The Term Newborn Student PDF

Chapter 11 The Term Newborn Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Lesson 12.1 Objectives 1. Describe the initial assessment of the normal newborn. 2. Briefly describe three normal reflexes of the newborn, including the approximate age of their...

Chapter 11 The Term Newborn Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Lesson 12.1 Objectives 1. Describe the initial assessment of the normal newborn. 2. Briefly describe three normal reflexes of the newborn, including the approximate age of their disappearance. 3. State methods of newborn pain management. 4. Demonstrate the details of physical assessment of the newborn. 5. State four methods of maintaining the body temperature of a newborn. Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Apgar Score  Standardized method of evaluating the newborn’s condition immediately after delivery  Heart rate, respiratory, muscle tone, reflexes and colour  Score obtained 1 and 5 minutes after birth How to complete an APGAR score https://www.youtube.com/watch?v=IpQkbjWg1-4 Transition Period  First 6 to 8 hours after birth  Transition from intrauterine to extrauterine life  Nurses are concerned with balancing need for observation and assessment of newborn with needs of the birthing person and family  First period of reactivity, the first 30 to 60 minutes of life – best time to initiate breastfeeding and bonding  Period of decreased responsiveness, 1 to 3 hours after birth – infant sleeps, less active  Second period of reactivity, between 3 to 8 hours after birth – alter and responsive Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Initial Assessment  Skin-to-skin  Obtaining vital signs  Gestational age assessment  Observing for injuries or anomalies  Weighing and measuring length and head circumference  Assess for passage of urine and meconium Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Supporting Thermoregulation (1 of 2)  Non-shivering thermogenesis – metabolism – they do not shiver til 6months  Produces heat via Brown fat (appears 26-28 weeks gestation)  Hypothermia can lead to cold stress  Hypoglycemia  Respiratory distress  Supporting thermoregulation - lose heat via  Evaporation - wet skin to surrounding air  Conduction – naked – cold blanket on skin  Convection – exposed to cold air that is cooler than baby skin  Radiation – room is cold – body heat goes to cold object Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Supporting Thermoregulation (2 of 2) Unstable heat-regulating system Acrocyanosis is evident because of sluggish peripheral circulation Cannot adapt to change in temperatures easily Sweat glands do not function during newborn period, so infant is at risk for developing elevated temperature if overdressed or placed in overheated environment Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Maintaining Body Temperature of the Newborn Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Bunnying General Nursing Care  Opthalmic Prophylaxis Vitamin K Prophylaxis Initial Assessment  Gestational Age Assessment  Heart rate  Skin  Apical  Vernix  Temperature  Hair  Blood pressure  Ears  Measurements  Breast tissue  Weight  Genitalia  Length  Sole creases  Head circumference  Vital Signs  Respiratory rate Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Obtaining Temperature, Pulse Rate, and Respirations  Temperature: axilla  Put skin-to-skin if abnormal and reassess  Pulse and respiratory rates: count for 1 full minute, assess prior to other assessments  The student must report  Temperature elevations >37.5° C or 160 or 60 or