonary dysplasia is majorly characterized by arrested alveolar development that has a reduced number but an increased size of alveoli as well as impaired capillaries. Such is recorded to be the significant respiratory problem of the preterm birth in the current population. Additionally, some factors lead to the development of BPD. Such are Small Gestation Age as well as Gestation Age. Different studies that have been carried out show that SGA is the main risk factor of BPD in preterm infants than AGA newborns. Ideally, the primary cause of SGA is the disease known as preeclampsia that is also the cause of BPD
Preeclampsia is a pregnancy disease that results into SGA as well as premature birth of the infants
BPD also results in low weight birth in several populations where the research was done. Research finds out that there are several cases of SGA as compared to cases of AGA newborns. This because this pandemic disease called preeclampsia is developed when the child born to the mother suffering from gestational hypertension which studied to be affecting 2% to 8% of pregnancies (Bancalari, et al. 2019). In addition to that, preeclampsia disease when occurs it results into BPD for newborns because it affects the pregnancies and may also cause premature birth which makes the newborn be underweight, the platelets counts can also so become low. Therefore, as a nurse, there is need to take of the patient by knowing the kinds of treatment of the diagnosed disease. Also, the newborns born before the normal gestation age ought to be taken care of through the provision of the prescribed medicine in cases of low respiratory defects as well as low platelet counts.
Critique of the article
Several studies and researches have been carried out concerning preeclampsia as an antigenic state that causes the impairment of the lungs, and that leads to BPD which later leads to low birth weight. However, no clear evidence shows how the two diseases link together until one leads to another. For instance, studies show that preeclampsia leads to BPD and the author does not elaborate the clarity of how this can be practical and believed. Generally, in the case of neonatal outcomes of newborns to mothers suffering from preeclampsia. Just a few studies outline the analysis of how this happens. However, none of the studies analyzes the consequences of BPD at 36 weeks of PMA, thus, making the research to ignore information that is required for the patients experiencing such defects to get solutions to their problems.
Based on the information given by the author in the article, there are different opinions of the researchers considering the studies based on SGA and AGA newborns. Some studies show that there is no critical difference between the two in terms of age (Mourani et al. 2015). However, infants born before the 28h week of gestation ought not to be included since the outcome can be death or serious neonatal care. As such, the research shows critical information. Additionally, the article outlines a significant aspect of increase in mortality in newborns that are born to mothers who suffer from vascular disorders. The study in the article shows that babies born after pregnancies with vascular disorders and register birth weight below the 10th percentile are at a higher risk of BPD.
According to Torching's study, it clearly shows that in cases of vascular pregnancy disorders. For instance, preeclampsia is one of the significant factors leading to the development of BPD but only when this disorder is associated with restrictions on fetal growth. Therefore, this confirms that for the BPD disease to occur, there must be the presence of the disease preeclampsia which comes as a result of gestational hypertension in mothers. The article, therefore, outlines the significance of preeclampsia disease to low birth weight as well as in the case of the development of the respiratory illness known as BPD. Moreover, the author also gives significant information on the study of the BPD. There is a higher risk of outcomes in SGA than in AGA in newborns and more occurrence of respiratory morbidities for SGA cases than in AGA preterm infants (Dravet-Gouno et al. 2018). According to the findings from the research done based on bronchi pulmonary dysplasia, the data shown concerning the number of babies born to mothers with preeclampsia help in the getting the significance of birth weight for GA in the development of BPD. Thus, this information gathered from the research helps in knowing the causes of some defects in newborns as well as problems associated with births. Therefore, making it easier to apply this information during my practice in the nursing environment.
How the research findings could be applied to your patient's nursing care
Bronchopulmonary dysplasia is a condition that often affects the infants owing to the use of ventilator of being in the oxygen machine for a considerable duration. Therefore, the findings of the article play a crucial role in nursing practice. The study establishes that is often likely amongst the preterm neonates, thus, presenting evidence-based practice that could be utilized in the management of such neonates. An evidence-based technique that the nurses could utilize in the study is the use of noninvasive ventilation for the pre-term neonates. Such has been proved by the survey as a technique that could avoid the complications that preterm neonates develop include ventilation morbidity. Issuing systemic steroids is another evidence-based technique that could be utilized in the management of Bronchopulmonary dysplasia, thus, improving the quality of life that they lead. The evidence-based care that the study proposes has the primary intention of minimizing the pulmonary disease that the neonates could acquire.
Conclusion
Mechanical ventilation leads to Bronchopulmonary dysplasia amongst the pre-term neonates. Therefore, the utilization of strategies such as continuous positive airway pressure and noninvasive ventilation has been proven as improving the health outcomes that the patients are likely to experience (Cheong, & Doyle 2018). The utilization of the evidence-based practices has the potential of reducing lung injuries of the preterm neonates, thus, improving the quality of life that they lead. Nurses need to enforce the evidence-based practice in there are of work owing to the positive role that it would play in the improvement of the health outcomes of the patients. However, training is required on how such could be implemented to eliminate likely incidence of clinical errors that could result from the process.
References
Bancalari, E., Claure, N., Jobe, A. H., & Laughon, M. M. (2019). Definitions and Diagnostic Criteria of Bronchopulmonary Dysplasia: Clinical and Research Implications. In The Newborn Lung (pp. 115-129). Content Repository Only! https://doi.org/10.1016/B978-0-323-54605-8.00006-4
Cheong, J. L., & Doyle, L. W. (2018, October). An update on pulmonary and neurodevelopmental outcomes of bronchopulmonary dysplasia. In Seminars in perinatology. WB Saunders. https://doi.org/10.1053/j.semperi.2018.09.013.
Dravet-Gounot, P., Torchin, H., Goffinet, F., Aubelle, M. S., El Ayoubi, M., Lefevre, C., ... & Zana-Taieb, E. (2018). Bronchopulmonary dysplasia in neonates born to mothers with preeclampsia: Impact of small for gestational age. PloS one, 13(9), e0204498. https://doi.org/10.1371/journal.pone.0204498
Mourani, P. M., Sontag, M. K., Younoszai, A., Miller, J. I., Kinsella, J. P., Baker, C. D., ... & Abman, S. H. (2015). Early pulmonary vascular disease in preterm infants at risk for bronchopulmonary dysplasia. American journal of respiratory and critical care medicine, 191(1), 87-95.
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