Newborn Care Immediate Assessment
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Questions and Answers

What is the primary concern for a preterm infant's body temperature?

  • Normal body temperature
  • Hypothermia (correct)
  • Fever
  • Hyperthermia

    • What is a characteristic of a post-term infant's skin?

  • Transparent and lanugo present
  • Thick and vernix caseosa present
  • Soft and smooth
  • Dry, wrinkled, and parched (correct)

    • What is the primary purpose of surfactant administration in preterm infants?

  • To improve nutrition
  • To stimulate breathing
  • To regulate body temperature
  • To mature the respiratory system (correct)

    • What is a common issue affecting preterm infants' breathing?

    <p>Irregular and weak breathing</p> Signup and view all the answers

    What is a vital aspect of nursing care for preterm infants?

    <p>All of the above</p> Signup and view all the answers

    What is a hallmark of preterm infants' physical development?

    <p>All of the above</p> Signup and view all the answers

    Why is it essential to teach caregivers about responding to an infant's cries?

    <p>To establish trust</p> Signup and view all the answers

    What is a long-term complication of long-term ventilation in preterm infants?

    <p>Bronchopulmonary dysplasia</p> Signup and view all the answers

    What is a benefit of using a radiant warmer in neonatal care?

    <p>To maintain a stable body temperature</p> Signup and view all the answers

    Why is it essential to monitor oxygen saturation in preterm infants?

    <p>To prevent retinopathy of prematurity</p> Signup and view all the answers

    What is the primary reason for suctioning the mouth before the nose in a newborn?

    <p>To prevent aspiration of amniotic fluid</p> Signup and view all the answers

    What is the normal respiratory rate for a newborn?

    <p>30-60 breaths per minute</p> Signup and view all the answers

    What is the most common method of measuring a newborn's heart rate?

    <p>Apically using a stethoscope</p> Signup and view all the answers

    What is the primary purpose of the APGAR score?

    <p>To monitor the newborn's oxygenation and adjustment to the outside world</p> Signup and view all the answers

    What is the recommended method for taking a newborn's temperature?

    <p>Axillary using a digital thermometer</p> Signup and view all the answers

    What is the primary purpose of the heel stick test?

    <p>To screen for inborn errors of metabolism</p> Signup and view all the answers

    What is the recommended frequency for feeding a newborn?

    <p>Every 2-3 hours, or on demand</p> Signup and view all the answers

    What is the primary benefit of breastfeeding?

    <p>It provides antibodies to the newborn</p> Signup and view all the answers

    What is the recommended method for burping a newborn?

    <p>By holding the baby upright and patting their back</p> Signup and view all the answers

    What is a danger sign in a newborn?

    <p>Lethargy</p> Signup and view all the answers

    What is a common finding in a newborn's breathing pattern immediately after birth?

    <p>Irregular, erratic respirations with periods of apnea</p> Signup and view all the answers

    What is the recommended method for measuring a newborn's heart rate?

    <p>Apically, using a stethoscope</p> Signup and view all the answers

    What is a crucial aspect of neonatal care in terms of body temperature?

    <p>Gradually rewarming the baby to prevent seizures</p> Signup and view all the answers

    What is the primary purpose of the APGAR score?

    <p>To evaluate the newborn's overall condition at birth</p> Signup and view all the answers

    What is a characteristic of a preterm infant's physical appearance?

    <p>Transparent skin</p> Signup and view all the answers

    What is a common issue affecting newborns' transition to extrauterine life?

    <p>Respiratory distress</p> Signup and view all the answers

    What is the recommended frequency for feeding a newborn?

    <p>Every 1-2 hours, around the clock</p> Signup and view all the answers

    Why is it essential to monitor oxygen saturation in preterm infants?

    <p>To prevent retinopathy</p> Signup and view all the answers

    What is a benefit of breastfeeding?

    <p>Enhanced immune system development</p> Signup and view all the answers

    What is a potential long-term complication of long-term ventilation in preterm infants?

