The Nurse's Role in Neonatal Therapeutic Hypothermia

Abstract

The registered nurse (RN) plays a vital role in the induction and maintenance of therapeutic hypothermia in neonatal patients. During a difficult labor and delivery, the nurse needs to recognize the risk factors for neonatal asphyxiation and signs thereof. It may be necessary for the nurse to draw attention to such a situation so that interventions and treatment can begin. Therapeutic hypothermia is the treatment of choice for instances of hypoxic ischemic encephalopathy (HIE). This requires the RN to have a clear understanding of the treatment and interventions associated with HIE. The RN in the neonatal intensive care unit (NICU) is then responsible for maintaining such treatment. The nurse needs to keep a vigilant watch of blood pressure, heart rate, blood glucose, electrolyte balance, serial arterial blood gases, skin, and level of sedation in the neonate. The nurse needs to have the skill set to maintain the treatment effectively and ensure the neonate is safe while under such conditions. While the data is there to support the use of such treatment for HIE, adverse outcomes are still present in about half of all cases. This requires the nurse to provide consistent, compassionate care in the instance of a palliative care choice. The nurse needs to understand interventions for the use of therapeutic hypothermia while forming a therapeutic relationship with the parents and family.