아동간호학 질환별 사전학습(정의, 원인, 증상, 치료, 간호)

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1. RDS(Respiratory Distress Syndrome)

RDS(Respiratory Distress Syndrome)는 신생아 호흡곤란 증후군으로, 출생 직후 폐가 지속적으로 팽창하지 못하고 찌그러들어 출생 후 진행성 호흡부전이 생기는 질환입니다. 미숙아는 폐가 작고, 폐를 팽창하게 하는 물질인 폐 표면활성제의 생산과 분비가 부족하기 때문에 위험성이 큽니다. 원인으로는 폐발달이 미숙한 미숙아와 당뇨병 산모의 신생아, 흉부 기형 등이 있습니다. 증상으로는 청색증, 가슴함몰, 빈호흡 등이 있으며, 치료로는 호흡곤란 증후군을 예방하기 위한 스테로이드 요법, 비강캐뉼라를 통한 산소 투여, CPAP 적용 등이 있습니다. 간호에서는 체온조절, 감염예방 등이 요구됩니다.
2. PDA(Patent Ductus Arteriosus)

PDA(Patent Ductus Arteriosus)는 선천성 심장기형의 일종으로, 동맥관 개존은 출생 전 태아에서 반드시 열려 있어야 하는 대동맥과 폐동맥 사이를 연결하는 부위(동맥관)가 출생 후에도 닫히지 않고 열려 있는 상태를 말합니다. 특별한 원인은 없으나 가족력이 원인이 될 수 있습니다. 증상으로는 동맥관의 크기에 따라 무증상에서 폐동맥압 상승, 심장기능 저하, 폐부종 등이 나타날 수 있습니다. 진단은 심잡음 청진 후 심전도, 심장 초음파 검사로 이루어지며, 치료는 심도자술을 통한 코일 삽입 등의 방법이 있습니다.
3. ROP(Retinopathy of Prematurity)

ROP(Retinopathy of Prematurity)는 미숙아 망막병증으로, 미숙아에서 망막의 혈관 발달 이상으로 발생하는 질환입니다. 심한 경우 망막에 비정상적인 신생혈관이 생기면서 출혈과 망막박리를 일으켜 실명에 이를 수 있습니다. 원인은 재태기간이 짧고 출생 시 체중이 낮을수록 위험성이 높습니다. 증상은 신생아의 경우 알기 어려우므로 정기적인 안과 검진이 중요하며, 치료는 조기진단과 레이저 치료가 필요합니다. 간호에서는 전신 혈압과 산소화의 변동을 유발하는 경우를 줄이고, 수술 중간호와 수술 후 간호가 요구됩니다.
4. NEC(Necrotizing Enterocolitis)

NEC(Necrotizing Enterocolitis)는 신생아의 소장이나 대장에 생기는 괴사성 장염으로, 주로 미숙아에게 발생합니다. 원인으로는 고농도 우유, 저산소증, 빠른 영양법, 감염증 등 다양한 요인이 작용합니다. 증상은 초기에는 소화 불량과 비슷할 수 있으나, 증상이 심해지면 무호흡증, 서맥, 저체온, 기민 상태, 신경과민, 담즙 섞인 구토, 피 섞인 구토, 복부 팽만, 혈변과 심한 설사 등이 나타날 수 있습니다. 진단은 복부 X-ray 사진으로 하며, 치료는 장기간 금식, 정맥 주사로 인공적 영양 공급, 수분과 전해질 균형 유지 등이 필요합니다.
5. PPHN(Persistent Pulmonary Hypertension of the Newborn)

PPHN(Persistent Pulmonary Hypertension of the Newborn)은 신생아 지속성 폐동맥 고혈압으로, 태아·신생아 전이 과정에서 출생 후 폐혈관 저항이 감소되지 않고 지속적으로 상승되어 있는 상태입니다. 증상으로는 수유 못견딤증, 장출혈, 무호흡, 서맥 등이 나타날 수 있습니다. 진단은 임상소견과 복부 방사선사진으로 하며, 치료는 적절한 호흡기계 치료로 산소화를 유지하는 것이 가장 중요합니다. 약물요법으로 혈량 증량제, 혈압상승제, 혈관확장제 등을 사용할 수 있습니다.
6. IVH(Intraventricular Hemorrhage)

