3^rd World Summit on Neonatology Nursing and Primary Health Care November 09-10, 2020 Prague, Czech Republic

The neonatal gastrointestinal system undergoes dramatic changes in response to enteral feeding. A Gastrointestinal growth spurt occurs in the first 24 hours after birth, largely driven by the trophic effect of enteral nutrition

Common Neonatal Gastroenterology Problems :

• Vomiting
• Constipation
• Diarrhea
• Abdominal Colic
• Neonatal Vomiting

Vomiting or, more often regurgitation is a relatively frequent symptom during the neonatal period in first few hours after infants may vomit mucus, occasionally blood streaked. This vomiting rarely persists after fist few feedings. It may be due to irritation of the gastric mucosa by material swallowed during delivery. If the vomiting is protracted, gastric lavage with physiologic saline solution may relive it.

A perinatologist - or maternal-fetal medicine specialist - is an obstetrician/gynecologist that has completed specialty training needed to understand and treat complex medical concerns relating to pregnancy that can involve the mother and her unborn baby. These concerns may be obstetrical, medical, surgical, and/or genetic complications, and may occur during pregnancy, childbirth, the postnatal and/or postpartum periods. The perinatologist will work in consultation with the primary obstetrician. The extent of the relationship between both doctors varies depending on the condition of the patient.

Perinatologists deal with many risk factors that may adversely impact the mother and/or her unborn baby. Some examples include: pre-term labor, pre-eclampsia, multifetal gestations, previous pregnancy concerns (such as cervical incompetence and miscarriage), diabetes (both gestational and pre-gestational), cardiovascular disease, chronic renal disease, chronic hypertension, congenital disorders (such as cystic fibrosis), neurological disorders (such as epilepsy and multiple sclerosis), infectious diseases (such as herpes, hepatitis, HIV and AIDS) , family medical history, eating disorders and substance abuse.

Nurses who specialize in pediatrics devote their knowledge and skills to caring for children from infancy through the late teenage years and their families. These specialized nurses usually complete advanced training in pediatrics and collaborate closely with physicians and other health care providers who share their dedication to children’s health. Like other nurses, paediatric nurses can perform physical examinations, measure vital statistics, take blood and urine samples and order diagnostic tests.

Clinical nurse specialists (CNS) are advanced practice registered nurses (APRNs) that serve as experts in evidence-based nursing practice within one of a number of different specialty areas. They integrate their advanced knowledge of disease processes in assessing, diagnosing, and treating patient illnesses, but their role extends beyond providing patient care. The fundamental goal of clinical nurse specialists is to provide safe, qualify, and cost-effective specialty care, all while working to improve the healthcare system from within. Clinical nurse specialists work in a variety of clinical practice areas, specializing in one or more of the following:

Paediatric surgery is a subspecialty of general surgery, a branch of medicine that deals with children from their infancy to their teenage years. Although paediatric surgery also includes the diagnosis of the patient, it is more involved with the treatment, specifically surgical care. A paediatric surgeon, the term used for specialists in this field, develops the best treatment plan for the patient, conducts pre-operative examinations and preparations, and follows up on the patient's progress as part of the post-surgical care.

Surgery can be classified as major or minor, depending on the seriousness of the illness, the parts of the body affected the complexity of the operation, and the expected recovery time.

Major surgery. These are surgeries of the head, neck, chest, and some surgeries on the belly (abdomen). The recovery time can be lengthy and may involve a stay in intensive care or several days in the hospital. There is a higher risk of complications after such surgeries. In children,

Good nutrition is essential for survival, physical growth, mental development, performance, productivity, health and well-being across the entire life-span: from the earliest stages of fetal development, at birth, and through infancy, childhood, adolescence and on into adulthood.

Premature babies need to receive good nutrition so they grow at a rate close to that of babies still inside the womb. Babies born at less than 37 weeks gestation (premature) have different nutritional needs than babies born at full term (after 38 weeks). Premature babies will often stay in the neonatal intensive care unit they are watched closely to make sure they are getting the right balance of fluids and nutrition. Incubators or special warmers help babies maintain their body temperature. This reduces the energy the babies have to use to stay warm. Moist air is also used to help them maintain body temperature and avoid fluid loss.

