the normal newborn: needs and care. assessment data: condition of the infant apgar scores at 1 and 5...
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Assessment Data: Condition of the Infant
• Apgar scores at 1 and 5 minutes
• Resuscitative measures
• Physical examination
• Vital signs
• Voidings
• Passing of meconium
Assessment Data: Infant Complications
• Excessive mucus
• Delayed spontaneous respirations or responsiveness
• Abnormal number of cord vessels
• Obvious physical abnormalities
Assessment Data: Labor and Birth
• Duration and course
• Status of mother and fetus
• Analgesia or anesthesia
Assessment Data: Labor and Birth Complications
• Prolonged rupture of membranes
• Meconium-stained amniotic fluid
• Nuchal cord
• Precipitous birth
• Use of forceps or vacuum extraction assisted device
• Fetal distress
Assessment Data: Maternal Complications
• Preeclampsia
• Spotting
• Illness
• Recent infections
• Rubella status
• Serology results
Assessment Data: Maternal Complications (continued)
• Hepatitis B screen results
• Exposure to group B streptococci
• History of maternal substance
• Human immunodeficiency virus (HIV) test result
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
Physiologic Alterations
• Respiratory distress
• Pallor
• Hypothermia
• Alterations in feeding and elimination
Nursing Care: Assessment
• Airway clearance
• Vital signs
• Body temperature
• Neurologic status
• Ability to feed
• Evidence of complications
Nursing Care: Assessment (continued)
• 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
Admission Procedures
• Newborn bath
• Vitamin K
• Eye prophylaxis
• Observation for distress
• Initiate feeding
• Facilitate parental-infant attachment
Daily Assessments
• Vital signs
• Weight
• Overall color
• Intake and output
• Umbilical cord
• Circumcision
Daily Newborn Care
• Assist with feedings
• Thermoregulation
• Skin care
• Cord care
• Prevention of infection
• Security
Common Concerns
• How to pick up a newborn
• Holding and feeding the infant
• Changing the diaper
• Interpreting newborn cues
• Bathing the newborn
The clamp is applied. Pressure is maintained for 3 to 4 minutes, and then excess prepuce is cut away .
Circumcision using the Plastibel. The bell is fitted over the glans. A suture is tied around the bell’s rim, and the excess prepuce is cut away. The plastic rim remains in place for 3 to 4 days until healing
occurs. The bell may be allowed to fall off; it is removed if still in place after 8 days.
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
Parent Education (continued)
• Progression of infant behaviors
• Information about available educational materials and support
Family Education
• Newborn care videos
• Newborn care classes
• Individual instruction
• Observation of parent-infant interaction
• Role modeling
Discharge Education
• Safety measures
• Voiding and stool characteristics
• Circumcision care
• Cord care
• Waking and quieting the newborn
• Car safety
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
Signs of Illness (continued)
• 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