THE NEWBORN CARE

Prepared By:
1.Moza Sulaiman Al-khaldi

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Define the key terms.

Relate the assessment preformed during
the immediate newborn period.
Employ interventions that meet the
immediate needs of the term newborn.
Demonstrate the components of a typical
examination of the newborn.

 The

newborn is defined as the first 28 days

of life.

 Assessments
1)

Apger Score
2) Length And Weight
3) Vital Signs
4) Gestational Age Assessment

uesd to evaluate a newborns physical

condition at 1 minute and 5 minutes after
birth .
Five parameter are assessed with Apger
Scoring :
A=apperatence (color)
P=pule (heart rate )
G=gerimace ( reflex irritability )
A= active ( muscle tone )
R=respiratory (respiratory effort)
A normal newborns score should be 8 to 10
points.
Is

 Length

is measured from the head of the

newborn to the heel with the newborn
unclothed ,because of the of the flexed
position of newborn after birth.
Place the newborn in supine position and
extend the leg completely when measuring
the length.
A normal length range is 44 to 55 cm .

 Newborns

are weighted using a digital

scale that reads the weight in grams .
A normal weight range is 2,500 to 4,000 g
( 5 pounds to 8 pounds ).

 Heart

rate : by taking apical pulse for 1 full

minute. NORMAL is 120 to 160 bpm.
Respiration : assessed when they are
quiet and sleeping. NORMAL is 30 to 60
bpm.
Temperature : by taking axillary , NORMAL
range is 36.5 to 37.5 C
Blood pressure ( Oscillometer): 50 to 75
mmHg systolic , 30 to 45 mm Hg diastolic

 Gestational

age is the stage of maturity ,

physical signs and neurologic
characteristics are assessed by using a
tool such as Ballard Score system ,
which provide an objective estimate of
gestational age by scoring the specific
parameter of physical and neuromuscular
maturity .

 Skin texture: leathery ,cracked, wrinkled.

Lanugo (soft downy hair ): mostly bald.
Plantar surface : creases on the soles of the

feet ( creases over entire sole).

Breast tissue: full areola 5 to 10 mm bud (the
darkened ring around nipple).
Eye and Ear :eyelids can be open and thick
cartilage ear stiff.
Genitals (M) : testes and appearance of
scrotum.
Genitals (F): majora cover clitoris and minora

Posture: how the newborn hold his or her extremities in

relation to trunk , normal arms and legs full flexion .
Square window (wrist):how far newborn can be flexed toward
the wrist , normal if the angle the newborn maturity +.
Arm recoil :how far the newborns arms spring back to a
flexed position , normal recoil less than 90 degree angle.
Popliteal angle :how far the newborns knee extend, normal
less than 90 degrees .
Scarf sign: how far the elbows be moved across the newborn
chest ,normal the elbow doesnt cross the proximate axillary
line.
Heel to Ear :how close can the newborns feet be moved to
the ear ,normal the lesser flexibility ,the grater the newborns
maturity.

NURSING INTERVENTIONS
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Maintaining Airway Patency.

Ensure Proper Identification.
Administering Prescribed Medications.
Maintaining thermoregulation.

A newborn is suctioned to remove fluid and mucus from the

month and nose .
Usually the newborns mouth is suctioned first with bulb
syringe to remove debris and than the nose.
when suctioned with a bulb syringe:

compress the bulb before placing it into the oral or nasal

cavity.
2.
Releases bulb compression slowly
3.
Making sure the tip is place away from the mucus
membranes to draw up the excess secretion.
4.
Remove bulb syringe and while holding bulb syringe tip over
emesis basin lined with paper towel ,compress bulb to expel
secretions.
Position the newborn , head down and to the side position
facilitate drainage . Give under radiant heat source
1.

 identification

bracelets on the newborn,

mother, and father or any significant other to
protect the newborn.
The newborn is commonly receives tow ID
bracelets one on a wrist and one on an ankle.
The mother receives matching one in her wrist.
The ID bands state name, gender, date and time
of birth and identification number.

 Tow
1.

medications are commonly ordered:

VITAMIN K : promotes blood clotting , a
deficiency of this vitamin delays clotting
and might lead to hemorrhage. Administer
within 1 to 2 hr after birth , give as IM
injection at a a90 degree angle into the
middle third of vastus lateralis muscle.

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EYE PROPHYLAXIS: to prevent opthalmia

neonatorum, which can cause neonatal blindness,
Be alert for the chemical conjunctivitis for 1-2 days,
Wear gloves, and open eyes by placing thumb and
finger above and below rhe eye.
Gently ampoule to apply medication into conjunctival
sac from the inner canthus to the outer canthus of
each eye.
Do not touch the tip to the eye
Cloes the eye to make sure the medication
premeates.
Wip off excess ointment after 1 min.

 The

bodys temperature should be taken

every 30 min for tow first hours.
Commonly a thermistor probe (automatic
sensor) is attached to the newborn to
record body tempeature on a monitoring
device . The probe is taped to the
newborns abdomen . The other end of
thermistor probe is inserted into the radiant
heat control panel.

 ASSESSMENT:
1.

Newborn physical examination.

 Length

: normal range is from 44 to 55 cm

(17 to 22 inches). From the head to the
sole of the feet with unclothe and position
on flat surface.
Weight: normal range is 2,500 to 4,000 g.
Head circumference: is 32 to 38 cm (13 to
15 in).
Chest circumference: is 30 to 36 cm (12 to
14 in )

 Normal
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skin should be :
smooth .
Flexible.
Good skin turgor.( checking by pinch a
small area of the skin over the chest or
abdomen and note how quickly it return to
its original position)
Warm

Assess the newborns reflexes to evaluate

neurologic function and development.

Bathing of the newborn can begin once the

infants temperature has stabilized to at least
36.5 C (97.7 F). A complete sponge bath
should be given within the first 1 to 2 hr after
birth under a radiant heat source to prevent
heat loss. If necessary, the first bathing will
be postponed until thermoregulation
stabilizes

After the initial bath, the newborns face, diaper

area, and skin folds are cleansed daily. Complete
bathing is performed 2 to 3 times a week.
Bathing by immersion is not done until the
umbilical cord has fallen off and the circumcision
has healed on males.

Gloves should be worn until the newborns

first bath to avoid exposure to body secretions.
Provide parent teaching on bathing of the
newborn (e.g., bathing should go from clean to
dirty areas).

Elimination:
Is needs to be monitored
closely.
Newborns should void once
within 24 hr of birth. They
should void 6 to 10 times a day
after 4 days of life.

Inspect the umbilical

cord:
for two arteries and one
vein. Observe for any
bleeding from the cord,
and ensure the cord is
clamped securely to
prevent hemorrhage.

Feedings may be started immediately following

birth.
Breastfeeding is often started shortly after
birth and promotes maternal-infant bonding.
Formula feeding is usually started at about 2
to 4 hr of age

Mother's milk is an integrated food because it

contains at least 400 species of nutrients,
including hormones and compounds that fight
disease and which is devoid of them artificial
milk. It should be noted, that the mother's milk
is aligned with the needs of a child who grows
and develops .