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Health Promotion and the NEWBORN Valerie Arsenault Colleen Cormier Haven Brown Skin of newborn is pink and look healthy. Newborn will have fine textured hair. 80% of newborn may have physiological jaundice (yellow skin) Growth and Development During Infancy One Month -Follows and fixes on bright objects with eyes when it moves within field of vision. -Turns head when prone, but unable to support. -Holds hands in fists. -Grows 1 inch monthly for 6 months. -Cries when hungry or uncomfortable. -Makes small, throaty sounds. Two Months -Has closed posterior fontanel. -Listens actively to sounds. -Lifts head almost 45 degrees off table when prone. -Follows moving objects with eyes. -Recognizes family faces. Piaget’s Five Stages of Infant Development Stage 1: Birth to 1 month -Modification of reflexes Infant practices and perfects reflexes present at birth. Sucking reflex becomes more refined and voluntary. Eriksons stage of Development Trust vs Mistrust Birth to one year Develop a healthy personality Apgar Score Permits rapid assessment of the newborn’s transition to extrauterine existence based on five signs that indicate the physiologic state of the newborn: (1) Heart Rate (2) Respiratory Rate A- Activity (3) Muscle Tone P- Pulse (4) Reflex irritability G- Grimace (5) Color A- Appearance R- Respiration Feeding 36-48 Hr to Discharge: A breast feeding and formula feeding mom should be feeding successfully 8-10 times/day. Advantages of Breast Feeding The correct balance of all essential nutrients for infants. Full of immunological agents to protect against disease. Easier to digest than formula. Contains anti-inflammatory properties. Promotes growth of Lactobacillus bifidus. Skin to Skin Contact It is helpful to place the infant on the mothers abdomen soon after birth. It helps with spontaneous breastfeeding and allows for bonding. Kangaroo Care The infant is placed on the mothers bare chest and is only wearing a diaper. It is used for both full term and preterm infants. Benefits…… Normal Sleep Patterns 2-3 Months Low: 10 hours of sleep in 24-Hour period Average: 16 ½ hours of sleep in 24-Hour period High: 23 hours of sleep in 24-Hour period (2 to 4 naps) Bathing a Newborn Benefits of bathing - complete cleaning of infant. - observer infants condition. - promote comfort and bonding time Bathing a newborn... Temperatures Gather supplies needed Bathing Cleansing hands and feet Cleansing genitals Umbilical Cord Care The umbilical cord stump is an excellent medium for bacterial growth and can easily become infected. Common methods of care include use of an antimicrobial agent such as bacitracin or triple dye. Also, use of soap and water or sterile water alone are used. Current recommendations for cord care include cleaning the cord with sterile water or a neutral pH cleanser. The stump and base should be assessed for edema, erythema, and drainage with each diaper change. The stump deteriorates and average seperation time is 10 to 14 days. Bowel Movements Meconium Transitional Stools Milk Stool Reflexes Good reflexes indicate a healthy nervous system. Reflexes are developed for survival Newborn exhibits many reflexes. ROOTING SUCKING Palmer Reflex Babinski Reflex Stepping Reflex MORO Reflex Tonic Neck Normal development of hearing After the amniotic fluid drains from the middle ear several days after birth, the infant’s hearing becomes acute. Hearing is one of the better-developed senses in the infant; the fetus can hear in utero and responds to loud sounds. The ability to listen and discriminate among sounds is an important task during infancy. The closer the infant is to the sound, the easier the sound can be discriminated. Touch The newborn is responsive to touch on all parts of the body. The face (especially the mouth), hands, and soles of the feet seem to be most sensitive. Taste The newborn can distinguish between tastes, and various types of solution elicit different facial expressions. Smell Newborns react to strong odors such as alcohol or vinegar by turning their heads away. Breastfed infants are able to smell breast milk and can differentiate their mother from other lactating women by the smell. Immunizations If the infant is born to an infected mother or to a mother who is a chronic carrier, hepatitis vaccine and hepatitis B immune globulin (HBIG) should be given within 12 hours of birth. For infants born to a hepatitis B-negative woman, the first dose of the vaccine may be given at birth or at 1 or 2 months of age (depending on province of residence). Motor Vehicle Safety A variety of car seats is available; for infants up to 20 lbs, the recommended type is rear-facing, molded plastic shell seat, which includes a shoulder restraint and employs the adult seat belt. -Never leave a child unattended in a parked car. -Never hold a child on laps in the front seat. -Always use infant car seat that is properly installed. -Keep car doors locked. -Do not be distracted by an infant while driving. Sudden Infant Death Syndrome SIDS is the sudden, unexplained death of an infant younger than 1 year of age. Sleeping positions for the infant. -Infant on its back. -Infant on its belly when you are around. -Avoid soft pillows, mattresses, etc. Circumcision Circumcision is a matter of personal choice. Parents usually decide to have their newborn circumcised based on one of more of the following factors: Hygiene Religious conviction Tradition Culture Social norms Circumcision continued… Circumcision involves removing the prepuce (foreskin) of the glans. The procedure is usually not done immediately after birth because of danger of cold stress and decreased clotting factors. The circumcision of the Jewish male is performed on the eighth day after birth and is done at home in a ceremony. It is recommended that if circumcision is performed, analgesia should be used. Circumcision….. Family Assessment Process Do the parents and infant have eye to eye contact frequently? How much body contact is present? Does vocalization by the parents evoke a smile from the infant? How much does the infant cry? What is the mother’s reaction? What is the father’s reaction? How does the mother describe the infant’s feeding and sleeping patterns? Does the mother describe the infant’s tasks positively or negatively? Nursing Interventions Improve family interactions and relationships. Improve family’s ability to cope with stress from the new addition to their family. Praise positive parenting behaviors. Provide adequate nutrition to malnourished infant. Allow parents to vent their feelings about the infant. Refer to appropriate agency for financial, social, or other family needs. PHC Principles Accessibility Intersectoral Collaboration: “It takes a whole community to raise a child” Determinants of Health EDUCATION FINANCIAL SUPPORT SUPPORT NETWORKS SUMMARY Appearance of Newborn Sleeping, eating, and elimination patterns Reflexes SIDS Car seats Bathing Process References Edelman, C. L. and Mandle C. L. (2002). Health promotion throughout the lifespan. St. Louis: Mosby Wong, D. L., Perry, S. E., Hockenbery, M.J., Lowdermilk, D. L., & Wilson D. (2006). Maternal Child Nursing Care (3rd ed.). St. Louis: Mosby.
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