    <p>Bronchopulmonary dysplasia</p> Signup and view all the answers

    What is the primary benefit of using a radiant warmer in neonatal care?

    <p>To maintain a stable body temperature</p> Signup and view all the answers

    What is the primary purpose of the heel stick test?

    <p>To screen for congenital metabolic disorders</p> Signup and view all the answers

    What is a danger sign in a newborn?

    <p>Lethargy</p> Signup and view all the answers

    What is a nursing consideration for preterm infants?

    <p>Establishing routines for feeding and sleeping</p> Signup and view all the answers

    What is a characteristic of post-term infants' physical development?

    <p>Long fingernails and dry, wrinkled skin</p> Signup and view all the answers

    What is a recommended method for burping a newborn?

    <p>On the shoulder, with gentle patting</p> Signup and view all the answers

    Why is it essential to address long-term issues with caregivers of preterm infants?

    <p>To address potential developmental delays</p> Signup and view all the answers

    What is a benefit of providing skin-to-skin contact to preterm infants?

    <p>Promotes bonding and trust</p> Signup and view all the answers

    What is a characteristic of preterm infants' respiratory system development?

    <p>Surfactant production starts at 32 weeks</p> Signup and view all the answers

    What is a potential issue affecting post-term infants' nutrition?

    <p>Placental insufficiency leading to small size for gestational age</p> Signup and view all the answers

    What is the primary reason for suctioning the mouth before the nose in a newborn?

    <p>To prevent aspiration of fluids in the mouth.</p> Signup and view all the answers

    Why is it essential to monitor a newborn's oxygen saturation?

    <p>To detect respiratory distress.</p> Signup and view all the answers

    What is the recommended method for taking a newborn's temperature?

    <p>Axillary, in the armpit.</p> Signup and view all the answers

    What is the primary purpose of the APGAR score?

    <p>To determine the need for resuscitation.</p> Signup and view all the answers

    What is a characteristic of a newborn's breathing pattern immediately after birth?

    <p>Irregular and erratic.</p> Signup and view all the answers

    What is the primary benefit of breastfeeding?

    <p>It provides perfect nutrition for the newborn.</p> Signup and view all the answers

    What is a danger sign in a newborn?

    <p>Lethargy.</p> Signup and view all the answers

    What is the recommended frequency for feeding a newborn?

    <p>Every 2-3 hours.</p> Signup and view all the answers

    What is a characteristic of preterm infants' physical development?

    <p>They have less muscle mass.</p> Signup and view all the answers

    What is a benefit of using a radiant warmer in neonatal care?

    <p>It helps with temperature regulation.</p> Signup and view all the answers

    What is the primary reason for removing the ID band of a newborn?

    <p>To prevent misidentification of the infant</p> Signup and view all the answers

    What is the primary benefit of providing a home visit for a newborn?

    <p>To provide additional support to the caregivers</p> Signup and view all the answers

    What is the primary characteristic of a preterm infant's central nervous system development?

    <p>Immature and partially developed</p> Signup and view all the answers

    What is the primary purpose of teaching caregivers about responding to an infant's cries?

    <p>To promote bonding and attachment</p> Signup and view all the answers

    What is the primary benefit of using a non-nutritive suck, such as a pacifier, in a preterm infant?

    <p>To provide comfort and relaxation</p> Signup and view all the answers

    What is the primary characteristic of a post-term infant's physical appearance?

    <p>Thin and wrinkled with long hair and nails</p> Signup and view all the answers

    What is the primary purpose of using humidified oxygen in neonatal care?

    <p>To prevent drying of the airways and mucous</p> Signup and view all the answers

    What is the primary benefit of providing skin-to-skin contact to preterm infants?

    <p>To promote bonding and attachment</p> Signup and view all the answers

    What is the primary purpose of teaching caregivers about establishing routines for eating, play, and rest?

    <p>To establish a sense of trust and security</p> Signup and view all the answers

    What is the primary benefit of using a radiant warmer in neonatal care?

    <p>To maintain a stable body temperature</p> Signup and view all the answers

    What is a common characteristic of a preterm infant's nervous system?

