Neonatal Nursing Care: Part 3 Nursing Care of Normal Newborn

1. Neonatal Nursing Care:Part 3Nursing 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 Newbornimmediately 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