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Transient Tachypnea of the Newborn: Nursing Case Study

Tuesday, 29 April 2014

Transient tachypnea of the newborn (TTN) is a mild respiratory problem. It begins after birth and generally lasts about 3 days. TTN is also known as wet lungs or type II respiratory distress syndrome.

Pathophysiology
TTN results from the delayed absorption of fetal lung fluid after birth. Before birth, the fetus doesn't use his lungs to breathe. Instead, the fetal lungs are filled with fluid. All of the fetus' nutrients and oxygen come from the mother through the placenta. During the birth process, some of the neonate's lung fluid is squeezed out as he passes through the birth canal. After birth, the remaining fluid is pushed out of the lungs as the lungs fill with air. Fluid that remains is later coughed out or absorbed into the bloodstream. TTN results when fluid remains in the lungs, forcing the neonate to breathe harder and faster to get adequate oxygen.


Complications
■ Infection

Assessment
Nursing history by functional health pattern (mother)
Health perception and management

■ History of cesarean delivery

Physical examination
Respiratory

■ Persistently high respiratory rate usually greater than 60 breaths/minute
■ Mild retractions
■ Nasal flaring
■ Expiratory grunting

Gastrointestinal
■ Difficulty feeding because of fast respiratory rate

Diagnostic studies
■ Chest X‑ray reveals hyperinflation, fluid in fissures, costophrenic angles, and a flattened diaphragm; patches of collapse may be seen.

■ Arterial blood gas (ABG) analysis may reveal slight hypoxemia and decreased partial pressure of carbon dioxide.

Teaching checklist
■ Purpose, dosage, administration schedule, and adverse effects of discharge medications
■ Feeding guidelines
■ Signs and symptoms requiring medical intervention
■ Date, time, and location of follow‑up appointments
■ Reasons to call the pediatrician and contact information

Image credit: Kidshealth.org
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