    <p>Immature central nervous system</p> Signup and view all the answers

    What is the primary reason for administering surfactant to a preterm infant?

    <p>To mature the respiratory system</p> Signup and view all the answers

    What is a characteristic of a post-term infant's skin?

    <p>Dry and parched</p> Signup and view all the answers

    What is a benefit of using a radiant warmer in neonatal care?

    <p>Maintains a stable body temperature</p> Signup and view all the answers

    What is a crucial aspect of nursing care for preterm infants?

    <p>Establishing routines for eating, play, and rest</p> Signup and view all the answers

    A newborn baby is experiencing respiratory distress, which of the following would be a sign of distress?

    <p>All of the above</p> Signup and view all the answers

    A newborn baby is experiencing a temperature of under 80, what should the nurse do?

    <p>Administer oxygen and stimulate the baby</p> Signup and view all the answers

    What is the primary purpose of the APGAR score?

    <p>To assess a newborn's oxygenation and adjustment to the outside world</p> Signup and view all the answers

    A newborn baby is not urinating within the first 24 hours, what should the nurse do?

    <p>Call the doctor immediately</p> Signup and view all the answers

    What is the recommended method for taking a newborn's temperature?

    <p>Axillary</p> Signup and view all the answers

    Study Notes

    Newborn Care

    • Immediately after birth:
      • Suction mouth to clear airway, then nose
      • Use bulb syringe, not a machine
    • Respirations:
      • 30-60 breaths per minute
      • Measure for 1 minute
      • Obligate nose breathers, may have wheezing or crackles
      • Grunting and periods of apnea expected at first
    • Circulation:
      • Heart rate: 120-160 beats per minute
      • Measure for 1 minute apically, use bell
      • Heart rate may be irregular
      • Report other sounds to DR, may be murmurs or holes
    • Body Temperature:
      • Take axillary temperature
      • Take rectal temperature to determine anal patency
    • APGAR:
      • Measure 1 minute and 5 minutes after birth
      • Assess oxygenation and adjustment to outside world
    • Screening Tests:
      • Over 40 tests done on newborns, including:
        • Amino acid metabolism disorders
        • Biotinidase deficiency
        • Congenital adrenal hyperplasia
        • Congenital hypothyroidism
        • Cystic fibrosis
        • Fatty acid metabolism disorders
        • Galactosemia
        • Glucose-6-phosphate dehydrogenase deficiency (G6PD)
        • Human immunodeficiency disease (HIV)
        • Organic acid metabolism disorders
        • Phenylketonuria (PKU)
        • Sickle cell disease and other hemoglobin disorders/traits
        • Toxoplasmosis

    Neonatal Resuscitation

    • APGAR:
      • Assess oxygenation and adjustment to outside world
      • Will probably not see chest rise and fall due to small lungs
    • Distress signs:
      • Nasal flaring
      • Grunting
      • Wheezing/crackles
      • Suprasternal retractions
      • Xiphoid retractions
    • Response to cries:
      • Important to respond to cries
      • Need to room in to understand cries
      • Feed on demand

    Newborn Assessment

    • Crying:
      • Only way they know how to communicate
      • Important to respond to cries
    • Elimination:
      • Urinate within 24 hours
      • BM within 12 hours
    • Anatomical issues:
      • Dark green tarry stool = meconium
    • Body Temperature:
      • Maintain body temperature and prevent cold stress
      • Keep baby warm
      • Rewarm slowly to prevent seizures
    • Cleansing:
      • Submersion bath at birth, no more until umbilical cord falls off
    • Sleeping Position:
      • Back or side lying
      • Never on stomach to reduce SIDS

    Handling Newborns

    • Support neck and butt
    • Bring baby close as soon as possible
    • Fontanels:
      • Open but not fragile
      • Encourage open palm when gripping baby's head
    • Dressing and wrapping newborn:
      • Swaddle
      • Dress one layer than you
      • Make neck bigger then pull over
    • Cord care:
      • 2 cm above belly
      • Remove cord when baby goes home
      • No alcohol

