A, preterm infants characteristics: 1, the appearance of preterm infants weight mostly below 2500g, less than 47cm long, cry light, weak neck muscles, low muscle tone of the limbs, red and tender skin, fetal hair, soft ear shell, areola unclear, plantar lines less, male infants testicles to descend or not fully descend, female infants labia majora can not cover the labia minora. 2, breathing preterm infants respiratory center is relatively more immature, irregular breathing; often occur apnea. Apnea (apnea) refers to respiratory arrest of 15 to 20 seconds, or less than 15 seconds, but accompanied by a slowed heart rate (<100 beats/min) and the appearance of cyanosis. Premature infants have immature lungs with little surface active substance and are susceptible to pulmonary hyaline membrane disease. Premature infants with a history of intrauterine distress are prone to aspiration pneumonia. 3, digestion Premature infants have a weak swallowing reflex and are prone to choking on milk and aspiration of milk. The gastric cardia sphincter is flaccid and small in volume, which makes it easy to overflow milk. Premature infants are preferable to breastfeeding, but need to increase protein in time. Premature infants are prone to necrotizing small bowel infection, and care should be taken that the osmotic pressure of milk does not exceed 460 mmol/L. Premature infants with immature liver and insufficient glucuronide conversion enzyme have heavier physiological gangrene, which lasts longer and is prone to nuclear jaundice. Because of the imperfect liver function, the intrahepatic vitamin K-dependent coagulation factor synthesis is low, and bleeding disorders are likely to occur. 4, neurological The function of the nervous system and gestational age are closely related, the younger the gestational age, the worse the reflexes. Premature infants are prone to hypoxia, leading to hypoxic-ischemic encephalopathy. In addition, because of the presence of well-developed embryonic germinal layer tissue under the ventricular canal of preterm infants, it is easy to lead to intracranial hemorrhage. 5, body temperature The body temperature regulation function is worse, less brown fat, low basal metabolism, less heat production, while the body surface area is relatively large, less subcutaneous fat, easy heat dissipation, immature sweat gland development and lack of cold shivering response. Therefore, the body temperature of preterm infants is prone to change with the change of environmental temperature. 6.Other Poor acid-base regulation in preterm infants makes them prone to water and electrolyte disorders and hypoglycemia (preterm infants have low glycogen stores and low glucose reabsorption capacity due to renal tubules), in addition, preterm infants are prone to hyperglycemia, anemia and serious infections. Common nursing diagnosis: 1. hypothermia is related to poor thermoregulatory function and insufficient heat production reserve; 2. nutritional disorders, lower than the body's needs, are related to insufficient intake and poor digestion and absorption; 3. risk of infection is related to insufficient immune function; 4. inability to maintain autonomic respiration is related to immature development of respiratory organs. Care measures: The conditions of the premature baby room should be separated from those of full-term babies. In addition to the conditions of the full-term baby room, it should be equipped with infant incubators, far-infrared warming beds, microinfusion pumps, suction devices and resuscitation capsules. The staff is relatively fixed. In order to strengthen the nursing management of preterm infants, it is better to carry out systematic and holistic nursing care. 2.Maintain stable body temperature Premature infants have an imperfectly developed temperature center, and their body temperature rises and falls unpredictably, and they are mostly hypothermic. Therefore, the temperature in the room for preterm infants should be maintained at 24-26oC, and raised to 27-28C during morning care, with relative humidity of 55%-65%. Different warming measures should be given according to the weight, maturity and condition of preterm infants, and body temperature monitoring should be strengthened 2 to 4 times a day. General weight less than 2000g, should be placed in the infant incubator as soon as possible to keep warm (see Chapter 5, Section IV "warm box use"). Weight greater than 2000g in the box outside the warm, should also be given to wear a flannel cap to reduce oxygen consumption and heat dissipation; necessary operations such as inguinal blood collection must be unpacked, should be in the far-infrared radiation bed to keep warm, no conditions, according to local conditions, take simple warming methods, and try to shorten the operating time. 3, reasonable feeding Premature infants have insufficient digestive enzymes, poor digestion and absorption, but more nutrients required for growth and development. Therefore, it is best to breastfeed preterm infants, those who cannot breastfeed to preterm infants formula milk is appropriate. The amount of breastfeeding depends on the tolerance of the preterm infant, in order not to occur gastric retention and vomiting Table 6-1. poor sucking ability can be fed by drip tube, gastric tube and supplemented with intravenous high nutrition fluid. Detailed daily records of intake and output, accurate weight for analysis and adjustment of supplementary nutrition. Premature infants are prone to vitamin K-dependent coagulation factors and should be supplemented with vitamin K1 after birth to prevent bleeding disorders. In addition, should be supplemented with vitamin A, C.D, E and iron and other substances. 4, prevention of infection Premature infants have lower resistance than full-term infants, sterilization and isolation requirements are higher. It is more important to strengthen the care of the mouth, skin and umbilicus, and the tiny lesions found should be treated in time. Change the position frequently to prevent pneumonia. Develop a strict disinfection and isolation system, strictly prohibit the entry of non-specialized room personnel, strictly control the number of visitors and demonstrations, and disinfect the air and related supplies in a timely manner after the excess flow of people to ensure clean air and instrument items to prevent cross-infection. 5. Maintain effective breathing Premature infants are prone to hypoxia and apnea. Those with hypoxic symptoms should be given oxygen inhalation. The concentration and duration of oxygen inhalation should be determined by the degree of hypoxia and the method of oxygen use, and it is best if the oxygen inhalation is continued for no more than 3 days, or the oxygen use should be guided under blood gas monitoring to prevent the complications of oxygen therapy. Apnea is given to popping the soles of the feet, back support, oxygen treatment, conditions allow the placement of water bladder mattress, the use of water vibration to reduce the occurrence of apnea. 6, close observation of the condition Because of the immature development of the organs of the systems of preterm infants, their functions are not perfect, nursing staff should have a high sense of responsibility and skilled business skills, strengthen the rounds, closely observe the changes in the condition. If you find the following conditions, you should promptly report to the physician, and help find the cause, and quickly deal with: ① body temperature is not normal; ② irregular breathing or moaning; ③ facial or general bruising (or pale); ④ restlessness or low response; ⑤ convulsions; early or severe yellow value; poor appetite, vomiting, diarrhea, abdominal distension, 3 days after birth still have black stool; q sclerosis; r bleeding symptoms; s 24 hours still no urine and stool.