IVH(Intraventricular Hemorrhage)는 뇌실 내 출혈로, 출생 체중이 1500gm 이하인 경우 약 20-40%의 빈도로 발생합니다. 원인으로는 초극소 저체중 출생아, 산모의 진통, 주산기 가사, 소생술, 기흉, 인공환기, 경련, 고혈압 등이 있습니다. 증상은 특징적이지 않으며 갑자기 창백해지거나 빈혈이 생기는 경우, 무호흡을 보이는 경우 의심할 수 있습니다. 진단은 두부 초음파 검사로 하며, 치료는 혈압안정제와 진통제 진정제 등으로 침상안정을 취하게 하고, 뇌실-복강 단락술이나 뇌실외 배액술 등의 수술이 필요할 수 있습니다.
7. TTN(Transient Tachypnea of the Newborn)

TTN(Transient Tachypnea of the Newborn)은 신생아 호흡기 질환 중 비교적 흔하고 경한 질환으로, 주로 만삭아나 만삭에 거의 가까운 후기 조산아에게 나타납니다. 출생 후 폐포액의 흡수가 지연되어 빈호흡, 경한 흉부함몰, 신음호흡, 경한 청색증 등 호흡곤란 증상이 나타나지만, 정상 혈액가스검사소견을 유지하기 위해 40%이상의 산소공급은 필요하지 않습니다. 원인으로는 거대아, 급속분만, 제왕절개 신생아 등이 있습니다. 치료는 산소 공급만으로 회복되는 것이 일반적입니다.
8. MAS(Meconium Aspiration Syndrome)

MAS(Meconium Aspiration Syndrome)는 태변흡인증후군으로, 양수가 태변에 착색된 채로 태어난 신생아에서 호흡곤란 증상을 보이는 경우를 말합니다. 태아가 자궁내 가사상태에 이르면 헐떡호흡에 의해 폐액이 기도방향으로 이동하고, 장운동의 항진과 항문 괄약근 이완으로 태변이 배출될 수 있습니다. 증상은 폐손상으로 인한 기도의 기계적 폐쇄, 폐 표면활성제 생성 및 활성 저하, 염증반응 활성화 등이 나타납니다. 치료는 기관내삽관을 통한 태변 제거, 폐표면활성제 투약, 기계적 환기 등이 필요합니다.
9. BPD(Bronchopulmonary Dysplasia)

BPD(Bronchopulmonary Dysplasia)는 기관지폐형성이상으로, 미숙아 만성 폐질환을 의미합니다. 기계환기와 산소공급이 미숙한 폐를 손상시키고, 신생아 호흡곤란 증후군, 무기폐, 국소적인 과팽창 등이 폐손상을 촉진합니다. 증상으로는 빈호흡, 빈맥, 흉부함몰, 코벌렁임, 신음 및 호흡수 증가 등이 있습니다. 치료는 충분한 산소화와 환기 제공, 폐의 추가적 손상 예방, 최적의 영양상태 촉진 등의 지지요법이 필요합니다.

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1. RDS(Respiratory Distress Syndrome)

RDS (Respiratory Distress Syndrome) is a serious respiratory condition that primarily affects premature infants. It is caused by a deficiency of surfactant, a substance that helps keep the alveoli (tiny air sacs in the lungs) open and prevent them from collapsing during exhalation. This leads to difficulty breathing, as the lungs struggle to expand and contract properly. The symptoms of RDS include rapid, labored breathing, nasal flaring, chest retractions, and cyanosis (bluish discoloration of the skin). If left untreated, RDS can lead to respiratory failure, lung damage, and other complications. Treatment typically involves the administration of supplemental oxygen, mechanical ventilation, and surfactant replacement therapy. Early diagnosis and prompt treatment are crucial in managing RDS. Advances in neonatal care, such as the use of antenatal corticosteroids and surfactant replacement therapy, have significantly improved the prognosis for infants with RDS. However, the condition still poses a significant challenge, especially for extremely premature infants, and ongoing research is needed to further improve outcomes.
2. PDA(Patent Ductus Arteriosus)