    Nutrition

    • Neonate stomach can hold 3 oz full term
    • Check output for adequate nutrition
    • Breastfeeding:
      • Breast is best
      • Sleep
      • Contains antibodies
      • Perfect nutrition
    • Formula feeding:
      • Inverted nipples
      • Nipple shield to pull nipple out
      • Chronic disease
      • HIV
      • Baby has abnormalities
      • Cleft lip/palate/poor suck
    • Supplements:
      • Multivitamins (Polyvisol, Polyviflor)
      • Iron (supplements or in formula)

    Discharge and Follow-up

    • Assessed by DR
    • PT teaching:
      • Bathing
      • Diapering
      • Feeding
      • Comfort/swaddling
      • Pacifier for non-nutritive suck
    • Monitor for jaundice:
      • May develop over a few days
      • Bilirubin by heel stick
      • Don't want it to hit 20 (problem)
    • Danger signs:
      • Lethargy
      • White, red, black, mucus stool
      • Respiratory distress
    • Home visit if necessary
    • Infant car seat:
      • Rear facing at an angle
      • Back seat

    Preterm and Postterm Care

    • Preterm:
      • Before the end of 37th week
      • S&S:
        • Thin
        • Minimal subcutaneous fat
        • Lanugo
        • Transparent skin
        • Breast tissue barely palpable
      • Male = undescended testes
      • Female = labia majora very thin
      • Irregular/weak breathing
      • Surfactant doesn't start being created until 24 weeks
    • Postterm:
      • After 42 weeks
      • S&S:
        • Resp & nutrition problems due to placental insufficiency
        • May be small for gestational age (SGA)
        • Lose weight in utero
        • Long fingernails
        • Long hair
        • Dry, parched skin
        • Meconium swallowed/aspirated
    • Nursing care for preterm and postterm:
      • Teaching plans:
        • Address long-term issues
        • May go home with trachs, NG, G tubes, etc.
      • NICU:
        • Surfactant to mature respiratory system
        • Radiant warmer
        • Monitor O2 sat & ABG
        • Daily wts
        • Fluids & electrolytes
        • Protect from infection
        • Increase calories
        • Using formula
        • Double caloric intake without doubling volume
        • Tire easily
        • Provide interaction without increasing energy consumption
        • Holding, caressing, speaking to baby, touch
        • Non-nutritive suck (pacifier)

    Developmental Milestones

    • Changing families and role of caregivers
    • Developmental stages:
      • Trust vs. mistrust
      • Newborn - 1 year
      • Important to respond to cries
      • Family caregivers
      • Accomplishment = develop trust
    • Nursing considerations:
      • Establish routines for eating, play, rest, etc.
      • Play during the day to sleep better at night
      • Satisfying basic needs:
        • Holding, cuddling, feeding, stroking
      • Bonding
        • Feelings of love, nurturing, skin to skin
      • Support family structure
      • Handling of newborn

    Newborn Care

    • Immediately after birth:
      • Suction mouth to clear airway, then nose
      • Use bulb syringe, not a machine
    • Respirations:
      • 30-60 breaths per minute
      • Measure for 1 minute
      • Obligate nose breathers, may have wheezing or crackles
      • Grunting and periods of apnea expected at first
    • Circulation:
      • Heart rate: 120-160 beats per minute
      • Measure for 1 minute apically, use bell
      • Heart rate may be irregular
      • Report other sounds to DR, may be murmurs or holes
    • Body Temperature:
      • Take axillary temperature
      • Take rectal temperature to determine anal patency
    • APGAR:
      • Measure 1 minute and 5 minutes after birth
      • Assess oxygenation and adjustment to outside world
    • Screening Tests:
      • Over 40 tests done on newborns, including:
        • Amino acid metabolism disorders
        • Biotinidase deficiency
        • Congenital adrenal hyperplasia
        • Congenital hypothyroidism
        • Cystic fibrosis
        • Fatty acid metabolism disorders
        • Galactosemia
        • Glucose-6-phosphate dehydrogenase deficiency (G6PD)
        • Human immunodeficiency disease (HIV)
        • Organic acid metabolism disorders
        • Phenylketonuria (PKU)
        • Sickle cell disease and other hemoglobin disorders/traits
        • Toxoplasmosis

