Nursing care of a normal newborn.pptx

This slides contain
1. immediate care of neonate at birth
2. Later and routine care of newborn

1. NURSING CARE OF A NEONATE Rajalakshmi.S

2. IMMEDIATE CARE OF NEWBORN AT BIRTH Deliver the baby on a warm and clean towel Establish and maintain a patent airway Ensure warmth Assessment and documentation of baby’s condition Care of eyes

3. 6.Clamp and cut the cord 7.Care of skin 8. Administration of vitamin K 9. Identification of baby 10.Transfer of the baby according to the level of care required

4. Deliver the baby on a warm and clean towel

5. Establish and maintain a patent airway Suctioning – Bulb syringe or Mucous trap

6. Tactile stimulation

7. CPR

8. Ensure warmth Delivery room should warm Dry infant using Warm towel Radiant warmer / KMC

9. Assessment and documentation of baby’s condition Apgar scoring Head to toe assessment

10. Care of eyes Sterile cotton swab dipped in sterile water Clean from Inner canthus to outer canthus with separate swab in each eye Medicated eye drops

11. Clamp and cut the cord Clamped when cord pulsation stops Clamped with 2 clamps Cut between the clamps leaving about 1’’ or 5 cm from abdomen of baby. Stump is left without any dressing Inspect repeatedly

12. Care of skin Gently wipe of blood, mucous and secretions Not rub off protective vernix caseosa Special attention :- neck, axillae , groins, creases at joints post pond baby bath for 48-72 hours

13. Administration of vitamin K 1 mg vitamin K – intramuscularly

14. Identification of baby Identification band on wrist Name of mother Registration number Date and time of birth Baby’s sex Foot impression of baby is taken for baby’s identification Provide mother an opportunity to see and touch and note the sex

15. Transfer of the baby according to the level of care required Normal babies – rooming – in Sick neonate to Neonate Intensive Care Unit (NICU) Level II Special baby care unit Preterm babies with Gestational age between 32- 36 weeks Low birth weight (1500- 2000gm) Major congenital malformations Suspected of having aspirated meconium Level III Intensive neonatal care unit Birth weight less than 1.5kg Gestational period less than 32 weeks Neonate with RDS Infants with convulsions, central cyanosis, severe neonate jaundice, those requiring major surgery.

16. LATER AND ROUTINE CARE OF NEW BORN Later care of new born includes the care that baby needs after being transferred to postnatal ward. Rooming- In Initiating feeding Observation for early signs of diseases Prevention of infections Care of bladder and bowel Maintenance of personal hygiene Parental teaching and follow- up

17. Rooming- In After the baby is transferred to the post natal ward he should be nursed in a bassinet beside the mother’s bed.

18. Initiating feeding Preferably within half an hour of birth Baby must receive colustrum

19. Observation for early signs of diseases Daily routine examination till the discharge of mother and baby from hospital. Nurse should watch the danger signs and report immediately to physician Failure to pass meconium within 24 hours of birth Failure to pass urine within 48 hours of birth Bleeding from any site Failure to take feed Excessive crying or undue lethargy Jaundice within 24 hours of birth Hypothermia or hyperthermia

20. Seizures Persistent vomiting or diarrhea Breathing difficulty Evidence of superficial infection Baby should be weighed daily at same time Monitor vital signs regularly

21. Prevention of infections All personnel coming in contact with the baby should be free from infection Hand washing should be practiced strictly Strict aseptic precautions should be taken while handling the baby The personal hygiene of mother and baby should be maintained Restrict the number of visitors attending the baby

22. Care of bladder and bowel If Neonate fail to pass urine and stool within 24 hours of birth , it should be notified to the physician The urine output is about 200-300 ml by the end of first week of life so neonate voids about 15- 20 times in a day . Diaper should change soon after wet. Diaper should be cleaned with mild soap and water- after stool passes Kept the baby clean and dry

23. Maintenance of personal hygiene Give sponge bath daily in summers and every alternate day in winters Care should taken t prevent chilling and draughts while giving dip bath to the baby Lukewarm water and mild soap for baby bath Special attention : - skin creases at axilla , neck, groin and thighs. Vernix caseosa should not be rubbed off during bath After bath- dry thoroughly and put on soft clothes Umbilical stump- cleaned with betadine solution

24. Eye care- daily using sterile swabs dipped in sterile water Cleaned from inner canthus to outer canthus using separate swab for each eye.

25. Parental teaching and follow- up About all aspects of baby care Observe the child’s daily behavior related to - sleeping, activity, cry, elimination etc holding the baby Baby bath Eye and cord care Feeding and nutritional supplements Immunization Prevention of infection Follow up Danger signs in the baby requires immediate hospitalization

26. Reference Sharma Rimple ; Essentials of peadiatric nursing, 2nd ed;2017, Jaypee brothers medical publishers(p) Ltd, New delhi