Module 9 - Newborn care Flashcards
When do the 3 phases of newborn care occur?
- Phase 1 - From birth to 1 hour (usually in delivery room)
- Phase 2 - From 1 to 3 hours (usually in transition nursery or postpartum unit)
- Phase 3 - From 2 to 12 hours (usually in postpartum unit if rooming-in with the mother)
Phase 1 - Initial care includes
- Maintaining thermoregulation
- Maintaining cardiorespiratory function
- Observing for urination and passage of meconium
- Identifying the mother, father, and newborn
- Performing a brief assessment for major anomalies
- Encouraging bonding and breastfeeding
what are general considerations of a newborn bath?
o Always test the water (Acceptable temperature 37.2 - 38 degrees Celsius)
o Wash from clean to dirty areas
o Shampoo head last to prevent heat loss (hold the baby wrapped in a towel)
o STAY WITH THE BABY
o Bath between feedings not after feedings
Describe cord care
- If not already done, apply a plastic clamp ½ inch above the skin and cut the extra cord
- Cord is assessed for number of vessels
- Keep the cord clean and dry
- Fasten diaper under the cord to allow the cord to air dry
- Clamp can be removed when the end of the cord is dry and crisp (24hrs)
- Report signs of infection
how many wet diapers should the newborn have per day
about 6
describe the guidelines for clothing for newborn
- Must be soft, washable, appropriate size and easy to don and doff
- Use of sensitive detergents
- Launder clothing before wear
- No drawstrings around the neck
- Button must be sewn on securely- SNAPS and VELCRO is preferable
- Diapers need to be changed as soon as are wet
What safety discharge teachings should be included?
- Infant security
- Sleep safety
- Car seat safety
- Crib safety
- Environment
what 2 medications are administered to the newborn right after birth and why?
- Erythromycin eye ointment administered to each eye - Administered within 1hour after birth. To prevent ophthalmia neonatorum (pink eye); most common cause of ON is chlamydia
- Vitamin K IM injection in the vastus lateralus to assist blood clotting, given at 1 hr
what are 2 newborn screening tests done
• Blood screening – Heel stick is performed to obtain capillary blood for the glucose screening test. Avoid the center heel
• Hearing test - ALGO hearing screening test, analyzes hearing by sending a series of soft clicks into the sleeping infants ear. computer compares response to normal responses; pass/fail score is recorded.
- Otoacoustic emisions test (OAE) – measures sounds from the cochlea in response to sound stimulation.
What are some general considerations for bathing a newborn?
o Always test the water (Acceptable temperature 37.2 - 38 degrees Celsius
o Wash from clean to dirty areas
o Shampoo head last to prevent heat loss (hold the baby wrapped in a towel)
o STAY WITH THE BABY
o Bath between feedings not after feedings (to avoid regurgitation)
- Alkaline products should not be used, can alter the normal pH of their skin, making them vulnerable for infection.
- Powders avoided b/c high risk of aspiration of small particles
what is the first step to cut cord? what do you assess?
- apply a plastic clamp ½ inch above the skin and cut the extra cord
- Asses for number and type of blood vessels; normal has 2 arteries, 1 vein; arteries project slightly, vein does not and looks like a flattened cylinder
When can the clamp be removed from the cord?
Clamp can be removed when the end of the cord is dry and crisp (within about 24hrs)
Parent teaching for cord care
report redness of the area, or a moist, foul-smelling umbilical cord
Describe the stool pattern of the newborn - what it consists of, appearance, when it’s passed
1st stool - Meconium, combination of amniotic fluid, lanugo and secretions from intestinal glands. Dark green-black, thick and tarry. Passed with in 8-24 hours
- Transitional stools- Stool gradually changes during the first week becoming loose and greenish-yellow with mucus.
What is the difference between the stool of a breastfed infant and formula fed?
- Breastfed infant: stools are bright yellow, soft and pasty. 3-6 stools per day
- Formula fed- stool is more solid, vary from yellow to brown and are less frequent