    Neonatal Resuscitation

    • APGAR:
      • Assess oxygenation and adjustment to outside world
      • Will probably not see chest rise and fall due to small lungs
    • Distress signs:
      • Nasal flaring
      • Grunting
      • Wheezing/crackles
      • Suprasternal retractions
      • Xiphoid retractions
    • Response to cries:
      • Important to respond to cries
      • Need to room in to understand cries
      • Feed on demand

    Newborn Assessment

    • Crying:
      • Only way they know how to communicate
      • Important to respond to cries
    • Elimination:
      • Urinate within 24 hours
      • BM within 12 hours
    • Anatomical issues:
      • Dark green tarry stool = meconium
    • Body Temperature:
      • Maintain body temperature and prevent cold stress
      • Keep baby warm
      • Rewarm slowly to prevent seizures
    • Cleansing:
      • Submersion bath at birth, no more until umbilical cord falls off
    • Sleeping Position:
      • Back or side lying
      • Never on stomach to reduce SIDS

    Handling Newborns

    • Support neck and butt
    • Bring baby close as soon as possible
    • Fontanels:
      • Open but not fragile
      • Encourage open palm when gripping baby's head
    • Dressing and wrapping newborn:
      • Swaddle
      • Dress one layer than you
      • Make neck bigger then pull over
    • Cord care:
      • 2 cm above belly
      • Remove cord when baby goes home
      • No alcohol

    Nutrition

    • Neonate stomach can hold 3 oz full term
    • Check output for adequate nutrition
    • Breastfeeding:
      • Breast is best
      • Sleep
      • Contains antibodies
      • Perfect nutrition
    • Formula feeding:
      • Inverted nipples
      • Nipple shield to pull nipple out
      • Chronic disease
      • HIV
      • Baby has abnormalities
      • Cleft lip/palate/poor suck
    • Supplements:
      • Multivitamins (Polyvisol, Polyviflor)
      • Iron (supplements or in formula)

    Discharge and Follow-up

    • Assessed by DR
    • PT teaching:
      • Bathing
      • Diapering
      • Feeding
      • Comfort/swaddling
      • Pacifier for non-nutritive suck
    • Monitor for jaundice:
      • May develop over a few days
      • Bilirubin by heel stick
      • Don't want it to hit 20 (problem)
    • Danger signs:
      • Lethargy
      • White, red, black, mucus stool
      • Respiratory distress
    • Home visit if necessary
    • Infant car seat:
      • Rear facing at an angle
      • Back seat

    Preterm and Postterm Care

    • Preterm:
      • Before the end of 37th week
      • S&S:
        • Thin
        • Minimal subcutaneous fat
        • Lanugo
        • Transparent skin
        • Breast tissue barely palpable
      • Male = undescended testes
      • Female = labia majora very thin
      • Irregular/weak breathing
      • Surfactant doesn't start being created until 24 weeks
    • Postterm:
      • After 42 weeks
      • S&S:
        • Resp & nutrition problems due to placental insufficiency
        • May be small for gestational age (SGA)
        • Lose weight in utero
        • Long fingernails
        • Long hair
        • Dry, parched skin
        • Meconium swallowed/aspirated
    • Nursing care for preterm and postterm:
      • Teaching plans:
        • Address long-term issues
        • May go home with trachs, NG, G tubes, etc.
      • NICU:
        • Surfactant to mature respiratory system
        • Radiant warmer
        • Monitor O2 sat & ABG
        • Daily wts
        • Fluids & electrolytes
        • Protect from infection
        • Increase calories
        • Using formula
        • Double caloric intake without doubling volume
        • Tire easily
        • Provide interaction without increasing energy consumption
        • Holding, caressing, speaking to baby, touch
        • Non-nutritive suck (pacifier)

