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Introduction

Introduction. http:// www.youtube.com/watch?v=yVLDi-FFjVo. Neonatal Nursing Care: Part 3 Nursing Care of Normal Newborn. Developed by D. Ann Currie, RN MSN 2012. Assessment Data: Condition of the Infant. Apgar scores at 1 and 5 minutes Resuscitative measures Physical examination

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Introduction

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Presentation Transcript

  1. Introduction • http://www.youtube.com/watch?v=yVLDi-FFjVo

  2. Neonatal Nursing Care:Part 3Nursing Care of Normal Newborn Developed by D. Ann Currie, RN MSN 2012

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

  4. Apgar Score

  5. 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

  16. 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

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

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

  19. Cord Care

  20. 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

  21. 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

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

  23. Wrapping Newborn

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

  25. 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

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

  27. The End of Part III

  28. QUESTIONS

  29. THANK YOU

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