PDA (Patent Ductus Arteriosus) is a congenital heart defect in which the ductus arteriosus, a blood vessel that connects the pulmonary artery to the aorta, fails to close after birth as it normally should. This can lead to an abnormal blood flow between these two major blood vessels, which can cause various complications. In a healthy newborn, the ductus arteriosus closes shortly after birth, allowing the lungs to receive the appropriate amount of blood flow. In a baby with PDA, the ductus arteriosus remains open, allowing oxygenated blood to flow back into the lungs, which can overload the heart and lungs and lead to heart failure, respiratory distress, and other problems. Symptoms of PDA can include rapid breathing, poor weight gain, and heart murmurs. Treatment options include medication, such as indomethacin or ibuprofen, to help close the ductus arteriosus, or surgical ligation if the condition persists or worsens. Early detection and prompt treatment of PDA are crucial to prevent long-term complications and ensure the best possible outcomes for affected infants. Ongoing research and advancements in medical care have significantly improved the prognosis for babies with PDA, but it remains an important condition to monitor and manage in neonatal care.
3. ROP(Retinopathy of Prematurity)

ROP (Retinopathy of Prematurity) is a serious eye condition that primarily affects premature infants, particularly those born before 32 weeks of gestation or with a birth weight of less than 1,500 grams. It is caused by the abnormal development of blood vessels in the retina, the light-sensitive tissue at the back of the eye. In a healthy eye, the blood vessels in the retina grow gradually and evenly. However, in premature infants, this process can be disrupted, leading to the formation of abnormal, fragile blood vessels that can leak, scar, and cause the retina to detach from the back of the eye. This can result in vision impairment or even blindness if left untreated. Symptoms of ROP can include abnormal blood vessel growth, retinal detachment, and changes in the appearance of the retina. Early detection and treatment are crucial, as ROP can progress rapidly and cause permanent vision loss if not addressed in a timely manner. Treatment options for ROP include laser therapy, cryotherapy, and anti-VEGF (vascular endothelial growth factor) injections, which can help to stabilize the condition and prevent further damage to the retina. Ongoing monitoring and follow-up care are also essential for managing ROP and ensuring the best possible visual outcomes for affected infants. Advances in neonatal care, including improved oxygen management and the use of specialized screening and treatment protocols, have significantly improved the prognosis for infants with ROP. However, it remains an important condition to monitor and manage in the neonatal intensive care unit, as the long-term impact on vision can be profound.
4. NEC(Necrotizing Enterocolitis)

NEC (Necrotizing Enterocolitis) is a serious and potentially life-threatening gastrointestinal condition that primarily affects premature infants. It is characterized by the inflammation and destruction of the intestinal tissue, which can lead to the development of ulcers, perforations, and sepsis (a severe, whole-body infection). The exact cause of NEC is not fully understood, but it is believed to be a multifactorial condition that involves a combination of factors, such as prematurity, formula feeding, and disruptions to the gut microbiome. Symptoms of NEC can include abdominal distension, bloody stools, feeding intolerance, and respiratory distress. Early diagnosis and prompt treatment are crucial in managing NEC, as the condition can progress rapidly and lead to serious complications, such as intestinal perforation, sepsis, and even death. Treatment typically involves a combination of antibiotics, bowel rest, and supportive care, such as intravenous fluids and parenteral nutrition. In severe cases, surgical intervention may be necessary to remove the affected portions of the intestine and address any complications. Long-term complications of NEC can include short bowel syndrome, intestinal strictures, and developmental delays. Ongoing research is focused on improving our understanding of the underlying causes of NEC and developing more effective prevention and treatment strategies. Advances in neonatal care, such as the use of probiotics and human milk feeding, have shown promise in reducing the incidence and severity of NEC in premature infants. However, NEC remains a significant challenge in the neonatal intensive care unit, and continued efforts are needed to improve outcomes for affected infants.
5. PPHN(Persistent Pulmonary Hypertension of the Newborn)

