Introduction http://www.youtube.com/watch?v=yVLDi-FFjVo
Neonatal Nursing Care: Part 3 Nursing Care of Normal Newborn Developed by D. Ann Currie, RN MSN 2012
Assessment Data: Condition of the Infant Apgar scores at 1 and 5 minutes Resuscitative measures Physical examination Vital signs Voidings Passing of meconium
Apgar Score
Care of the Newborn immediately after birth Maintain respirations Provide and maintain warmth Apgar score Physical assessment Newborn identification Facilitate attachment
Signs of Newborn Transition
Neonatal Distress
Newborn Care Positioning Feeding Elimination Safety Issues- Newborn identification Newborn abduction Bonding Cord Care Circumcision Care/Uncircumcision Care
When to Call for Help
Assessment Data: Infant Complications Excessive mucus Delayed spontaneous respirations or responsiveness Abnormal number of cord vessels Obvious physical abnormalities
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
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
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
Physiologic Alterations Respiratory distress Pallor Hypothermia Alterations in feeding and elimination
Nursing Care: Assessment Airway clearance Vital signs Body temperature Neurologic status Ability to feed Evidence of complications
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
Daily Assessments Vital signs Weight Overall color Intake and output Umbilical cord Circumcision Newborn feeding Attachment
Daily Newborn Care Assist with feedings Thermoregulation Skin care Cord care Prevention of infection Security
Cord Care
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
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
Discharge Education Safety measures Voiding and stool characteristics Circumcision care Cord care Waking and quieting the newborn Car safety Immunizations Signs of illness
Wrapping Newborn
Infant car restraint for use from birth to about 12 months of age
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
Documentation of Discharge Teaching How Checking of ID Bands With whom Condition at discharge Where
The End of Part III
QUESTIONS
THANK YOU