newborn care

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newborn care

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Slide 1: 

CARE OF NEWBORN

INTRODUCTION: : 

INTRODUCTION: Essential care of the normal healthy Neonates can be best provided by the mothers under supervision of nursing personnel or basic/ primary health care providers. About 80% of the newborn babies should be kept with their mothers rather than in a separate nursery.

definition: : 

definition: A healthy infant born at term b/w 38-42 wks should have average birth wt, cries immediately following birth, establishes independent rhythmic respiration & quickly adapts to the changed envt.

Slide 4: 

IMMEDIATE BASIC CARE

immediate basic care : 

immediate basic care Includes: Maintenance of temperature Establishment of open airway & circulation Identification of newborn. Vit k injection Initiation of breastfeeding.

Maintenance of temperature : 

Maintenance of temperature Immediately dry the infant under a radiant warmer or skin to skin contact with the mother Keep neonates head covered The baby should not be separated from the mother.

Establishment of open airway : 

Establishment of open airway As majority babies cry at birth & take spontaneous Respiration, no requires at birth about in 95% -98% Neonates. When the head is delivered birth attendant immediately suction the secretions Wipe mucus from face and mouth and nose Aspirate/suction mouth and nose bulb syringe Keep head slightly lower than the body

Slide 9: 

Position the Baby, Babies should be kept on their backs or tilted to the side, but not on their stomachs

Suction the Airway : 

Suction the Airway When  babies are born, they need to clear the mucous and amniotic fluid from their lungs. Several natural mechanisms help with this: As the fetal chest passes through the birth canal it is compressed, squeezing excess fluid out of the lungs prior to the baby taking its' first breath. This is noticed most often after the fetal head is delivered but prior to delivery of the shoulders. After several seconds in this "partly delivered" position, fluid can be seen streaming out of the baby's nose and mouth. After birth, babies cough and sneeze, mobilizing additional fluid that may be in their lungs.

Slide 11: 

After birth, babies cry loudly and repeatedly, clearing fluid and opening air sacs in the process. Crying is a reassuring event and does not indicate distress. Newborn grunting actions may further mobilize fluid, in addition to opening the air sacs in the lungs Check the Heart beat, The normal newborn heart rate is over 100 BPM

Slide 12: 

Assign Apgar Score

Slide 14: 

Scoring 7-9 = free from immediate distress; normal 4-6 = moderately depressed; may require additional resuscitative measures 0-3 = severely depressed; necessitates immediate medical attention

Newborn Identification : 

Newborn Identification Before a baby leaves the delivery area, identification bracelets with identical numbers are placed on the baby and mother. Babies often have two, on the wrist and ankle.

Vitamin K : 

Vitamin K Prevent neonatal hemorrhage during first few days of life before infant is able to produce vit. K Recommended route of administration: intramuscular Dose: 1mg Preterm infants may receive 0.5mg. Alternative Route: Oral Dose: 2mg orally at birth; Repeat dose (2mg) at 3-5 days and at 4-6 weeks of age.

Initiation of breastfeeding. : 

Initiation of breastfeeding. Babies can be breast-fed as soon as the airway is cleared and they are breathing normally. try to breast-fed babies with respiratory difficulties until the breathing problems are resolved.

Slide 18: 

DAILY ROUTINE CARE OF NEONATES

Daily routine care of neonates : 

Daily routine care of neonates The majority of complication of the normal newborn may occur during first 24 hours or within 7 days. So close observation & daily essential routine care are important For health &survival of the newborn baby. The major goals: Establish & maintain homeostasis Stability of normal physiological status The daily routine care of the neonates are as follows

Slide 20: 

Warmth Breastfeeding Skin care & baby bath Care of umbilical cord Care of the eyes. Clothing of the baby General care Observation taking anthropometric measurement Immunization Follow up & advice

Slide 21: 

Warmth:- Warmth is provided by keeping the baby dry & wrapping the baby with adequate clothing in two layers, ensuring head & extremities are well covered . Baby should kept by the side of the Mother .

