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Introduction
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Neonatal Nursing Care: Part 3 Nursing Care of Normal Newborn
Developed by D. Ann Currie, RN MSN 2012
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Assessment Data: Condition of the Infant
Apgar scores at 1 and 5 minutes Resuscitative measures Physical examination Vital signs Voidings Passing of meconium
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Apgar Score
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Care of the Newborn immediately after birth
Maintain respirations Provide and maintain warmth Apgar score Physical assessment Newborn identification Facilitate attachment
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Signs of Newborn Transition
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Neonatal Distress
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Newborn Care Positioning Feeding Elimination Safety Issues-
Newborn identification Newborn abduction Bonding Cord Care Circumcision Care/Uncircumcision Care
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When to Call for Help
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Assessment Data: Infant Complications
Excessive mucus Delayed spontaneous respirations or responsiveness Abnormal number of cord vessels Obvious physical abnormalities
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Assessment Data: Labor and Birth
Duration and course Status of mother and fetus Analgesia or anesthesia Prolonged rupture of membranes Meconium-stained amniotic fluid Nuchal cord Precipitous birth Use of forceps or vacuum extraction assisted device Fetal distress
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Assessment Data: Maternal Complications
Preeclampsia Spotting Illness Recent infections Rubella status Serology results Hepatitis B screen results Exposure to group B streptococci History of maternal substance Human immunodeficiency virus (HIV) test result
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Assessment Data: Family
Parents’ interactions with their newborn Their desires regarding infant care Information about other children in the home Available support systems Patterns of interaction within each family unit
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Physiologic Alterations
Respiratory distress Pallor Hypothermia Alterations in feeding and elimination
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Nursing Care: Assessment
Airway clearance Vital signs Body temperature Neurologic status Ability to feed Evidence of complications
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Nursing Care: Assessment
Review of prenatal and birth information Gestational age Newborn’s adaptation to extrauterine life Weight and measurement Vital signs every 30 minutes Assessment of Hct or blood glucose if warranted
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Daily Assessments Vital signs Weight Overall color Intake and output
Umbilical cord Circumcision Newborn feeding Attachment
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Daily Newborn Care Assist with feedings Thermoregulation Skin care
Cord care Prevention of infection Security
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Cord Care
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Common Concerns How to pick up a newborn
Holding and feeding the infant Changing the diaper Interpreting newborn cues Bathing the newborn Cord and circumcision care Normal voiding and stooling pattern
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Parent Education Periods of reactivity and expected newborn responses
Normal physical characteristics of the newborn The bonding process The infant’s capabilities for interaction The role of touch in facilitating parent-infant interaction Comforting techniques Progression of infant behaviors Information about available educational materials and support
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Discharge Education Safety measures Voiding and stool characteristics
Circumcision care Cord care Waking and quieting the newborn Car safety Immunizations Signs of illness
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Wrapping Newborn
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Infant car restraint for use from birth to about 12 months of age
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Signs of Illness Temperature above 38oC or below 36.6oC axillary
Continual rise in temperature Forceful or frequent vomiting Refusal of two feedings in a row Difficulty in awakening baby Cyanosis with or without a feeding Absence of breathing longer than 20 seconds Inconsolable infant or continuous high-pitched cry Discharge or bleeding from umbilical cord, circumcision, or any opening Two consecutive green watery or black stools, or increased frequency of stools No wet diapers for 18 to 24 hours Fewer than 6 to 8 wet diapers per day after 4 days of age Development of eye drainage
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Documentation of Discharge
Teaching How Checking of ID Bands With whom Condition at discharge Where
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The End of Part III
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QUESTIONS
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THANK YOU
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