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Newborn Care PDF
Newborn Care PDF
APGAR
Dr. Virginia Apgar
Taken on 1st and 5th minutes at birth
1st minute – neonate’s initial adaptation to
extrauterine life and necessity for
resuscitation
5th minute – more reliable picture of
neonate’s overall status
MUSCLE TONE (ACTIVITY) – resistance to
extension
HEART RATE (PULSE RATE) – apical pulse or
pulsation from umbilical cord
REFLEX IRRITABILITY (GRIMACE)– suction
catheter; slapping of the soles of the Feet
COLOR (APPERANCE) – Pink; *acrocyanosis ASSESSMENT OF GESTATIONAL MATURITY
RESPIRATORY EFFORT – regular at 1 minute; Not routinely done = UTZ
*analgesia / anesthetic Ballad or Dubowits Assessment Scale
Page 439 book
INTERPRETATION OF APGAR RESULT:
Total score has corresponding age in weeks
0-3 = baby is in serious danger and needs
PROPER IDENTIFICATION OF NEWBORN
immediate resuscitation
FOOT PRINT
4-6 = the baby’s condition is guarded and may
need more extensive clearing of the airways and The infant’s foot should be clean and dry
supplementary oxygen and must be pressed firmly on the ink pad
and then gently on the footprint from
7-10 = is considered good and in the best possible
beginning in the heel (upward motion)
health
ID BRACELETS
red on the dependent side and pale on the Gray patches across the sacrum or
upper side; due to immature circulation buttocks and consist of collection of pigment
cells (melanocytes)
DESQUAMATION Arms and legs; x school age w/o treatment
first 2-4 weeks of life Asian, Southern European, African ethnicity
skin becomes dry and it will peel BIRTHMARKS
palms, soles of feet
apply lotion HEMANGIOMAS
By the fourth day of life, stool depends on the type able to hear in utero (25-27 weeks AOG)
of feeding: respond to sound through generalized
activity to a specific sounds
a. Breast-fed babies – light yellow, mushy, more difficulty locating where sound is coming
frequent and sweet smelling (high in lactic acid – from
not foul smelling) recognize mother’s voice = calms
b. Bottle-fed babies – bright yellow, firm, less b. Vision
frequent and foul-smelling
positive pupillary reflex
c. Under phototherapy (jaundice) – bright green focus best on black and white objects at 9-
stools 12 inches
d. Bile duct obstruction – clay colored (gray) positive vision
stools c. Touch
e. Anal fissure – blood flecked most developed sense
f. Bleeding (swallowed maternal blood during quieting at a soothing touch
delivery / GI) – black, tarry stools positive sucking and rooting reflexes
(elicited by touch)
+ Apt Downey Test -> remains black -> GI bleeding reacts to pain stimuli
g. Milk allergy, lactose intolerance, digestion d. Taste
problems – mixed with mucus; watery and loose
ability to discriminate taste (taste buds are
URINARY SYSTEM developed and functioning even before
birth)
Voids within 24 hours after birth
Urine is odorless and light in color e. Smell
Daily urine output for the first 1-2 days of life
is 30-60 mL AND MAY INCREASE TO present when nose is clear of mucus and
ABOUT 300 Ml AFTER 1 WEEK amniotic fluid
Specific gravity is 1.008-1.010; may have turn towards mother’s breast partly out of
small amount of protein recognition of the smell of breastmilk and as
First voiding may be pink or dusky manifestation of rooting reflex
NEUROMUSCULAR SYSTEM
Demonstrates neuromuscular function
CJBS KBBS BSN 2-C
DISCHARGE INSTRUCTIONS Done on the 48th hour or at least 24 hours
from birth
FEEDING
* < 24 hours – some disorders are
Breastfeeding undetected
Screening again after 2 weeks for more
Preferred method of feeding a newborn accurate results
Remains the ideal nutritional source for
infants through the first year of life BRIEF DECRIPTION OF THE DISORDERS
Infants routinely receives an initial feeding - Lack or absence of thyroid hormone, which
about 1 oz of sterile water at 4-6 hours of is essential to growth of the brain and the
age body
To be certain the infant can swallow without CONGENITAL ADRENAL HYPERPLASIA
gagging and aspirating
Fed every 4 hours - Endocrine disorder that causes severe salt
loss, DHN, and abnormally high levels of
BATHING
May be given anytime convenient for
parents; not within 30 mins after feeding
* increased handling can cause
regurgitation
Sponge bath done until the cord falls off (7th
– 14th day)
Wash infant’s hair daily with the bath. First
soap the hair with the baby lying on the
bassinet. Then hold the infant on one arm
over the basin of water (foot ball hold)
Body 1st then head
SLEEPING PATTERNS
Sleeps 16-20 hours / day
CORD CARE
Use rubbing alcohol 70% 2 or 3x a day for
faster drying
Fold down diapers so that cord does not get
wet during voiding
Small pink granulating area may be seen on
the day the cord falls off
DIAPER CARE
After each change, wash area with clear
water and dry well
* to prevent ammonia
NEWBORN SCREENING
Procedure to find out congenital metabolic
disorder that may lead to mental retardation
and even death if left untreated