Babies born before 34 to 37 weeks often have problems feeding from a bottle or a breast. This is because they are not yet mature enough to coordinate sucking, breathing, and swallowing.

Other illness can also interfere with a new-born’s ability to feed by mouth. Some of these include:

Neonatal Resuscitation is an intervention after a baby is born to help it breathe and to help its heart beat. Before baby is born the placenta provides oxygen & nutrition to the blood and removes carbon dioxide. After a baby is born the lungs provide oxygen to the blood and remove carbon dioxide.

The transition from using the placenta to using the lungs for gas exchange begins when the umbilical cord is clamped or tried off, and the baby has its first breath.

Primary healthcare is a term used to describe the first contact a person has with the health system when they have a health problem or issue that is not an emergency. It is the part of the health system that people use most and may be provided, for example, by a general practitioner physiotherapist or pharmacist. Primary healthcare is a term used to describe a range of healthcare providers who work in the community. Any healthcare professional who is the first point of contact for the health system can be a primary healthcare provider. Most people visit their general practitioner (sometimes referred to as the 'local doctor') as a first step when they have a health problem that is not an emergency. The primary healthcare system also includes allied health professionals, such as dentists and physiotherapists.

Primary healthcare is provided in a community setting, such as a general practice or dental clinic. Primary healthcare providers may work in medical clinics, community health centres and allied health practices, such as physiotherapy and podiatry practices.

Primary healthcare services

Services delivered by primary healthcare providers include:

Primary healthcare is about providing ‘essential healthcare’ which is universally accessible to individuals and families in the community and provided as close as possible to where people live and work. It refers to care which is based on the needs of the population. It is decentralised and requires the active participation of the community and family.

Providing mental health services in primary healthcare involves diagnosing and treating people with mental disorders; putting in place strategies to prevent mental disorders and ensuring that primary healthcare workers are able to apply key psychosocial and behavioural science skills, for example, interviewing, counselling and interpersonal skills, in their day to day work in order to improve overall health outcomes in primary healthcare.

Integrated primary mental health services are complementary with tertiary and secondary level mental health services (see the ‘optimal mix of services’ information sheet), e.g. general hospital services (short stay wards, and consultation-liaison services to other medical departments), which can manage acute episodes of mental illness quite well but do not provide a solution for people with chronic disorders who end up in the admission–discharge–admission (revolving door syndrome) unless backed up by comprehensive primary healthcare services or community services.

Primary health care nurses work in a range of settings, every sharing the characteristic that they are a part of the first level of contact with the health system.

Primary care nurses must be skilled in a variety of everyday basic nursing procedures. Primary care nurse may encounter a wide range of medical problems. These are typically minor illnesses, such as colds and allergic reactions.  Primary care nurse will also vary depending on specialty. For example, primary care nurses specializing in general family medicine will see patients of all ages. Pediatric primary care nurses, on the other hand, treat only children, while primary care nurses specializing in geriatrics treat only elderly patients.

Roles of a primary health care nurse

The term “neurologic disorder” applies to any condition that is caused by a dysfunction in part of the brain or nervous system, resulting in physical and/or psychological symptoms. The development of the human brain begins during pregnancy and continues through infancy, childhood and adolescence. Most brain cells are formed before birth but the trillions of connections between these nerve cells (neurons) are not developed until infancy. The brain is composed of gray matter (neurons and interconnections) and white matter (axons surrounded by a myelin sheath). A motor neuron (above) carries impulses away from the brain.

The brain is self-organizing. It selects information to forward its growth and development. It also adapts to the environment. Experience of the environment through the senses of touch, smell, sight, taste and hearing produces connections in the brain. All neurologic disorders involve the brain, spinal column or nerves. Symptoms depend on where damage occurs. Areas that control movement, communication, vision, hearing or thinking can be affected.