    Developmental Milestones

    • Changing families and role of caregivers
    • Developmental stages:
      • Trust vs. mistrust
      • Newborn - 1 year
      • Important to respond to cries
      • Family caregivers
      • Accomplishment = develop trust
    • Nursing considerations:
      • Establish routines for eating, play, rest, etc.
      • Play during the day to sleep better at night
      • Satisfying basic needs:
        • Holding, cuddling, feeding, stroking
      • Bonding
        • Feelings of love, nurturing, skin to skin
      • Support family structure
      • Handling of newborn

    Newborn Care

    • Immediately after birth:
      • Suction mouth to clear airway, then nose
      • Use bulb syringe, not a machine
    • Respirations:
      • 30-60 breaths per minute
      • Measure for 1 minute
      • Obligate nose breathers, may have wheezing or crackles
      • Grunting and periods of apnea expected at first
    • Circulation:
      • Heart rate: 120-160 beats per minute
      • Measure for 1 minute apically, use bell
      • Heart rate may be irregular
      • Report other sounds to DR, may be murmurs or holes
    • Body Temperature:
      • Take axillary temperature
      • Take rectal temperature to determine anal patency
    • APGAR:
      • Measure 1 minute and 5 minutes after birth
      • Assess oxygenation and adjustment to outside world
    • Screening Tests:
      • Over 40 tests done on newborns, including:
        • Amino acid metabolism disorders
        • Biotinidase deficiency
        • Congenital adrenal hyperplasia
        • Congenital hypothyroidism
        • Cystic fibrosis
        • Fatty acid metabolism disorders
        • Galactosemia
        • Glucose-6-phosphate dehydrogenase deficiency (G6PD)
        • Human immunodeficiency disease (HIV)
        • Organic acid metabolism disorders
        • Phenylketonuria (PKU)
        • Sickle cell disease and other hemoglobin disorders/traits
        • Toxoplasmosis

    Neonatal Resuscitation

    • APGAR:
      • Assess oxygenation and adjustment to outside world
      • Will probably not see chest rise and fall due to small lungs
    • Distress signs:
      • Nasal flaring
      • Grunting
      • Wheezing/crackles
      • Suprasternal retractions
      • Xiphoid retractions
    • Response to cries:
      • Important to respond to cries
      • Need to room in to understand cries
      • Feed on demand

    Newborn Assessment

    • Crying:
      • Only way they know how to communicate
      • Important to respond to cries
    • Elimination:
      • Urinate within 24 hours
      • BM within 12 hours
    • Anatomical issues:
      • Dark green tarry stool = meconium
    • Body Temperature:
      • Maintain body temperature and prevent cold stress
      • Keep baby warm
      • Rewarm slowly to prevent seizures
    • Cleansing:
      • Submersion bath at birth, no more until umbilical cord falls off
    • Sleeping Position:
      • Back or side lying
      • Never on stomach to reduce SIDS

    Handling Newborns

    • Support neck and butt
    • Bring baby close as soon as possible
    • Fontanels:
      • Open but not fragile
      • Encourage open palm when gripping baby's head
    • Dressing and wrapping newborn:
      • Swaddle
      • Dress one layer than you
      • Make neck bigger then pull over
    • Cord care:
      • 2 cm above belly
      • Remove cord when baby goes home
      • No alcohol

    Nutrition

    • Neonate stomach can hold 3 oz full term
    • Check output for adequate nutrition
    • Breastfeeding:
      • Breast is best
      • Sleep
      • Contains antibodies
      • Perfect nutrition
    • Formula feeding:
      • Inverted nipples
      • Nipple shield to pull nipple out
      • Chronic disease
      • HIV
      • Baby has abnormalities
      • Cleft lip/palate/poor suck
    • Supplements:
      • Multivitamins (Polyvisol, Polyviflor)
      • Iron (supplements or in formula)

