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NORMAL NEWBORN

NORMAL NEWBORN. Mrs. G.SAVITHA M.Sc (N) Assistant Professor, OBG Department Annammal College of Nursing. NEWBORN ASSESSMENT. Respiration/perfusion. Assessments Rate – quite Vs active Labored – retractions,grunting Color,heart rate,heart murmurs. Nursing considerations Airway patent

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NORMAL NEWBORN

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  1. NORMAL NEWBORN Mrs. G.SAVITHA M.Sc (N) Assistant Professor, OBG Department Annammal College of Nursing

  2. NEWBORN ASSESSMENT

  3. Respiration/perfusion Assessments • Rate – quite Vs active • Labored – retractions,grunting • Color,heart rate,heart murmurs Nursing considerations • Airway patent • Limit activities • Monitor blood gases • Keep oxygen ready • Prepare a possible intubation.

  4. Nutrition • Wt &length • Head&chest circumference • Bottle feeding • Increased demand Sepsis Resp distress Stress • Monitor vol of fluid intake • Sp gravity of urine • Caloric value of intake • Monitor output in first 24 hrs.

  5. Heat regulation • Ability to maintain normal body temp • Acidosis may develop if poor body temp. • Provide regular monitoring. • Adjust environmental Temperature appropriately • Body covering • Use of incubator

  6. CNS • Reflexes • Fontanelles • Sever hypo or hyper activity • Activity/sleep/cry • Anatomical anomalies • Paralysis/paresis • Respond to life threatening problems immediately • Absence of swallow reflex • Bulging fontanelle • Cranial nerve injury.

  7. Parenting • Infant – behavior,individual differences • Mother/father • Report any deviations

  8. Circumcision • Observe for bleeding,infection • Record first voiding after procedure. • Apply dressing.

  9. Assessment • Airway – bulb suctioning – mouth first, then nose. • Apgar scoring at 1 and 5 min.

  10. Apgar score

  11. Scoring • 0-3 ;poor • 4-6 ;fair • 7-10;good

  12. Measurement at term • Wt 6-9 lb (2.7-4 kg) • Length – 19-21” (48-53cm) • Head circumference –13-14” (33-35cm) • Chest circumference –1”<head circumference,12-13”(30.5-33cms)

  13. Vital signs • Temp 97.7-99.7F (36.5-37.6 C) • Apical rate- 100bpm (sleep) 120-140bpm(awake) • Respiration – 30-60 breaths/min • B.P – 65/41 mmHg.

  14. Posture • Maintains fetal position for several days • Resistance to extension of extremities

  15. Skin • Erythematous • Vernix Caseosa • Lanugo • Milia • Pigmentation • Mongolian spots • Birth marks (telaniectatic nevi, Nevus vasculosus, Nevus Flammeus)

  16. milia

  17. A stork bite is a vascular lesion quite common in newborns consisting of one or more pale red patches of skin. Most often stork bites appear on the forehead, eyelids, tip of the nose, upper lip or back of the neck. They are usually gone within 18 months of birth.

  18. Port wine stains are always present at birth. In an infant, they are flat, pink, vascular lesions. Common locations include the face and neck, but they may be present anywhere on the body. Port wine stains may appear in association with other syndromes

  19. This child has a juvenile hemangioma (strawberry hemangioma) on the chin. These may begin as flat, red spots and later become larger and elevated. Juvenile hemangiomas often go away (involute) spontaneously

  20. HEAD • Fontanelles • Cephalhematoma • Caput Succedaneum • Face • Eyes • Mouth • Ears

  21. Caput succadeneum cephalhematoma

  22. cephalhematoma

  23. Caput succedanium

  24. Chest • Breast enlargement lasting upto 2 weeks may occur in both males and females.

  25. Abdomen • Cylindrical and slightly protuberant • Umbilical cord- fall off in 1-2 weeks • First stool is black and tarry within 12-24 hrs

  26. Genitourinary • Urine passed in 12-24hrs females - may have pseudomensturation males – testes can be felt in scrotum

  27. Trunk and extremities • Arms and leg symmetry • Foot in straight angle • Hips abducted to >60 degree

  28. Reflexes • Rooting and sucking • Pupillary • Palmer grasp • Planter grasp • Tonic Neck • Moro’s • Stepping reflex • Babinski’s

  29. Analysis • Airway clearance, ineffective • Thermoregulation, ineffective • Growth and development, altered

  30. Plan/Implementation • Establish effective airway and maintain • Observe for Apgar score at 1 and 5 min • Clamp umbilical cord • Maintain warmth and keep exposure to environment minimal • Place identification band • Administer prophylactic medication

  31. Record first stool and urine • Weight and measure baby • Observe and support mother and infant bond • Begin and monitor feeding schedule. • Umbilical cord care • Care of penis

  32. NORMAL REPRODUCTION

  33. Assessment • Knowledge of normal sexual function • Prevention of illness through self-care • Promotion of health through control of fertility • Cultural influences

  34. Analysis • Potential nursing diagnosis -self esteem disturbance related to infertility -Anxiety related to reproductive health • Diagnostic tests and procedures(e.g colposcopy, laparoscopy)

  35. Implementation • Provide privacy • Assess knowledge • Teach about BSE • Instruct patient in BSE - examine monthly - procedure • Provide information about mammography

  36. Implementation cont. • Provide teaching about testicular self-examination • Assess knowledge on birth control • Assess knowledge of menopause - symptoms ,ERT,kegel exercise,Supplemental calcium,regular exercise &good nutrition.

  37. METHODS OF CONTRACEPTION • ORAL CONTRACEPTIVES- inhibits the release of FSH, resulting in anovulatory menstrual cycles • Contraindicated in HTN,Thromboembolic disease,H/O circulatory disease or DM.

  38. IUD • Presumed either to cause degeneration of the fertilized egg or render the uterine wall impervious to implantation • Inserted by physician on the 5th day of the menstrual period . • S/E – cramping or excessive menstrual flow,infection

  39. Barrier Methods • Condoms • Diaphragm Action is by preventing the sperm from entering the cervix Diaphragms- must be fitted according to the size.inserted 6hrs prior to intercourse,must be smeared with spermicide cream for best results.

  40. Vaginal spermicides • Interferes with the viability of sperm and prevents their entry into the cervix. • Report symptoms of reaction.

  41. RHYTHM METHOD • Periodic abstinence from intercourse during fertile period;based on the regularity of ovulation. • fertile period may be determined by drop in basal body temp before ovulation and rise after it. • Cervical mucus – clear, thin , stretchable, abundant, slippery.

  42. Coitus interruptus • Man withdraws penis before ejaculation to avoid deposition of sperm into vagina.

  43. Steroid implant (Norplant) • Requires surgical insertions • Effective for 5 yrs • S/E – irregular bleeding, N/V, skin changed

  44. Sterilization • Vasectomy • Tubectomy

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