Causes of Neurologic Disorders

Many neurologic disorders are “congenital,” meaning they were present at birth. But some of the disorders are “acquired,” which signifies that they developed after birth. Those with an unknown cause are termed “idiopathic.

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” In other words, your health is about much more than physical ailments — it's about emotional and social fitness, too.

On the other hand, wellness is the “active process of becoming aware of and making choices toward a healthy and fulfilling life. A dynamic process of change and growth.” The two concepts are not opposites, but rather go hand in hand in one’s quest toward complete well-being. We can’t always choose the state of our health. High cholesterol and blood pressure are largely genetic. People are born with heart disease and a predisposition toward diabetes. Accidents cause injuries that last a lifetime.

Wellness is a way for us to actively work toward better health. A way to take some control of our bodies and minds. Even though none of us will ever be in “perfect” health, making a conscious effort to improve our wellness can make us feel better.

Neonatal respiratory diseases are common in premature new-borns born before 32 weeks of pregnancy, because their lungs are not able to make enough surfactant, a foamy substance that keeps the lung fully expanded.

Neonatal respiratory diseases include:

After birth, doctor‘s will check baby for signs and symptoms of respiratory diseases, such as very slow or irregular breathing, rapid breathing, noisy or gurgled breathing, a weak cry, a rapid heart rate, grunting, flaring of the nostrils with each breath.

Neonatal respiratory diseases can lead to low levels of oxygen to the body, affecting vital organs such as the heart, brain, and kidney. They can also lead to long-term lung damage, frequent lung infections, and developmental delays. With careful treatment, the complications of neonatal respiratory diseases may go away over time. Learn more about research studies to improve the quality of life for new-borns who have respiratory diseases in Research for Your Health.

Infectious diseases are illness caused by germs

Bacteria, Viruses, Fungi, Parasites

How are illnesses & infestations spread?

Routine Practices:

Treatment is accessible in a very form of clinical settings, like the hospital-based adolescent clinic, further as school-based clinics and community settings. School members have experience in drugs, nursing, psychology, health education, welfare work and reach.

Chronic conditions: Management of complex medical problems and chronic conditions (asthma, chronic fatigue, headaches, diabetes, chronic anemia and other illnesses)

Specialist in the treatment of medical and psychological effects of cancer therapies

Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes.

Primary care doctor can monitor for diabetes patients at patient regular check-ups. Doctor may perform blood tests to check for the disease, depending on patient symptoms or risk factors. If patient have diabetes, doctor may prescribe medication and manage your condition. Primary health care provides guide to patients about diabetes. Make healthy eating and physical activity part of your daily routine. Maintain a healthy weight.

Type 1 diabetes:  develop at any age, but occurs most frequently in children and adolescents

Type 2 diabetes:  more common in adults and accounts for around 90% of all diabetes cases. When you have type 2 diabetes, your body does not make good use of the insulin that it produces. The cornerstone of type 2 diabetes treatment is healthy lifestyle, including increased physical activity and healthy diet

Gestational diabetes: is a type of diabetes that consists of high blood glucose during pregnancy and is associated with complications to both mother and child.

Dental Science is the study of the oral cavity and the diseases associated with oral tissues primary dental care, including prevention, diagnosis and treatment of oral and dental diseases. Treatment involves areas such as the restoration of damaged teeth, the correction of irregularities, the replacement of missing teeth and surgical procedures such as the removal of teeth. In recent years there has been an exponential advance in dental science with greater emphasis on preventing disease as well as the development of new, minimally invasive methods and materials for restoring teeth.

Advanced Practice Registered Nurse include nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives, and all play a pivotal role in the future of health care. Advanced Practice Registered Nurse are often primary care providers and are at the forefront of providing preventive care services to the public. Advanced Practice Registered Nurse treat and diagnose illnesses, advise the public on health issues, manage chronic disease, and engage in continuous education to remain ahead of any technological, methodological, or other developments in the field.

Women's health refers to the branch of medicine that focuses on the treatment and diagnosis of diseases and conditions that affect a woman's physical and emotional well-being.

Women's health includes a wide range of specialties and focus areas, such as:

Preventative care for women includes the following services