2. The neonatal period : The neonatal period : is defined as the first 28 days of life. Purpose of immediate newborn care: 1. To establish, maintain and support respirations. 2. To provide warmth and prevent hypothermia. 3. To ensure safety, prevent injury and infection. 4. To identify actual or potential problems.

4. ABCW principles of delivery: A → Airway. B → Breathing. C → Circulation. W → Warmth.

5.  Thermoregulation: is the process of maintaining the balance between heat loss and heat production. The four mechanisms of heat loss in the newborn: Causes of heat lose in newborn Heat loss mechanisms ConductionEvaporation. Radiation.Convection

6. A.Conduction involves the transfer of heat from one object(newborn’s body) to another(solid surface) when the two objects are in direct contact such as a cold mattress, scale. MECHANISMS OF HEAT LOSS B. Convection involves the flow of heat from the body surface to cooler surrounding air or to air circulating over a body surface such as (open doors, windows, fans, air conditioners)

7. MECHANISMS OF HEAT LOSS C. Evaporation involves the loss of heat when a liquid is converted to a vapor, it may be insensible (such as from skin and respiration) or sensible (such as from sweating). D. Radiation : involves loss of body heat to cooler, solid surfaces but not in direct contact with the newborn. For example, when a newborn is placed in a single-wall isolate next to a cold window

10. A  Keeping airway clear through: 1. Wipe mouth and nose of secretions after delivery of the head clean sterile gauze pad. 2. Holding the newborn's head down & heels up for few seconds immediately after birth. 3. Position of newborn:  Trendelenburg position – head lower than the body  Side lying position : to permit drainage of mucus from the mouth. Place a small pillow or rolled towel at the back to prevent newborn from rolling back to supine position. 4. Gently suctioning with bulb syringe or small soft and short catheter from mouth first then nose to prevent aspiration of fluid into the lungs.

12. C→ Circulation.  Assess the state of cardiopulmonary function by using Apgar score as a method of assessing the newborn ’ s adjustment to extrauterine life. It is taken at one minute and five minutes after birth.  With depressed infants, repeat the scoring every five minutes as needed.  The one minute score indicates the necessity for resuscitation. The five minute score is more reliable in predicting mortality and neurologic deficits.

15. 6. Avoiding the placement of newborns in near air vents to prevent heat loss through convection 7. Delaying the initial bath until temperature has stabilized. 8. Covering the head with cap or warm towel. 9. placing a newborn under radiant warmer or warm incubator. 10. Placing the newborn against the mother's skin & covering him to transfer heat from the mother to newborn (Kangaroo Care).

16. (A)Radiant warmer. (B) Isolette or incubator

17. Umbilical cord care: 1. Assess the end cutting for 3vessels (one vein+ 2arteries) in shape smile face. 2. The cord is clamped and cut approximately within 30 seconds after birth. 3. Double ligation may be used (2 clamp), first put at 5cm from umbilicus and second one at 2cm. 4. One disposable plastic clamp measure 2fingers then placed it and cut the cord. 5. Keep the site dry and exposed to air.

19. 1. No tub bathing until cord falls off. 2. The cord and the area around it are cleansed with antiseptic 3. Do not apply anything on the cord such as baby powder or antibiotic, except the prescribed antiseptic solution alcohol. 4. Avoid wetting the cord. Fold diaper below so that it does not cover the cord. 5. Leave cord exposed to air. Do not apply dressing or abdominal binder over it. The cord dries and separates more rapidly if it is exposed to air. 6. If you notice the cord to be bleeding, apply firm pressure and check cord clamp if loose and fasten. 7. Report any unusual signs and symptoms which indicates infection.  Foul odor in the cord /Presence of discharge /Redness around the cord  The cord remains wet and does not fall off within 7 to 10 days  Newborn fever

20. Apply 2 identification bands for wrist and ankle. It include: (mother's hospital number, mother's full name, sex of baby and date & time of birth. Identification:

22. Measuring a newborn’s length. (A)The nurse extends the newborn’s leg and marks the pad at the heel. (B)(B) The nurse measures from the newborn’s head to the heel mark.

23. Weighing a newborn

24.  The first Temperature in newborn measure rectally to ensure if anus open or not then measure axillary, the temperature be taken every 30 minutes for the first 2 hours or until stabilization is reached and then every 8 hours until discharge. Pulse is apical pulse by stethoscope or femoral pulse or brachial pulse in newborn.

25. Assessing the newborn’s vital signs. (A) Assessing the apical pulse. (B) Palpating the femoral pulse. (C) Palpating the brachial pulse.

26. Normal ranges School, adolescent & adult Infant, toddler & preschool newbornVital signs 36.4 - 37.4 ◦c36.5-37.5 ◦c36.5-37◦cTEM 80-100 b/min80-120 b/m120-160 b/mHR 18-24 br/min20-30 br/min 30-60 br/min is symmetric irregular and shallow R.R 100/60 ± 15/10100/60 mmHg80/50 mmHgBL.P __40-80 mg/dIBL.GLU. WT = 2.700 -4000 GWT HT = 48 -53 CMHT School age 53- 54 CM H.C = 33-35 CMHC C.C = 31 -33 CMCC

27. Normal RangeLab Data 17–20 g/dLHemoglobin 52-63% Hematocrit 100,000–300,000/μLPlatelets 5.1–5.8 (1,000,000/μL)RBCs 10–30,000/mm 3 WBCs Normal Newborn Blood Values

29.  The normal flora bacteria of the intestine produce vitamin K.  The newborn’s bowel is sterile and vitamin K is not produced in the intestine until after microorganisms are introduced with the first feeding. Usually, it takes about a week.  Administer vitamin K to prevent vitamin K deficiency bleeding (VKDB)which is necessary for the formation of clotting factors.  A preventive measure single dose is(0,5mg in preterm and 1 mg in full term Vitamin K is injected IM in the newborn’s vastus lateralis (lateral anterior thigh) muscle. Administer Vit K

31. Birth record documentation: 1. Date and time of birth. 2. Time the infant breathed. 3. If respirations were spontaneous or aided. 4. Apgar score at 1and 5 minutes of life. 5. Name of eye prophylaxis was given. 6. Administer vitamin K and site of administration. 7. General condition of newborn. 8. Number of vessels in umbilical cord. 9. Measurements and vital signs. 10. Reflexes examination. 11. If the newborn pass urine and stool.