PPHN (Persistent Pulmonary Hypertension of the Newborn) is a serious and potentially life-threatening condition in which the blood vessels in the lungs remain constricted after birth, leading to high blood pressure in the pulmonary arteries. This can result in reduced blood flow to the lungs and impaired oxygenation of the blood, which can have severe consequences for the newborn. PPHN can occur in both term and preterm infants, and it is often associated with other underlying conditions, such as meconium aspiration syndrome, congenital diaphragmatic hernia, and sepsis. Symptoms of PPHN can include rapid breathing, cyanosis (bluish discoloration of the skin), and poor feeding. Prompt diagnosis and treatment are crucial in managing PPHN, as the condition can rapidly progress and lead to respiratory failure, organ damage, and even death. Treatment typically involves the use of supplemental oxygen, mechanical ventilation, and medications to help dilate the blood vessels in the lungs and improve blood flow. In severe cases, more advanced therapies, such as inhaled nitric oxide or extracorporeal membrane oxygenation (ECMO), may be necessary to support the infant's respiratory and cardiovascular function. Ongoing research is focused on improving our understanding of the underlying causes of PPHN and developing more effective prevention and treatment strategies. Advances in neonatal care, such as the use of antenatal corticosteroids and surfactant replacement therapy, have helped to reduce the incidence and severity of PPHN in some cases. However, it remains a significant challenge in the neonatal intensive care unit, and continued efforts are needed to improve outcomes for affected infants.
6. IVH(Intraventricular Hemorrhage)

IVH (Intraventricular Hemorrhage) is a serious condition that primarily affects premature infants, particularly those born before 32 weeks of gestation. It is characterized by bleeding into the ventricles, the fluid-filled spaces within the brain, which can lead to a range of complications and long-term neurological consequences. The causes of IVH are not fully understood, but it is believed to be related to the fragility of the blood vessels in the developing brain, as well as factors such as fluctuations in blood pressure, coagulation disorders, and inflammation. Symptoms of IVH can include seizures, apnea (pauses in breathing), and changes in heart rate and blood pressure. The severity of IVH is typically graded on a scale of I to IV, with higher grades indicating more extensive bleeding and a greater risk of complications. Treatment for IVH often involves supportive care, such as maintaining stable blood pressure and oxygenation, as well as the management of any associated complications, such as hydrocephalus (buildup of fluid in the brain). In some cases, surgical interventions, such as the placement of a shunt to drain excess fluid, may be necessary. The long-term consequences of IVH can be significant and may include developmental delays, cognitive impairments, and motor disabilities. Ongoing research is focused on improving our understanding of the underlying causes of IVH and developing more effective prevention and treatment strategies. Advances in neonatal care, such as the use of antenatal corticosteroids and improved management of preterm infants, have helped to reduce the incidence and severity of IVH in some cases. However, it remains a significant challenge in the neonatal intensive care unit, and continued efforts are needed to improve outcomes for affected infants.
7. TTN(Transient Tachypnea of the Newborn)

