1. ASSESSMENT AND MANAGEMENT OF HIGH RISK NEW BORN

3. GESTATIONAL AGE
GA ,the number of weeks the neonate remained in utero

4. FACTORS AFFECTING FETAL GROWTH…..Contd
MATERNAL FACTORS
PLACENTAL FACTORS
FETAL FACTORS

5. CLASSIFICATION OF NEONATE ACCORDING TO GESTATIONAL AGE AND BIRTH WEIGHT
ACCORDING TO GA
PRE TERM – Before 37th week
TERM – Between 38 and 42 weeks
POST TERM - After 42 weeks

6. CLASSIFICATION OF NEONATE ACCORDING TO GESTATIONAL AGE AND BIRTH WEIGHT
ACCORDING TO BIRTH WEIGHT
Large for gestational age (LGA)
Appropriate for gestational age (AGA)
Small for gestational age (SGA)

7. CLASSIFICATION OF NEONATE ACCORDING TO GESTATIONAL AGE AND BIRTH WEIGHT
ACCORDING TO BIRTH WEIGHT
Low birth weight
Moderately low birth weight
Very low birth weight
Extremely low birth weight

8. NURSING PROCESS IN HIGH RISK NEONATAL CARE
NURSING ASSESSMENT
Identification of associated factors
Maternal characteristics
Reproductive history
Substance abuse
Environmental hazards
Medical problems
Complications of present pregnancy
Immediately after birth
Apgar scoring
Maternal history of anesthesia and analgesia

9. APGAR SCORING
SCORE
SIGNS 1 2
RESPIRATORY EFFORT
Apneic
Slow irregular
Good crying
HEART RATE
Absent
Low (Below 100)
Over 100
MUSCLE TONE
Flaccid
Flexion of extremities
Active body movements
REFLEX IRRITABILITY
No response
Grimace
Cough or sneeze
COLOUR
Blue,pale
Body pink extremities blue
Complete pink
Total score – 10 , No depression – 7-10 , Moderate depression – 4-6
Severe depression – 0-3

10. PLANNING AND INTERVENTION….Contd
Resusitation
Transport of the neonate at risk
Providing neutral thermal environment
Maintaining skin integrity
Prevention of infection
Respiratory care
Nutritional need

11. NURSING DIAGNOSIS Impaired gas exchange related to lack of surfactant
Fluid volume deficit related to insensible water loss and inadequate fluid intake
Altered nutrition less than body requirement related to actual intake less than caloric requirement

12. NURSING DIAGNOSIS
Impaired skin integrity related to the presence of tapes and other abrasive materials used with monitoring device
Altered comfort related to invasive painful procedure
Risk for injury
Risk for infection