Newborn Care Presentation

7/31/2019 Newborn Care Presentation

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Nursing Assessment Maternal

history/labor dataindicating

potential problemswith newborn

Apgar Scores

Findings of briefphysicalexaminationperformed in thedelivery room


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1. When the head isdelivered birth attendantimmediately suctionsecretions Wipe mucus from face and

mouth and nose

Aspirate/suction mouth and

nose bulb syringe Keep head slightly lower

than the body


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2. Assess airway status

A. Assess for 5 Symptoms ofrespiratory distress

Retractions

Tachypnea (rate: >60 cpm)

Dusky color/circumoral cyanosis

Expiratory grunt

Flaring nares


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B. Do not hyperextendneck at anytime (may closeglottis)

Place infant in sniffposition

Neck slightly extendedas if sniffing air

Opens airway


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3. Immediately dry infantunder a radiant warmeror skin to skin contactwith the mother

Keep neonates headcovered


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Infant temperatureshould be above36.4C.

Infants lose heatthrough evaporation,radiation, conduction

and convection.


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4. Obtain APGAR Scoring at 1 minand 5 min


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Apgar test is a scoring system

designed by Dr. Virginia Apgar,an anesthesiologist,

a systematic and measurable methodto access the newborn in the crucialminutes after birth.


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Purposes:

evaluate the conditions of the baby at

birth, determine the need for resuscitation,

evaluate the effectiveness of

resuscitative efforts, identify neonates at risk for morbidity

and mortality.


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Test 0 Points 1 Point 2 PointsActivity (Muscle Tone) Absent Arms & legs

extended Active movement

with flexed arms &legsPulse (Heart Rate) Absent Below 100

bpm Above 100 bpmGrimace (ResponseStimulation or Reflex

Irritability)NoResponse Facialgrimace Sneeze, cough,pulls away

Appearance (SkinColor) Blue-gray,pale all

overPink bodyand blue

extremitiesNormal over entirebodyCompletely

pinkRespiration

(Breathing)Absent Slow,

irregularGood, crying


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If there are problems withthe infant:

an additional score may be

repeated at a 10-minuteinterval.

For a Cesarean section:

the baby is additionallyassessed at 15 minutes afterdelivery.


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Scoring 7-9 = free from immediate distress; normal

4-6 = moderately depressed; may require additionalresuscitative measures

0-3 = severely depressed; necessitates immediate

medical attention

Note: APGAR score is strictly used to determine the newborns immediate

condition at birth and does not necessarily reflect the future health of your

baby.


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Scores done at 1 minute to identify whoneeds immediate intervention.

Scores taken again at 5 minutes toassess recovery from depression or a

subsequent turn for the worse.

Resuscitation takes precedence overdetermining score.


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5. Do quick Gestational AgeAssessment

A. Sole CreasesB. Breast tissue bud

C. Skin, vessels, and peeling

D. Genitalia

E. Resting Posture


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6. Cord Care A. Clamp

umbilical cordapproximately2.5 cm (1 inch)from abdominal

wall w/ cordclamp

Examine clampfor closure, nooozin of blood


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B. ExamineCord for

presence of 3vessels anddocument

2 arteries and 1vein


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8. Document passage ofmeconium or urine afterdelivery

For presence ofmeconium beforedelivery, mechanicalsuctioning of

naspharynx upondelivery of infant w/ an8-10 French catheter isdone


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Recent studies indicate that 2.5% povidone-

iodine solution also may be useful inpreventing neonatal ophthalmia, but a product

for this purpose is not commercially available.

Silver nitrate appears to be the best agent inareas where the incidence of penicillinase-

producing N gonorrhoeae (PPNG) is significant.

Neonates born to mothers with activegonococcal infection should receive a single IMinjection of aqueous penicillin G.


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11.Administer a prophylactic vitamin K

Prevent neonatal hemorrhage during first few days oflife before infant is able to produce vit. K

Recommended route of administration: intramuscular

Dose:

1mg (of Konakion MM, 2mg/0.2ml) being given at birth. Preterm infants may receive 0.5mg.

Alternative Route: Oral

Dose:

2mg orally at birth; Repeat dose (2mg) at 3-5 days and at 4-6 weeks of age.

Repeat dose if the infant vomits or regurgitates within 1hour


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13. Footprints areoften taken andrecorded in the

medical record.


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Measure weight, length, and headcircumference helps determine if a baby's weight and

measurements are normal for the number of weeks

of pregnancy.

Small or underweight babies, as well as very largebabies, may need special attention and care.


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Before a baby leavesthe delivery area,identification

bracelets withidentical numbersare placed on thebaby and mother.

Babies often havetwo, on the wristand ankle.

Documents

Newborn Care Presentation