    Discharge and Follow-up

    • Assessed by DR
    • PT teaching:
      • Bathing
      • Diapering
      • Feeding
      • Comfort/swaddling
      • Pacifier for non-nutritive suck
    • Monitor for jaundice:
      • May develop over a few days
      • Bilirubin by heel stick
      • Don't want it to hit 20 (problem)
    • Danger signs:
      • Lethargy
      • White, red, black, mucus stool
      • Respiratory distress
    • Home visit if necessary
    • Infant car seat:
      • Rear facing at an angle
      • Back seat

    Preterm and Postterm Care

    • Preterm:
      • Before the end of 37th week
      • S&S:
        • Thin
        • Minimal subcutaneous fat
        • Lanugo
        • Transparent skin
        • Breast tissue barely palpable
      • Male = undescended testes
      • Female = labia majora very thin
      • Irregular/weak breathing
      • Surfactant doesn't start being created until 24 weeks
    • Postterm:
      • After 42 weeks
      • S&S:
        • Resp & nutrition problems due to placental insufficiency
        • May be small for gestational age (SGA)
        • Lose weight in utero
        • Long fingernails
        • Long hair
        • Dry, parched skin
        • Meconium swallowed/aspirated
    • Nursing care for preterm and postterm:
      • Teaching plans:
        • Address long-term issues
        • May go home with trachs, NG, G tubes, etc.
      • NICU:
        • Surfactant to mature respiratory system
        • Radiant warmer
        • Monitor O2 sat & ABG
        • Daily wts
        • Fluids & electrolytes
        • Protect from infection
        • Increase calories
        • Using formula
        • Double caloric intake without doubling volume
        • Tire easily
        • Provide interaction without increasing energy consumption
        • Holding, caressing, speaking to baby, touch
        • Non-nutritive suck (pacifier)

    Developmental Milestones

    • Changing families and role of caregivers
    • Developmental stages:
      • Trust vs. mistrust
      • Newborn - 1 year
      • Important to respond to cries
      • Family caregivers
      • Accomplishment = develop trust
    • Nursing considerations:
      • Establish routines for eating, play, rest, etc.
      • Play during the day to sleep better at night
      • Satisfying basic needs:
        • Holding, cuddling, feeding, stroking
      • Bonding
        • Feelings of love, nurturing, skin to skin
      • Support family structure
      • Handling of newborn

    Newborn Care

    • Immediately after birth:
      • Suction mouth to clear airway, then nose
      • Use bulb syringe, not a machine
    • Respirations:
      • 30-60 breaths per minute
      • Measure for 1 minute
      • Obligate nose breathers, may have wheezing or crackles
      • Grunting and periods of apnea expected at first
    • Circulation:
      • Heart rate: 120-160 beats per minute
      • Measure for 1 minute apically, use bell
      • Heart rate may be irregular
      • Report other sounds to DR, may be murmurs or holes
    • Body Temperature:
      • Take axillary temperature
      • Take rectal temperature to determine anal patency
    • APGAR:
      • Measure 1 minute and 5 minutes after birth
      • Assess oxygenation and adjustment to outside world
    • Screening Tests:
      • Over 40 tests done on newborns, including:
        • Amino acid metabolism disorders
        • Biotinidase deficiency
        • Congenital adrenal hyperplasia
        • Congenital hypothyroidism
        • Cystic fibrosis
        • Fatty acid metabolism disorders
        • Galactosemia
        • Glucose-6-phosphate dehydrogenase deficiency (G6PD)
        • Human immunodeficiency disease (HIV)
        • Organic acid metabolism disorders
        • Phenylketonuria (PKU)
        • Sickle cell disease and other hemoglobin disorders/traits
        • Toxoplasmosis

    Neonatal Resuscitation

    • APGAR:
      • Assess oxygenation and adjustment to outside world
      • Will probably not see chest rise and fall due to small lungs
    • Distress signs:
      • Nasal flaring
      • Grunting
      • Wheezing/crackles
      • Suprasternal retractions
      • Xiphoid retractions
    • Response to cries:
      • Important to respond to cries
      • Need to room in to understand cries
      • Feed on demand

