newborn care

1. NEW BORN CARE

2. IMMEDIATE CARE OF THE
NEWBORN
•AIRWAY
•TEMPERATURE
•APGAR
•IDENTIFICATION

3. AIRWAY
• Suctioning
Suction gently and quickly (5 to 10
seconds). Prolonged and deep
suctioning of the nasopharynx during
the first 5 to 10 minutes of life will
stimulate the VAGUS NERVE (located
in the esophagus) and cause
bradycardia.

4. > Suction the MOUTH first before
the nose. If the nose is suctioned
first, the stimulation of the nasal
mucosa will cause reflex inhalation
of pharyngeal material into the
trachea and bronchi, causing
ASPIRATION.
>To test the patency of the airway,
occlude one nostril at a time.
(REMEMBER: newborns are
NOSE BREATHERS.) If a newborn
struggles when a nostril has been
occluded, additional suctioning is
indicated.

5. POSITIONING OF THE NEWBORN
Right side lying
1. promote drainage secretion
2. promote closure of foramen
ovale
3. fasten gastric emptying time
4. prevent an increase in
intracranial pressure

6. > The position when suctioning
should be one that promotes
drainage of secretions – HEAD
LOWER THAN THE REST OF THE
BODY BUT head should be higher
than the rest of the body if there
are signs of increased ICP:
•Vomiting
•Bulging, tense fontanels
•Dilated scalp veins
•Abnormally large head
•Increased BP
•Decreased PR and RR
•Widening pulse pressure
•Shrill, high-pitched cry

9. TEMPERATURE REGULATION
(THERMOREGULATION)
• Maintain appropriate Body Temperature. Chilling
will increase the body’s need for O2. The newborn
suffers large losses of heat (cold stress) because
he is wet at birth, the delivery room is cold, he does
not have enough adipose tissue and does not know
how to shiver.
• Wrap the newborn immediately
• Wrap him warmly
• Put him under a droplight

10. TEMPERATURE
 36.5 – 37.4ºC
 Rectal thermometer
 check the patency of rectum
 passage of meconium after 24 hours
 (imperforate anus)

11. HEAT LOSS IN NEWBORN
• CONVECTION – flow of heat from body surface
to cooler surroundings
• RADIATION – transfer of body heat to a cooler
solid object not in contact with the body
• CONDUCTION – transfer of body heat to a
cooler solid object in contact with the body
• EVAPORATION – loss of heat through
conversion of a liquid to a vapor

12. convection
radiation
conduction
evaporation

13. APGAR

14. 0 1 2
APPEARANCE BLUE/ PALE BODY PINK, Completely
EXTREMITIES BLUE,
(ACROCYANOSIS S-
PINK
NORMAL) 1ST 480 DUE RUDDY SKIN
TO IMMATURITY OF
CIRCULATION
PULSE ABSENT < 100 BEATS / > 100 BEATS /
MIN MIN
GRIMACE NONE > WEAK CRY > SNEEZE, /
COUGH,LUSTY CRY
(GOOD, STRONG,
VIGOROUS)
ACTIVITY FLACID / LIMP > SOME EXT. WITHDRAWAL
FLEX OF FEET
 EXT. FLEX
WELL
RESPIRATION ABSENT < 30 > 60

15. APGAR : AREAS OF ASSESSMENT

16. TOTAL SCORE
INTERPRETATION
0-3
• POOR,SERIOUS,SEVERELY
DEPRESSED; CPR
4-6
• FAIR,GUARDED, MODERATELY
DEPRESSED
• NEEDS SUCTIONING & FURTHER
OBSERVATION
7-10
• GOOD, HEALTHY, ADAPTS WELL IN
THE EXTRAUTERINE LIFE

17. IDENTIFICATION
• Boy (blue), Girl (pink)
• Gender and Name of the mother
ex. baby girl Ingrid Garcia
• Bed number
• Room number
• Name of the Ob-Gyne/Pediatrician

18. ROUTINE NEW BORN CARE
• BATHING
• ANTHROPOMETRIC MEASUREMENT
• CREDE’S PROPHYLAXIS
• VITAMIN K INJECTION
• UMBILICAL CORD CARE
• PRINTS

19. BATHING
• Oil Bath
spread or remove vernix caseosa
• Warm bath
f. foot ball hold
g. check temp using the elbow(37-38ºC)
h. from the cleanest the most soiled areasnof the body.
head eyes nose mouth ear neck chest
axilla UE (arm, forearm & hands) abdomen
back LE (thigh,leg & foot) genitalia anus

20. ANTHROPOMETRIC
MEASUREMENT
• HEAD CIRCUMFERENCE : 33-35cm
• CHEST and ABDOMEN : 31-33cm
• LENGTH: 47-54cm
• WEIGHT : 2500-4000 grams

21. • Note: A reduction of NB weight of
about 5-10% of BW (6-10oz) or less
known as Physiologic weight loss
during the 1st 3-10 days of life is
normal.
• Causes:
• -Infant is no longer under the
influence of maternal hormones.
• -Voids and passes out stools.
• -Has relatively low nutritional
intake
• -Has beginning difficulty
establishing sucking

23. CREDE’S
PROPHYLAXIS
To prevent Ophthalmia
Neonatorum or Gonorrheal
Conjunctivitis (Neisseria
gonorrhea) which causes
blindness if not treated.
Infection can be acquired
during delivery from a mother
with untreated gonorrhea

25. Ophthalmic drops
BEFORE: Silver Nitrate or
AgNO3 1% 1-2 drops
1-2 gtts into the lower
conjunctival sac
PRESENT:
Ointment – inner to outer canthus
Erythromycin – drug of choice of
Chlamydial Trachomatis

26. VITAMIN K INJECTION
Vitamin K facilitates production of the clotting
factor; thus, prevents bleeding, should be given
within one hour after birth.
Full term (0.1 ml)
Preterm (0.05 ml)
Aquamephyton (generic: phytonadione)
Route: IM into the lateral anterior thigh
(Vastus lateralis). In children below 12 months
of age who have not yet learned how to walk,
this is the preferred site of injection because
the gluteal muscles are not yet fully developed.

27. UMBILICAL CORD CARE
• Check two umbilical arteries, one umbilical vein
& wharton’s jelly
• Milking (depends on hospital policy)
• Disinfect the cord
– *Practice aseptic technique
• Use povidoneiodine (Betadine); 70%
Isoprophyl alcohol to prevent Tetanus
Neonatorum and Omphalitis infection of the
cord (streptococcal and staphylococcal)

28. • Place the cord clamp
1-2 inches from the base
• cut (1 cm or ½ inch from the cord clamp) and
disinfect
– ** The cord will fall off after – 7-10 days
• Application of sterile cord clamp to prevent
bleeding within the 1st 24 hours
• Signs of Omphalitis:
• *Reddening of the area
• *Fever
• *Discharge and foul smell

30. PRINTS
• Foot prints of the baby (most reliable)
• Thumb mark of the mother
• Identification bracelet

32. Nursing Intervention
1. Meet physiologic needs
2. Meet psychological needs
3. Foster healthy family relationships
4. Provide education

33. THE END