TTN (Transient Tachypnea of the Newborn) is a relatively common respiratory condition that affects newborn infants, particularly those delivered by cesarean section or born to mothers with certain medical conditions, such as diabetes or hypertension. TTN is characterized by rapid, labored breathing in the first few hours or days after birth, which is caused by a delay in the clearance of fluid from the infant's lungs. This fluid buildup can make it more difficult for the lungs to expand and contract properly, leading to the characteristic rapid breathing and respiratory distress. Symptoms of TTN can include rapid breathing, nasal flaring, chest retractions, and grunting. In most cases, the condition is self-limiting and resolves within 24 to 72 hours with supportive care, such as the administration of supplemental oxygen and monitoring of the infant's respiratory status. Treatment for TTN typically involves providing the infant with supplemental oxygen, maintaining proper fluid and electrolyte balance, and monitoring for any complications. In severe cases, the infant may require more intensive respiratory support, such as continuous positive airway pressure (CPAP) or mechanical ventilation. The prognosis for infants with TTN is generally good, as the condition is usually transient and resolves without long-term consequences. However, in some cases, TTN can be a precursor to more serious respiratory conditions, such as respiratory distress syndrome (RDS) or pneumonia, and close monitoring is essential. Ongoing research is focused on improving our understanding of the underlying causes of TTN and developing more effective prevention and treatment strategies. Advances in neonatal care, such as the use of antenatal corticosteroids and improved management of maternal conditions, have helped to reduce the incidence and severity of TTN in some cases.
8. MAS(Meconium Aspiration Syndrome)

MAS (Meconium Aspiration Syndrome) is a serious respiratory condition that can occur in newborn infants when they inhale a mixture of meconium (the first stool passed by the infant) and amniotic fluid during the birthing process. Meconium is normally passed by the infant after birth, but in some cases, it can be passed before delivery, often as a result of fetal distress or other complications. When the infant breathes in this meconium-contaminated fluid, it can cause inflammation and obstruction of the airways, leading to respiratory distress and other complications. Symptoms of MAS can include rapid, labored breathing, cyanosis (bluish discoloration of the skin), and poor feeding. In severe cases, the condition can progress to respiratory failure, pneumonia, and other life-threatening complications. Treatment for MAS typically involves a combination of supportive care, such as the administration of supplemental oxygen and mechanical ventilation, and more specialized interventions, such as the use of surfactant replacement therapy or extracorporeal membrane oxygenation (ECMO) in severe cases. The prognosis for infants with MAS can vary widely, depending on the severity of the condition and the presence of any underlying medical issues. In mild cases, the condition may resolve with supportive care, but in more severe cases, the long-term consequences can include chronic lung disease, developmental delays, and other neurological complications. Ongoing research is focused on improving our understanding of the underlying causes of MAS and developing more effective prevention and treatment strategies. Advances in neonatal care, such as the use of antenatal corticosteroids and improved management of high-risk pregnancies, have helped to reduce the incidence and severity of MAS in some cases. However, it remains a significant challenge in the neonatal intensive care unit, and continued efforts are needed to improve outcomes for affected infants.
9. BPD(Bronchopulmonary Dysplasia)

BPD (Bronchopulmonary Dysplasia) is a chronic lung condition that primarily affects premature infants, particularly those born before 32 weeks of gestation. It is characterized by the abnormal development and scarring of the lungs, which can lead to a range of respiratory and developmental complications. The exact causes of BPD are not fully understood, but it is believed to be the result of a complex interplay of factors, including prematurity, mechanical ventilation, oxygen therapy, and inflammation. These factors can disrupt the normal development of the lungs, leading to the formation of abnormal, fibrotic tissue and impaired gas exchange. Symptoms of BPD can include persistent respiratory distress, the need for supplemental oxygen, and poor growth and development. In severe cases, the condition can lead to pulmonary hypertension, heart failure, and other life-threatening complications. Treatment for BPD typically involves a combination of supportive care, such as the administration of supplemental oxygen and mechanical ventilation, and more specialized interventions, such as the use of diuretics, corticosteroids, and bronchodilators to manage the underlying lung disease. The long-term prognosis for infants with BPD can vary widely, depending on the severity of the condition and the presence of any associated complications. Some infants may experience ongoing respiratory issues and developmental delays, while others may recover with minimal long-term effects. Ongoing research is focused on improving our understanding of the underlying causes of BPD and developing more effective prevention and treatment strategies. Advances in neonatal care, such as the use of gentler ventilation techniques and the administration of surfactant replacement therapy, have helped to reduce the incidence and severity of BPD in some cases. However, it remains a significant challenge in the neonatal intensive care unit, and continued efforts are needed to improve outcomes for affected infants.

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