Breastfeeding : 

Breastfeeding The baby should be put to the mother’s breast within half an hour of birth or as soon as possible the mother has recovered From the exertion of lobour

Skin care & baby bath : 

Skin care & baby bath The should be cleaned off blood, mucus & meconium by gentle wiping before he/she is presented to the mother baby bath can be given at the hospital or home by using warm water in a warm room gently& quickly.

First Bath : 

First Bath Bath once a baby's temperature Has stabilized, the First bath can be given.

Cord Clamping : 

Cord Clamping

Cord Blood Collection : 

Cord Blood Collection Make sure cord blood is collected for analysis and sent to laboratory for checking of: RH Blood type Hematocrit Possible cord blood gases

Care of umbilical cord : 

Care of umbilical cord Keep the cord stump clean and dry. Daily wiping of the cord with alcohol and leaving it open to the air facilitates drying and discourages bacterial growth. Topical application of antiseptics is usually not necessary unless the baby is living in a highly contaminated area.

Care of the eyes. : 

Care of the eyes. Eyes should be clean at birth & once in every day using sterile cotton swabs soaked in sterile water or normal saline. Separate swabs for each eyes.

Clothing of the baby : 

Clothing of the baby The baby should be dressed with loose, soft & cotton cloths. The frock should be open on the front or back for easy wearing. large button, synthetic frock and plastic or nylon napkin should be avoided.

General care : 

General care Bedding- in Rooming -in gentle approach Aseptic technique sensory stimulation tender& loving care.

Observation : 

Observation The baby should be kept in continuous observation twice daily for detection of any abnormalities.

Anthropometric measurement : 

Anthropometric measurement Measure weight, length, and head circumference helps determine if a baby's weight and measurements are normal for the number of weeks of pregnancy. Small or underweight babies, as well as very large babies, may need special attention and care.

Weight : 

Weight The average daily wt gain healthy term babies is about 30gm/day in the first month & of life. It is about 20gm/ay in second month & 10gm per day afterwards during the first year of life.

Length (from top of head to the heel with the leg fully extended : 

Length (from top of head to the heel with the leg fully extended

Normal Length : 

Normal Length Average range: 18-22 inches (46-56 cm) Measured from crown to rump and rump to heel or from crown to heel at birth

Head circumference (repeat after molding and caput succedaneum are resolved) : 

Head circumference (repeat after molding and caput succedaneum are resolved)

Head circumference : 

Head circumference Average range: 33 to 35 cm (13-14 inches) Normally, 2 cm larger than chest circumference Place tape measure above eyebrows and stretch around fullest part of occipital at posterior fontanel

Chest circumference (at the nipple line : 

Chest circumference (at the nipple line

Chest circumference (at the nipple line) : 

Chest circumference (at the nipple line) Average range: 30-33 cm (12-13 inches) Normally, 2 cm smaller than head circumference Stretch tape measure around scapulae and over nipple line

immunization : 

immunization Newborn should be immunized with BCG vaccine & ‘0’ dose of ‘OPV’. Hepatitis ‘b’ vaccine can be administered at birth as first dose & other two doses in one month & 6 months of age.

Follow up & Advice : 

Follow up & Advice Each infant should be followed up, at least once every month for first 3 months & subsequently 3 month interval till one year of age.

Slide 42: 

HARMFUL TRADITIONAL PRACTICES FOR THE CARE OF NEONATES

Harmful traditional practices for the care of neonates : 

Harmful traditional practices for the care of neonates Not adopting clean delivery at home. Harmful Resuscitation Practices Use of unclean substance like cow dung, mud on umbilical card. Immediate bathing Use of prelacteal feeds. Application of kajal in the newborn eyes Instillation of oil drops into ears & nostrils during bathing the baby use of unhygienic herbal water

Slide 44: 

Use of pacifiers Introduction of artificial feeding with diluted milk. Giving opium & brandy to neonates. Use of readymade expensive formula foods,

Nursing Diagnoses : 

Nursing Diagnoses Ineffective airway clearance related to nasal and oral secretions from delivery Ineffective thermoregulation related to environment and immature ability for adaptation Risk for injury related to immature defenses of the newborn

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