Lecture 2 Newborn Adaptation
Assessment & Nursing Care (EXAM 1)
Immediate Newborn Care at Delivery - Answer-1.) Establish and maintain respirations
2.) Prevent hypothermia/cold stress
3.) Frequent assessment of respiration and color
4.) Physical examination, vital signs
5.) Identification
Immediate Newborn Care - Answer-1.) Prevent Cold Stress
- warm blankets & heat source present at all deliveries
2.) Think,"Airway,Breathing,Circulation"
- An oxygen source must be available at ALL deliveries as must an endotrachial tube and laryngoscope
4.) Suction Airway if Necessary
- Bulb syringe, mechanical suction
- Mouth before nose
• stimulation of nares causes reflex stimulation that could cause aspiration of the fluids in the mouth
,5.) *Apgar Scoring* at 1 and 5 minutes (and again at 10 min if either score was less than 7 out of 10)
-APGAR: appearance, pulse, grimace, activity, respiration
6.) QuickAssessment
- heart, lungs, appearance, cord vessels (stethoscope must be handy)
- Full head-to-toe done at a later time, after bonding and breastfeeding
• if baby is stable, we want to put on mom for skin-to-skin
7.) Medications (Code drugs/Narcan if needed)
8.) Promote Bonding and Feeding
Suctioning Secretions - Answer-1.) Bulb suction immediately PRN to clear airway
- Mouth then nose
2.) May use mechanical suction if needed but not necessary if bulb syringe is successful
- Creates vagal stimulation resulting in bradycardia
3.) Always have bulb syringe handy, and teach parents how to use it.
-vaginal delivery babies' chests and stomach gets squeezed and they spit up a lot of saliva in their lungs
-c/section babies don't go through this and they have more mucus and are "spittier"
4.) Cardiac sphincter (between esophagus and stomach) is relaxed, so newborns regurgitate feedings
frequently: Risk for aspiration
Preventing Heat Loss - Answer-1.) Radiant warmer preparation
-if baby is unstable
-needing meds
-giving baths
2.) Place infant on abdomen of mother immediately after birth
3.) Dry and remove wet linen
4.) Hat
,5.) Warm anything that is applied directly to infant's skin
6.) Kangaroo care (skin to skin)
*Methods of Heat Loss* - Answer-1.) *Evaporation*
- Heat loss when water is converted to vapor
- Air drying of the skin that results in cooling
2.) *Conduction*
- Movement of heat away from the body when infants come in direct
contact with objects cooler than their skin
3.) *Convection*
- Transfer of heat from the infant to cooler surrounding air
4.) Radiation
- Transfer of heat to cooler objects that are not in direct contact with the infant
*Preventing Heat Loss in the Newborn* - Answer-1.) *evaporation*
- Dry at delivery
- Dry after bathing
- Keep linens dry
- Use K pads
- Use saran wrap blankets
- Use humidified air
2.) *Convection*
- Warm the environment
- Avoid drafts
- Cover the infant
, - Use hats
3.) *Conduction*
- Pre-warm bedding
- Use a warmed scale
- Cover x-ray plates
- Warm the diapers
- Warmwater
4.) *radiation*
- Avoid windows
-Use incubator door covers
- Double walled isolettes
*Thermogenesis* - Answer-1.) Methods of heat production
- Increase activity
- Flexion
- Metabolism
- Vasoconstriction
• blue hands and feet
- Nonshivering thermogenesis (brown fat)
•fat that has mitochondria that can burn and produce heat
• can't shiver like we do
•if they shivering they are hypoglycemic or have neurological problems
2.) These factors increase oxygen and glucose consumption and may cause respiratory distress,
hypoglycemia, and jaundice.
Assessment & Nursing Care (EXAM 1)
Immediate Newborn Care at Delivery - Answer-1.) Establish and maintain respirations
2.) Prevent hypothermia/cold stress
3.) Frequent assessment of respiration and color
4.) Physical examination, vital signs
5.) Identification
Immediate Newborn Care - Answer-1.) Prevent Cold Stress
- warm blankets & heat source present at all deliveries
2.) Think,"Airway,Breathing,Circulation"
- An oxygen source must be available at ALL deliveries as must an endotrachial tube and laryngoscope
4.) Suction Airway if Necessary
- Bulb syringe, mechanical suction
- Mouth before nose
• stimulation of nares causes reflex stimulation that could cause aspiration of the fluids in the mouth
,5.) *Apgar Scoring* at 1 and 5 minutes (and again at 10 min if either score was less than 7 out of 10)
-APGAR: appearance, pulse, grimace, activity, respiration
6.) QuickAssessment
- heart, lungs, appearance, cord vessels (stethoscope must be handy)
- Full head-to-toe done at a later time, after bonding and breastfeeding
• if baby is stable, we want to put on mom for skin-to-skin
7.) Medications (Code drugs/Narcan if needed)
8.) Promote Bonding and Feeding
Suctioning Secretions - Answer-1.) Bulb suction immediately PRN to clear airway
- Mouth then nose
2.) May use mechanical suction if needed but not necessary if bulb syringe is successful
- Creates vagal stimulation resulting in bradycardia
3.) Always have bulb syringe handy, and teach parents how to use it.
-vaginal delivery babies' chests and stomach gets squeezed and they spit up a lot of saliva in their lungs
-c/section babies don't go through this and they have more mucus and are "spittier"
4.) Cardiac sphincter (between esophagus and stomach) is relaxed, so newborns regurgitate feedings
frequently: Risk for aspiration
Preventing Heat Loss - Answer-1.) Radiant warmer preparation
-if baby is unstable
-needing meds
-giving baths
2.) Place infant on abdomen of mother immediately after birth
3.) Dry and remove wet linen
4.) Hat
,5.) Warm anything that is applied directly to infant's skin
6.) Kangaroo care (skin to skin)
*Methods of Heat Loss* - Answer-1.) *Evaporation*
- Heat loss when water is converted to vapor
- Air drying of the skin that results in cooling
2.) *Conduction*
- Movement of heat away from the body when infants come in direct
contact with objects cooler than their skin
3.) *Convection*
- Transfer of heat from the infant to cooler surrounding air
4.) Radiation
- Transfer of heat to cooler objects that are not in direct contact with the infant
*Preventing Heat Loss in the Newborn* - Answer-1.) *evaporation*
- Dry at delivery
- Dry after bathing
- Keep linens dry
- Use K pads
- Use saran wrap blankets
- Use humidified air
2.) *Convection*
- Warm the environment
- Avoid drafts
- Cover the infant
, - Use hats
3.) *Conduction*
- Pre-warm bedding
- Use a warmed scale
- Cover x-ray plates
- Warm the diapers
- Warmwater
4.) *radiation*
- Avoid windows
-Use incubator door covers
- Double walled isolettes
*Thermogenesis* - Answer-1.) Methods of heat production
- Increase activity
- Flexion
- Metabolism
- Vasoconstriction
• blue hands and feet
- Nonshivering thermogenesis (brown fat)
•fat that has mitochondria that can burn and produce heat
• can't shiver like we do
•if they shivering they are hypoglycemic or have neurological problems
2.) These factors increase oxygen and glucose consumption and may cause respiratory distress,
hypoglycemia, and jaundice.
