1. Neonatal Nursing Care: Part 3 Nursing Care of Normal Newborn
Developed by D. Ann Currie, RN MSN

2. Assessment Data: Condition of the Infant
Apgar scores at 1 and 5 minutes
Resuscitative measures
Physical examination
Vital signs
Voidings
Passing of meconium

3. Apgar Score

4. Care of the Newborn immediately after birth
Maintain respirations
Provide and maintain warmth
Apgar score
Physical assessment
Newborn identification
Facilitate attachment

6. Signs of Newborn Transition

7. Neonatal Distress

8. Newborn Care Positioning Feeding Elimination Safety Issues-
Newborn identification
Newborn abduction
Bonding
Cord Care
Circumcision Care/Uncircumcision Care

9. When to Call for Help

10. Assessment Data: Infant Complications
Excessive mucus
Delayed spontaneous respirations or responsiveness
Abnormal number of cord vessels
Obvious physical abnormalities

11. 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

12. 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

13. 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

14. Physiologic Alterations
Respiratory distress
Pallor
Hypothermia
Alterations in feeding and elimination

15. Nursing Care: Assessment
Airway clearance
Vital signs
Body temperature
Neurologic status
Ability to feed
Evidence of complications

17. 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

21. Daily Assessments Vital signs Weight Overall color Intake and output
Umbilical cord
Circumcision
Newborn feeding
Attachment

22. Daily Newborn Care Assist with feedings Thermoregulation Skin care
Cord care
Prevention of infection
Security

23. Cord Care

24. 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

26. 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

27. Discharge Education Safety measures Voiding and stool characteristics
Circumcision care
Cord care
Waking and quieting the newborn
Car safety
Immunizations
Signs of illness

28. Wrapping Newborn

29. Infant car restraint for use from birth to about 12 months of age

30. 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

31. Documentation of Discharge
Teaching
How
Checking of ID Bands
With whom
Condition at discharge
Where

32. The End of Part III