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Comprehensive Guide on Newborn Care: Assessment, Characteristics, and Daily Care

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  1. OB Unit 4 Care of the Newborn Rev. 2015

  2. Neonate • Term used for a child in the first 4 weeks of life

  3. Initial Care & Assessment of the Newborn Immediately After Birth

  4. Assess: Respirations Heart Rate Temp APGAR Warmth

  5. Identification • Done in delivery room • 2 ID bands (ankle & wrist) on newborn • 1 ID band on mother • Footprinting & fingerprinting

  6. Protection of Disease • Eye prophylaxis w/ Erythromycin • Vitamin K injection

  7. Spine & Extremities • Straight without curves • Dimples, tufts of hair and masses • Syndactyly/Polydactyly • Single crease • Equal leg length

  8. Simian Crease

  9. Bonding • Promotion of attachment between neonate & family • Should begin immediately

  10. Characteristics of the Normal Newborn

  11. A. Weight & Length • Weight ranges from 5.5-10 lbs. • Loses 5-10% during the 1st few days after birth • Length ranges from 18-22 inches

  12. B. Head & Body • Lg. Head (13-14”) • Short neck • Chest smaller than head (12-13”) • Large protruding abdomen

  13. Head irregularly shaped “molded” • Caput succedaneum • Cephalhematoma • Both resolve on their own • Reassure parents

  14. C. Fontanels • Soft spots • Anteriorabove forehead, diamond shaped,closes bet. 18 mos. • Posterior@ crown of head, Triangular, closes at 2nd mo.

  15. D. Eyes • Blue or gray @ birth • Appear cross-eyed, unable to focus • Eyelids red/edematous • No tears

  16. E. Ears • Positioned with outer canthus of the eye • High pitched sounds • Mothers voice

  17. F. Skin • Rashes are common • By 3rd day, more natural tone • Acrocyanosis • Harlequin sign

  18. G. Jaundice • Pathological  occurs w/i 24 hrs  Abnormal • Physiologic  May occur in 2-3 days  Normal • Immature liver • Elevated bilirubin

  19. Treatment • Freq. Feeding q 2-3 hrs • Sunlight • Phototherapy • Monitor temp • Allow for bonding

  20. Influences of Maternal Hormones on Neonate • gynecomastia • Edematous labia in females • Pseudomenstruation • Large scrotum

  21. Common Skin Observations IN THE NEWBORN…..

  22. Milia • Erythema toxicum • Stork bites • Mongolian spots • Port wine stain

  23. Stork bites

  24. Milia

  25. Epsteins pearls • Various birthmarks • Petechiae • Lanugo • Vernix caseosa

  26. Harlequin sign

  27. Mongolian spots

  28. Lanugo

  29. Normal Activities and Reflexes Of the Neonate….

  30. Rest & Sleep • Sleeps ~ 17 hrs/day • Awakens easily • Cries when hungry or uncomfortable • Arms & legs move freely & symmetrically

  31. Reflexes • Rooting Reflex • Sucking Reflex • Dance or Step • Grasp • Moro or Startle

  32. Tonic neck reflex • Babinski reflex • Newborn movements are jerky due to immature nervous system

  33. Senses • Sight • Hearing • Touch • Smell & Taste

  34. Protection of the Newborn

  35. Preventing Infant Abduction • Essential role of nurse • Proper ID w/ badge • Visitors required to check in • Sensors, alarms, exits lock automatically

  36. Daily Newborn Care Nursing Assessment

  37. Every day, assess : Vital Signs Weight Eyes, Nose & Ears Elimination (Urine & Stools) Umbilical Cord

  38. Urination • Usually 4-8 hrs fol. delivery • Be sure baby voids & document • Should have 6-8 wet diapers/day

  39. STOOLS Meconium1st stool Transitional stool Milk stool

  40. Meconium stools

  41. MILK STOOLS

  42. Hypothermia • Caps • Clothing • Blankets • Warmer/isolette • Incubator

  43. Cleansing the Newborn • 1st bath after Temp = 98.6 • Assess skin color; assess for blemishes, rash,abnormal jerking, twitching, bleeding, or congenital abnormalities during bathing

  44. Use mild soap sparingly • Special attention to skin folds • Observe for bleeding at circumcision site first 12 hrs.

  45. Circumcision • Part or all of foreskin is removed • Ritual for all Jewish babies • Must be kept clean • Assess for bleeding, swelling, & voiding

  46. Normal Anatomy

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