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11.03 Transient Tachypnea of Newborn

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Overview

  1. Self resolving tachypnea noted in the newborn
    1. Respirations greater than 60 per minute
    2. Normal RR is 30-60 breaths/min

Nursing Points

General

  1. Believed to be due to retained lung fluid
  2. Transient → Typically resolves itself within 24-48 hours

Assessment

  1. Infant might start out comfortable and unlabored but tire out and become labored
  2. All symptoms are respiratory
    1. Tachypnea
    2. Labored breathing (retractions, grunting)
    3. Nasal flaring
    4. General cyanosis
    5. Abnormal breath sounds

Therapeutic Management

  1. Supplemental O2
  2. Monitor oxygen saturation and work of breathing
  3. Provide emotional support

Nursing Concepts

  1. Oxygenation
  2. Gas Exchange

Patient Education

  1. Educate on overstimulation
  2. Educate on the situation

Reference Links

Video Transcript

In this lesson I will help you understand transient tachypnea of the newborn and what is means for the patient and your role in care.

Ok so transient tachypnea of newborn is also known as TTN. So basically the baby breathes fast. Our normal newborn respirations are 30-60 so these babies breathe over 60 per minutes. This is transient soit will typically resolve itself within 24 to 48 hours. So why does this happen? It is typically caused by retained lung fluid. That fluid shouldn’t be there anymore so it causes the newborn to have more labored breathing.

We’ve already said this baby will be tachypneic but what else? So all the assessment findings are going to be respiratory related. They might start out breathing fast, but comfortable but they get tired out from this tachypnea and start having respiratory distress. So we will see tachypnea always with this diagnosis and labored breathing could start. So this could be retractions, nasal flaring, grunting. General cyanosis could also present itself because of poor perfusion.

So what can we do to help this baby? We are going to monitor the oxygen saturation and the work of breathing. Is the baby stable? If the baby isn’t then we might to offer some supplemental oxygen. In rare cases TTN gets worse and a ventilator might be necessary but otherwise just supportive care is necessary. Sometimes a baby suffering from TTN can not be stimulated so this means no touch or holding. It makes them work harder with breathing, it just adds stress. So we might need to offer support for these parents that are unable to hold her baby. We need to educate the family on the situation and explain that the baby might not tolerate being held or touched.

Oxygenation and gas exchange are the nursing concepts. With TTN there is excess fluid in lungs that is making it difficult for for the baby to properly gas exchange and oxygenate.
Ok so remember these main points. This infant has tachypnea so breathing over 60 breaths per minute. There is excess fluid in the lungs that needs to be absorbed. These babies need low stimulation and sometimes oxygen and TTN will self resolve in 24-48 hours.

Make sure you check out the resources attached to this lesson and review the key points. Now, go out and be your best selves today. And, as always, happy nursing.

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