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Immediate Care of the Newborn

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Presentation on theme: "Immediate Care of the Newborn"— Presentation transcript:

1 Immediate Care of the Newborn
Prepared By /lamiaa Elsayed Pediatric Nursing Immediate care of newborn

2 The 1st 24 hours of Life The first 24 hours of life is a very significant time due to critical transition from intrauterine to extra uterine life .

3 Immediate care of newborn

4 Purposes of immediate care of newborn
Establish and maintain respiratory function. Provide warmth and prevent hypothermia. Ensure safety from injury and infection. Identify actual and potential problems that might require immediate action. Immediate care of newborn

5 Immediate Care of the Newborn
Airway Breathing Temperature APGAR IDENTIFICATION

6 Immediate care of newborn
Implementation: Oro-pharengeal Suctioning: 1.Wipe the neonate’s mouth with a piece of gauze around your index finger once his head has been delivered. Wrap and dry the neonate in a warmed towel. Suction the neonate’s mouth with a disposable Suctioning. Immediate care of newborn

7 Immediate care of newborn
Implementation: Place the neonate in a radiant warmer. Replace the wet towel and wrap the neonate in another dry towel. Place newborn in trendlenburng position. Do suction of oropharyngeal canal. Oxygen may be given. Continue suction as fluid is aspirated. Immediate care of newborn

8 Dry the Baby Hypothermia is common Wet newborns rapidly lose heat
Use a warm, dry, soft towel Any absorbent material:

9 Replace the Wet Towels Then let the mother hold the baby
Her body heat will help keep the baby warm Cover the head to prevent heat loss

10 POSITIONING OF THE NEWBORN
Right side lying 1. promote drainage secretion 2. fasten gastric emptying time good airway.

11 Immediate care of newborn
Airway & Breathing Suction gently & quickly using bulb syringe or suction catheter Starts in the mouth then, the nose to prevent aspiration Immediate care of newborn

12 Suction first from Mouth and then from Nose Use a by use of bulb syringe

13 Immediate care of newborn
Airway & Breathing Stimulate crying by rubbing Position properly- side lying / Provide oxygen when necessary Immediate care of newborn

14 Assess the newborn’s condition
A- One minute APGAR Score&­ reassess at 5 minutes. B-Neurological examination by checking common reflexes of the newborn. C-Vital signs pulse, respiration & temperature. D-Growth measurement include length, weight, head & chest circumferences. Immediate care of newborn

15 Assess the newborn’s condition
E-Assess for any gross abnormality, congenital defects in head, F- eyes, ears, chest, spine,. face, nose, abdomen, anus, external genitalia &extremities. G-Assess for any signs of eye infection. Immediate care of newborn

16 Immediate care of newborn
Apgar score The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two and summing up the five values.The resulting Apgar score ranges from zero to 10. Immediate care of newborn

17 Immediate care of newborn
APGAR Scoring System A ctivity/ Muscle Tone P ulse/ Heart Rate G rimace/ Reflex Irritability/ Responsiveness A ppearance/ Skin Color R espiration/ Breathing Immediate care of newborn

18 APGAR

19 Apgar score Sign Respiratory effort Muscle tone Reflex irritability
Pink Body pink , extremities blue Blue or pale Color Cry Grimace No response Reflex irritability Active motion , extremities well flexed . Some flexion of extremities none Muscle tone Good , strong cry Weak cry Absent Respiratory effort Above 100 Below 100 Heart rate(pulse 2 1 Sign Immediate care of newborn

20 Significance of Apgar score
Healthy newborn: 7-10 at both 1 and 5 minutes . Moderately depressed newborn : 3-6 ( Need resuscitation ) Severely depressed newborn : 1-2 ( Intensive resuscitation ) Immediate care of newborn

21 Immediate care of newborn
Cord Care Immediate care of newborn

22 Immediate care of newborn
Cord Care Use sterile plastic clamp or ligature, the first ligature is placed about cm from the abdomen & second ligature is placed about 1cm from the first ligature. Press between the two ligatures. Cut the cord by blunt sterile scissor after the second clamp. Examine umbilical cord structure (two arteries and one vein) Immediate care of newborn

23 Immediate care of newborn
Cord Care Continue Paint the end of the stump with alcohol. Clean the cord at the base of cord firstly, then the stump from down to up with one direction and cleaning the cord clamp. Let the cord exposed not covered by the diaper. Assess the signs of cord healing and signs of infection (erythema edema tenderness). Immediate care of newborn

24 Immediate care of newborn
Cord Care Immediate care of newborn

25 Immediate care of newborn
Eye care: Clean the eye lids é sterile warm sterile water and cotton. Wipe from inner to outward. Install one drop of solution of isophenicol. Wipe the excess of solution by clean cotton. Immediate care of newborn

26 Immediate care of newborn
Vitamin K Injection Administer 1mg. Vitamin K by I.M injection. Route: IM into the lateral anterior thigh (Vastus lateralis). Immediate care of newborn

27 Vitamin K Administration
Immediate care of newborn

28 Identification of the newborn
Identification of the newborn which place on wrist & ankle (mother name, hospital no, sex, weight of newborn). Before transferring to nursery, ID tag should be applied. Immediate care of newborn

29 Immediate care of newborn
Dressing/ Wrapping “Mummy” Wrap in warm blanket Cover head with stockinette cap Immediate care of newborn

30 Assessment of vital signs
temperature : the axillary method is the safest . Normal axillary temperature is 36 – °C Heart Rate ( HR ) : HR is counted for 60 seconds at the apex of the heart (Range from b/m immediately after birth ) . Respiratory Rate ( RR ) : RR varies from b/m when the infant is not crying . Blood Pressure ( BP ) : Not routinely assessed in healthy term infants . The range of normal blood pressure in term infants is mmhg for systolic pressure and 40 – 50 mmhg for diastolic pressure . Immediate care of newborn

31 ANTHROPOMETRIC MEASUREMENT
HEAD CIRCUMFERENCE : 33-35cm CHEST and ABDOMEN : 31-33cm LENGTH : 47-54cm WEIGHT : grams Immediate care of newborn

32 Immediate care of newborn
Assessment of Growth Immediate care of newborn

33 Immediate care of newborn

34 Neurologic System

35 Neonatal Primitive Reflexes
Immediate care of newborn

36 Immediate care of newborn
Reflexes Include the Moro , startle , palmer and planter grasps, sucking and rooting and swallowing reflexes, tonic neck reflex ,stepping , and babinski sign . Immediate care of newborn

37 Moro Reflex or startle reflex
quick change in the infant's position will cause the infant to throw the arms outward, open the hands, and throw back the head. Immediate care of newborn

38 Immediate care of newborn
Palmer grasp Palmar and plantar grasp - the infant's fingers or toes will curl around a finger placed in the area Immediate care of newborn

39 Immediate care of newborn
planter grasp Palmar and plantar grasp - the infant's fingers or toes will curl around a finger placed in the area Immediate care of newborn

40 Immediate care of newborn
Babniski reflex the infant's foot is stroked, the toes will extend upward. Immediate care of newborn

41 Immediate care of newborn
Rooting reflex This reflex begins when the corner of the baby's mouth is stroked or touched. Immediate care of newborn

42 Immediate care of newborn
Sucking reflex When the roof of the baby's mouth is touched, the baby will begin to suck. Immediate care of newborn

43 Asymmetric tonic neck reflex
Tonic neck reflex - When a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. Immediate care of newborn

44 Immediate care of newborn
Dance or step reflex This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his/her feet touching a solid surface. Immediate care of newborn

45 Immediate care of newborn


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