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NURSING CARE OF THE NEWBORN

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					NURSING CARE OF THE
     NEWBORN
        NURSING CARE OF THE
             NEWBORN
   Immediate care after birth: Phase 1 – birth to 1
    hour old
     use of bulb syringe-compress the bulb syringe
    before inserting in the mouth then the nose.
   Injection of Aquamephyton IM
    Measurements-head, chest, wt, length
    Identification bands – must be the same
    number for infant & mother, significant other
     IMMEDIATE CARE:
 INITIAL CARE DIRECTED TOWARD:
 1. Maintaining cardiorespiratory
  function
 2. Maintaining thermoregulation
 3. Ensuring identification and security
 4. Assessing vital signs
 5. Assessing gestational age to ID
  maturity and birth injuries or anomalies.
 Prevention of hemorrhage/eye care
       Phase 2 – 1 to 4 hours
 Infection prevention
 Best method is proper handwashing
 Signs of infection: Poor feeding, lethargy,
  periods of apnea
 NB Screening: PKU, hearing tests
 Hep B done soon after birth, 1 mo., 6
  mos.
        GENERAL NURSING
         INTERVENTIONS:
 SAFETY—
 Never leave infant alone on bed/ table
 Never prop bottle
 Always leave side rails up in crib
 Use a car seat
 Place infant on back or side to sleep
 Do not leave pillows, etc in crib
        GENERAL NURSING
         INTERVENTIONS
 BONDING—
 Teach NB interactions:
 Hearing
 Touch
 Gaze
 Eye contact
 Facial expressions
      ROUTINE ASSESSMENT
           AND CARE
 Encourage parents to participate in care
 Assess infant q 4 – 8 hrs:
 Vital signs, appearance of skin, color, fluid
  intake, voiding and stooling, infant’s
  activity, and parent-infant attachment.
 Keep warm but do not overdress
    Phase 3 – Parent Education
 The interactive bath - Skill 11-4
 Plain water 1st 1 – 2 weeks
 Sponge bath until cord falls off & healed;
  then may have tub bath
 Avoid bath right after feeding or on empty
  stomach
 Teach bathing to parent in hospital
               Cord Care
 Clean with alcohol 2 or 3 times daily; with
  each diaper change
 Cord falls off in 7 –10 days
 Fold diaper down to keep dry of urine
 Teach parent to report if cord:
 Moist, reddened, foul odor, bleeding, or
  discharge
    Positioning/Holding Infant
 Support head
 Place on firm mattress, never in prone
  position when left alone= > SIDS
 3 ways to hold, Fig. 11-9
 Cradle—used for feeding
 Upright hold—used for burping
 Football hold—shampooing, breastfeed
   Nasal & oral suctioning – see fig 11-10
   Temperature Assessment – axillary
   Stools & voiding – 6-8 voids per day; fast focus
    11-4
   Collection of urine from infant see procedure 11-
    4
   Diapering – use clear water or premoistened
    wipes without chemicals/soap
 Clothing – dress for weather
 Circumcision – Gomco method or plastibell
  see fig 11-11
 potential complications – infection &
  hemorrhage; box 11-11
Caring for the Uncircumcised Penis
 Avoid forceful retraction of the foreskin
 Use only plain water to wash during infancy; no
  need to retract the foreskin
 Toddler age: gentle retraction may be done
  during bath. Always replace the foreskin to it’s
  normal position
 School age: child can be taught to gently
  retract the foreskin weekly during bathing
 Cultural beliefs influence the type of care
  given to newborns. If the beliefs are
  harmful to the newborn the nurse should
  try to educate the parents about concerns
  related to the practice
 Discharge & follow up care –
  recommended f/u 7-10 days for infant
 Nursing care plan 11-1