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Nursing Care of the Newborn

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Chapter 25 Nursing Care of the Newborn Birth Through the First 2 Hours Assessment and nursing diagnoses Initial assessment and Apgar score Initial physical assessment ... – PowerPoint PPT presentation

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Title: Nursing Care of the Newborn


1
(No Transcript)
2
Chapter 25
  • Nursing Care of the Newborn

3
Birth Through the First 2 Hours
  • Assessment and nursing diagnoses
  • Initial assessment and Apgar score
  • Initial physical assessment
  • External
  • Chest
  • Abdomen
  • Neurologic
  • Other observations

4
Birth Through the First 2 Hourscontd
  • Implementation
  • Airway maintenance
  • Body temperature maintenance
  • Eye prophylaxis
  • Vitamin K prophylaxis
  • Promoting parent-infant bonding

5
From 2 Hours After Birth Until Discharge
  • Assessment
  • Gestational age assessment
  • Newborn classification by gestational age and
    birth weight
  • Large for gestational age above 90th percentile
  • Appropriate for gestational age
  • Small for gestational age below 10th percentile

6
From 2 Hours After Birth Until Dischargecontd
  • Late preterm infant
  • Often the size and weight of term infant
  • 34 to 36 6/7 weeks of gestation
  • Have risk factors because of physiologic
    immaturity
  • Respiratory distress, temperature instability,
    feeding difficulties, hyperbilirubinemia

7
From 2 Hours After Birth Until Dischargecontd
  • Umbilical cord care
  • Hospital protocol determines technique for cord
    care
  • Cochrane review of 21 studies no difference in
    dry cord compared with those treated with
    antiseptics
  • Natural healing, soap and water, alcohol, or
    povidone-iodine
  • Clamp is removed once the stump is dry

8
From 2 Hours After Birth Until Dischargecontd
  • Common newborn problems
  • Physical injuries
  • Soft-tissue injuries
  • Skeletal injuries
  • Lacerations

9
From 2 Hours After Birth Until Dischargecontd
  • Common newborn problems
  • Physiologic problems
  • Conjugation of bilirubin
  • Physiologic jaundice
  • Jaundice associated with breastfeeding
  • Hypoglycemia
  • Hypocalcemia (blood calcium levels less than 7
    mg/dl)

10
From 2 Hours After Birth Until Dischargecontd
  • Laboratory and diagnostic tests
  • Routine testing
  • Blood glucose
  • Bilirubin levels
  • Newborn genetic screening
  • Newborn hearing screening

11
From 2 Hours After Birth Until Dischargecontd
  • Collection of specimens
  • Heel stick
  • Venipuncture
  • Obtaining a urine specimen
  • Restraining the infant

12
From 2 Hours After Birth Until Dischargecontd
  • Implementation
  • Protective environment
  • Environmental factors
  • Measures to control infection
  • Safety factors

13
From 2 Hours After Birth Until Dischargecontd
  • Supporting parents in care of their infant
  • Social interaction
  • Infant feeding
  • May be put to breast shortly after birth
  • At least within first 4 hours of life
  • On-demand feeding
  • Encourage feeding every 2 to 3 hours

14
From 2 Hours After Birth Until Dischargecontd
  • Therapeutic and surgical procedures
  • Intramuscular injection
  • Therapy for hyperbilirubinemia
  • Phototherapy
  • Exchange transfusion
  • Parent education

15
From 2 Hours After Birth Until Dischargecontd
  • Therapeutic and surgical procedures
  • Circumcision
  • Procedure
  • Procedural pain management
  • Care of newly circumcised infant

16
Discharge Planning and Teaching
  • Temperature
  • Respirations
  • Feeding schedules
  • Elimination
  • Positioning and holding
  • Rashes
  • Clothing

17
Discharge Planning and Teachingcontd
  • Use of car seats
  • Nonnutritive sucking
  • Bathing
  • Cord care
  • Skin care
  • Infant follow-up
  • Immunizations

18
Key Points
  • Assessment of newborn requires data from
    prenatal, intrapartal, and postnatal periods
  • Knowledge of biologic and behavioral
    characteristics is essential for guiding
    assessment and interpreting data

19
Key Pointscontd
  • Providing a protective environment is key
    responsibility of nurse
  • Careful identification procedures
  • Protection from abduction
  • Support of physiologic functions
  • Measures to prevent infection
  • Maintaining adequate ventilation includes
    ensuring open airway and body temperature within
    normal range

20
Key Pointscontd
  • Parent education is a major responsibility of
    nurse and includes involvement of parents
  • Newborn has social and physical needs
  • Circumcision is elective surgical procedure
  • Parents appreciate anticipatory guidance in care
    of newborn
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