A pele do recém-nascido prematuro sob a a avaliação do enfermeiro: cuidado norteando a manutenção da integridade cutânea

Abstract

The prematurity expressed relevance to the health neonatal, demonstrating ascending compromising regarding morbi-mortality of this patients, whose larger incidence can be attributed to the inadequate practices with the skin of the premature. Revision of the literature about the beneficial interaction among the skin of premature infant newborn and the appropriate handling, orientated by the nurse, that through the standardization of the cares of direct interference and continuous evaluation of the cutaneous integrity and attending the premature. It publishes the importance of the care with the skin of the premature newborn, not just making possible the survival, but the opportunity to integrate and to enjoy of the life with quality.

Skin care of the newborn: the state of art

“…They are separated by database searched. After data analysis showed that three articles were published [6][7]18 in 2009, five [8][9][10]17,19 in 2010, five 20,22 in 2011, four 21,23 in 2012 and one 16 in 2013, showing that it is relevant, and was being searched steadily by health professionals by the year 2012.…”

“…As for the language of publication, ten articles [7][8][9][10][11][12][13][14][15][16] were available in English and eight 6,[17][18][19][20][21][22][23] Regarding the NB skin, all authors [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] highlight the fragility and immaturity of its layers, especially the epidermis and its outermost layer, the stratum corneum, with concordance between the studies on the importance of preserving the integrity of integument, in order to promote safe care to hospitalized newborns.…”

“…Regarding handling, three studies 6,17,21 guide minimal handling of the NB and suggest that decubitus change is performed every three to four hours. One of authors 6 further recommends that the NB, whenever possible, is nestled in bed in a fetal position, as this position, as well as providing safety and comfort to the newborn, contributes to the reduction of heat loss.…”

“…Regarding the newborn, thermoregulation and preventing transepidermal water loss (PAT), two studies 6,17 suggest the use of double-walled incubator with humidification, maintaining a neutral thermal environment. The axillary temperature of the newborn should be regularly monitored and maintained between 36,5 to 37,5°C values.…”

“…6 In its recently revised Guideline, the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) (2013), 24 directs that the RH of the air in the incubator should be above 70% in the first seven days and may be gradually reduced to 50% after the first week, until the child is 28 days old. The AWHONN 24 also suggests that the RH is maintained at 50% to 30-32 weeks post-conceptional age.…”