    Newborn Assessment

    • Crying:
      • Only way they know how to communicate
      • Important to respond to cries
    • Elimination:
      • Urinate within 24 hours
      • BM within 12 hours
    • Anatomical issues:
      • Dark green tarry stool = meconium
    • Body Temperature:
      • Maintain body temperature and prevent cold stress
      • Keep baby warm
      • Rewarm slowly to prevent seizures
    • Cleansing:
      • Submersion bath at birth, no more until umbilical cord falls off
    • Sleeping Position:
      • Back or side lying
      • Never on stomach to reduce SIDS

    Handling Newborns

    • Support neck and butt
    • Bring baby close as soon as possible
    • Fontanels:
      • Open but not fragile
      • Encourage open palm when gripping baby's head
    • Dressing and wrapping newborn:
      • Swaddle
      • Dress one layer than you
      • Make neck bigger then pull over
    • Cord care:
      • 2 cm above belly
      • Remove cord when baby goes home
      • No alcohol

    Nutrition

    • Neonate stomach can hold 3 oz full term
    • Check output for adequate nutrition
    • Breastfeeding:
      • Breast is best
      • Sleep
      • Contains antibodies
      • Perfect nutrition
    • Formula feeding:
      • Inverted nipples
      • Nipple shield to pull nipple out
      • Chronic disease
      • HIV
      • Baby has abnormalities
      • Cleft lip/palate/poor suck
    • Supplements:
      • Multivitamins (Polyvisol, Polyviflor)
      • Iron (supplements or in formula)

    Discharge and Follow-up

    • Assessed by DR
    • PT teaching:
      • Bathing
      • Diapering
      • Feeding
      • Comfort/swaddling
      • Pacifier for non-nutritive suck
    • Monitor for jaundice:
      • May develop over a few days
      • Bilirubin by heel stick
      • Don't want it to hit 20 (problem)
    • Danger signs:
      • Lethargy
      • White, red, black, mucus stool
      • Respiratory distress
    • Home visit if necessary
    • Infant car seat:
      • Rear facing at an angle
      • Back seat

    Preterm and Postterm Care

    • Preterm:
      • Before the end of 37th week
      • S&S:
        • Thin
        • Minimal subcutaneous fat
        • Lanugo
        • Transparent skin
        • Breast tissue barely palpable
      • Male = undescended testes
      • Female = labia majora very thin
      • Irregular/weak breathing
      • Surfactant doesn't start being created until 24 weeks
    • Postterm:
      • After 42 weeks
      • S&S:
        • Resp & nutrition problems due to placental insufficiency
        • May be small for gestational age (SGA)
        • Lose weight in utero
        • Long fingernails
        • Long hair
        • Dry, parched skin
        • Meconium swallowed/aspirated
    • Nursing care for preterm and postterm:
      • Teaching plans:
        • Address long-term issues
        • May go home with trachs, NG, G tubes, etc.
      • NICU:
        • Surfactant to mature respiratory system
        • Radiant warmer
        • Monitor O2 sat & ABG
        • Daily wts
        • Fluids & electrolytes
        • Protect from infection
        • Increase calories
        • Using formula
        • Double caloric intake without doubling volume
        • Tire easily
        • Provide interaction without increasing energy consumption
        • Holding, caressing, speaking to baby, touch
        • Non-nutritive suck (pacifier)

    Developmental Milestones

    • Changing families and role of caregivers
    • Developmental stages:
      • Trust vs. mistrust
      • Newborn - 1 year
      • Important to respond to cries
      • Family caregivers
      • Accomplishment = develop trust
    • Nursing considerations:
      • Establish routines for eating, play, rest, etc.
      • Play during the day to sleep better at night
      • Satisfying basic needs:
        • Holding, cuddling, feeding, stroking
      • Bonding
        • Feelings of love, nurturing, skin to skin
      • Support family structure
      • Handling of newborn

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    Description

    This quiz assesses knowledge on the immediate care of newborns, including respiratory and circulatory assessments, temperature regulation, and initial interventions. It covers the first minutes of life, focusing on breathing, heart rate, and body temperature.

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