THE NORMAL NEWBORN; NEEDS, CARE AND FEEDING

Question 1

ADMISSION PROCEDURES

Answer 1

*AFTER BIRTH, THE NEWBORN IS FORMALLY 
 ADMITTED TO THE HEALTHCARE FACILITY.
 THE ADMISSION INCLUDES:
    -REVIEW PRENATAL & BIRTH INFO FOR
     POSSIBLE RISK FACTORS
    -GESTATIONAL AGE ASSESSMENT
    -ENSURE INFANT IS ADAPTING TO
     EXTRAUTERINE LIFE
    -MUST BE DONE NO LATER THAN 2 HRS 
     AFTER BIRTH

Question 2

WEIGHING OF NEWBORN

Answer 2

THIS SCALE IS CLEANED AND BALANCED BEFORE EACH WEIGHING, WITH THE PROTECTIVE PAD IN PLACE

Question 3

ASSESSMENT DATA: CONDITION OF INFANT

Answer 3

• APGAR SCORES AT 1 AND 5 MINUTES
• RESUSCITATIVE MEASURES
• PHYSICAL EXAMINATION
• PATIENT AIRWAY
• V/S
• VOIDINGS
• PASSING OF MECONIUM

Question 4

ASSESSMENT DATA: LABOR AND BIRTH

Answer 4

• DURATION AND COURSE
• STATUS OF MOTHER AND FETUS
• ANTEPARTUM HISTORY
  
  • MATERNAL PROBLEMS
  • MATERNAL AGE
  • ESTIMATED DATE OF BIRTH
  • PREVIOUS PREGNANCIES
  • PRESENCE OF CONGENITAL ANOMALIES

Question 5

PHYSICAL ASSESSMENT

Answer 5

• WEIGHT
• MEASUREMENTS
• V/S
• HEMATOCRIT (IF INDICATED) SMALL FOR FA
• BLOOD GLUCOSE (IF INDICATED) SGA

Question 6

NURSING CARE: ASSESSMENT

Answer 6

*MATERNAL AND BIRTH HISTORY
*RESPIRATORY STATUS
*V/S: MONITOR EVERY 30 MIN UNTIL NEWBORN
HAS BEEN STABLE FOR 2 HRS
*BODY TEMP: (97.5-99.0) < TEMP =
METABOLIC ACIDOSIS, HYPOXIA, SHOCK
*CORD CARE - NO RUBBING, AIR DRY, ASSESS
FOR INFECTION

Question 7

CIRCUMCISION CARE

Answer 7

EPITHELIAL LAYER IS REMOVED.  ASSESS FOR INFECTION
   *WATCH FOR VOIDING
   *ASSESS THE SITE EVERY 30 MIN FOR AT
    LEAST 2 HRS.
   *PETROLEUM OINTMENT GAUZE TO SITE

Question 8

PHYSIOLOGIC ALTERATIONS

Answer 8

*RESP DISTRESS
   CLEAR SECRETIONS W/BULB SYRINGE OR
   WALL SUCTION
*HYPOTHERMIA
    -WRAP IN BLANKET W/HEAD COVERING
    -RADIANT WARMER
*ALTERATIONS IN FEEDING & ELIMINATION

Question 9

MAINTENANCE OF STABLE NEWBORN TEMP

Answer 9

*KEEP THE NEWBORNS CLOTHING & BEDDING
 DRY
*DOUBLE-WRAP THE NEWBORN & PUT A 
 STOCKING CAP ON HIM/HER
*USE THE RADIANT WARMER DURING
 PROCEDURES
*REDUCE THE NEWBORNS EXPOSURE TO
 DRAFT
*WARM OBJECTS THAT WILL BE IN CONTACT
 WITH THE NEWBORN (EG STETHOSCOPE,
 BLANKETS)
*ENCOURAGE THE MOTHER TO SNUGGLE
 W/THE NEWBORN UNDER BLANKETS OR TO 
 BREASTFEED THE NEWBORN W/HAT AND
 LIGHT COVER ON

Question 10

ADMISSION PROCEDURES

Answer 10

*VITAMIN K1- RECOMMENDED TO PREVEN
  HEMORRHAGE (<PROTHROMBIN LEVELS)
*EYE PROPHYLAXIS - LEGALLY REQUIRED.
  GONORRHEA.  GIVEN RIGHT AFTER BIRTH
*INITIATE FEEDING
*FACILITATE PARENTAL-INFANT ATTACHMENT

Question 11

PARENT EDUCATION

Answer 11

*SHOULD TAKE PLACE WHILE DEMONSTATING
 THE PROPER METHOD OF PROVIDING INFANT
 CARE
*NEARLY EVERY CONTACT W/THE PARENTS
 PROVIDES AN OPPORTUNITY FOR 
 TEACHING
   -TEACH ABOUT BATHING THE INFANT WHILE
    GIVING THE BABY A BATH
  -TEACH FEEDING TECHNIQUES WHILE THE 
   MOTHER IS FEEDING

Question 12

PREPARATION FOR D/C HOME

Answer 12

*PARENT TEACHING - INTERACTION, FEEDING,
 AND CAREGIVER ACTIVITIES
*CHANGING DIAPERS, WRAPPING BABY, 
 HANDLING, FEEDING,, CORD CARE, TEMP
 READING, SAFETY TOPICS, NASAL AND ORAL
 SUCTIONING, CAR SEAT SAFETY.
*PARENT INVOLVEMENT
*GENERAL INSTRUCTIONS ON CARE

Question 13

WHEN PARENTS SHOULD CALL THEIR HEALTHCARE PROVIDER

Answer 13

*TEMP ABOVE 100.4F AXILLARY OR BELOW
97.8 AXILLARY
*CONTINUAL RISE IN TEMP
*MORE THAN ONE EPISODE OF FORCEFUL
VOMITING OR FREQUENT VOMITING OVER A
6 HR PERIOD
*REFUSAL OF 2 FEEDINGS IN A ROW
*LETHARGY, DIFFICULTY IN AWAKENING BABY
*CYANOSIS (BLUISH DISCOLORATION OF SKIN)
W/WO A FEEDING
*ABSENCE OF BREATHING LONGER 20 SECS
*INCONSOLABLE INFANT (QUIETING
TECHNIIQUES ARE NOT EFFECTIVE) OR
CONTINUOUS HIGH-PITCHED CRY
*DISCHARGE OR BLEEDING FROM UMBILIAL
CORD, CIRCUMCISION, OR ANY OPENING (EXCEPT VAGINAL MUCUS OR PSEUDO-
MENSTRUATION
*2 CONSECUTIVE GREEN, WATERY STOOLS
OR BLACK STOOLS OR INCREASED
FREQUENCY OF STOOLS
*NO WET DIAPERS FOR 18-24 HRS OR FEWER
THAT 6-8 WET DIAPERS PER DAY AFTER 4
DAYS OF AGE
*DEVELOPMENT OF EYE DRAINAGE