Developmental Care For Preterm Baby
Developmental Care For Preterm Baby
Developmental Care For Preterm Baby
Preterm baby
Introduction
Infant development a reflection of the dynamic
relationship between endowment & environment
Technologic
advances in Mortality Survival rate
neonatal care
Perubahan dalam
fokus perawatan
bayi prematur
Menyelamatkan Meningkatkan
hidup kualitas hidup
Morbiditas baru Perkembangan
bayi prematur otak
Usia gestasi
Lingkungan
Ekstra-uterin
Brain growth & development
Dialami di luar
uterus (NICU)
• Migrasi sel
Periode • Sinaptogenesis • Perkembangan
Perkembangan
• Mielinisasi otak terganggu
otak yg pesat
• Organisasi fungsi
Lahir otak Long term
prematur outcome
Intra-uterin
Input sensoris positif
terhadap
perkembangan otak
Cue based-care
Organisasi Perilaku
(Behavioral Organization)
Westrup B. Early Hum Dev. 2007; 83: 443-449
Signs of stress signal
Stress signs of diffuse or disorganized states include:
Grimaces or frown
Frequent jerks or movement during sleep
Eye floating
Persistent gaze aversion
Hyperalertness or panic expression
Signs of uncontrolled activity from stress/ fluctuating muscle
tone:
Neck & trunk arching
Jerky extremity movement
Sitting on air
Salutes with finger splaying
Limp extremities
Signs of stress signal
• Pencahayaan
Lingkungan • Suara/kebisingan
Makro • Bau
• Aktivitas
• Posisi
Lingkungan • Containment
Mikro • Handling
• Tactile & kinestetik (touch)
Pencahayaan
Alat2
Suara bising yg terus menerus
Personel
Kehilangan pendengaran
Ekstra-uterin
Agitasi, menangis TIK , Desaturasi O2
Siklus tidur-bangun terganggu
STRATEGI INTERVENSI ??
STRATEGI INTERVENSI ??
Taktil / kinestetik
Overstimulasi
Selalu diinterupsi
3 dr4 episode
hipoksia &
Hipoksia, apnu, frekuensi peningkatan
Prosedur jantung & tekanan darah tdk kadar hormon
rutin stabil stress
(medikal,
Kekurangan waktu istirahat prosedur rutin
nursing)
(wkt istirahat <60’ tdk efektif
STRATEGI INTERVENSI ??
STRATEGI INTERVENSI ??
Sukrosa
Medikasi Analgetik
Sedatif
BODY CONTAINMENT
BAYI
Mengurangi stres & nyeri
Meningkatkan self-
regulation
Memfasilitasi pertumbuhan
dan maturasi
Most care can be provided in the
kangaroo position
Change Give
Insert Insert
i.v. infusion i.v. injection
i.v. cannula feeding tube
Suctioning: Take
Endotracheal temperature
tube, nasal
Chest Reposition
auscultation pulse oximeter,
Tc monitor
Insert endo-
tracheal tube Change
diaper
Head CPAP Ventilator Draw
ultrasound treatment treatment blood sample
Cara membuat nest