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The  1 st  24 hours   of Life The  first 24 hours  of life is a very significant and a highly vulnerable time due to critical transition from intrauterine  to extrauterine life
Immediate  Care of the Newborn ,[object Object],[object Object],[object Object]
Airway & Breathing ,[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care
Airway & Breathing ,[object Object],[object Object],[object Object],051104 Neonatal Care
Temperature ,[object Object],[object Object],[object Object],051104 Neonatal Care
APGAR Scoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Care of the Newborn in the Nursery
Components ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Components ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Proper Identification ,[object Object],[object Object],[object Object],051104 Neonatal Care
Bathing ,[object Object],[object Object],[object Object],051104 Neonatal Care
Cord Care 051104 Neonatal Care
Weight/ Anthropometric Measurements 051104 Neonatal Care
051104 Neonatal Care
Crede’s Prophylaxis 051104 Neonatal Care
Vitamin K Administration 051104 Neonatal Care
Foot Printing 051104 Neonatal Care
Vital Signs 051104 Neonatal Care
Dressing/ Wrapping ,[object Object],[object Object],[object Object],051104 Neonatal Care
Daily Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
NEWBORN ASSESSMENT Assessment of the newborn is essential to ensure a successful transition
Major Time Frames ,[object Object],[object Object],[object Object],051104 Neonatal Care
APGAR Scoring System ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care 1  2  3  4  5
051104 Neonatal Care APGAR Scoring System INDICATORS 2 1 0 Activity Active, spontaneous  Some flexion of extremities No movement (flaccid, limp) Pulse >100 bpm < 100 bpm Absent Grimace Pulls away, sneezes, coughs Facial grimace only No response with stimulation Appearance Completely pink Acrocyanosis Bluish-gray or pale all over Respiration Good vigorous cry Slow, irregular Weak cry Absent
051104 Neonatal Care Score Interpretation Score Interpretation Nursing Interventions 7 to 10 Well baby Rarely needs resuscitation 4 to 6 At risk INFANT NEEDS INTENSIVE CARE  Requires resuscitation Suction Dry immediately Ventilate until stable Careful observation 0 to 3 Sick baby PROGNOSIS FOR NB IS GRAVE Intensive resuscitation ET/ Ambu bag Ventilate with 100% O 2 CPR Maintain body temperature Parental support
General Guidelines ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
GENERAL APPEARANCE
Posture ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Special Concerns  ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
VITAL SIGNS
TEMPERATURE ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Heat Loss Mechanisms ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Nursing Considerations ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Pulse ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Nursing Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Special Concerns ,[object Object],[object Object],051104 Neonatal Care
Respiration ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Nursing Considerations ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Silverman-Anderson Index ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Silverman Scoring System 051104 Neonatal Care 0 1 2
Example  051104 Neonatal Care 0 1 2 Score:  5
Score Interpretation 051104 Neonatal Care Score Interpretation 0-3 No RDS 4-6 Moderate RDS 7-10 Severe RDS
Blood Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
ANTHROPOMETRIC MESUREMENTS
Body Measurements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
SKIN
Nursing Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Skin Color ,[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care
Skin Color ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Acro cyanosis ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Pallor/ Cyanosis ,[object Object],051104 Neonatal Care
Jaundice ,[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Management of Jaundice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Phototherapy units 051104 Neonatal Care
051104 Neonatal Care Nursing Responsibilities: -cover eyes and sex organ
Meconium Staining ,[object Object],[object Object],051104 Neonatal Care
Lanugo ,[object Object],[object Object],051104 Neonatal Care
Nursing Considerations: ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Vernix Caseosa ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care Vernix Caseosa
Desquamation ,[object Object],[object Object],[object Object],051104 Neonatal Care
Milia ,[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care ,[object Object]
Birthmarks
Mongolian Spots ,[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care
Salmon Patches ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Stork bites ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Strawberry marks ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care                                          
051104 Neonatal Care
051104 Neonatal Care Large capillary hemangioma
051104 Neonatal Care Cavernous Hemangioma
Port-wine stain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care                                           
Sturge-Weber syndrome ,[object Object],051104 Neonatal Care
Other Skin Marks
Mottling ,[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care
Erythema toxicum ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care                                                             
Petechiae ,[object Object],[object Object],[object Object],051104 Neonatal Care
Ecchymosis ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care                                        
Harlequin Sign ,[object Object],[object Object],[object Object],051104 Neonatal Care CLOWN’S SUIT
Café-au-lait spots ,[object Object],[object Object],[object Object],051104 Neonatal Care
Neurofibromatosis  051104 Neonatal Care
HEAD
What to assess ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],051104 Neonatal Care
Caput Succeedaneum ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Cephalhematoma ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Molding ,[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care
Forcep Marks ,[object Object],051104 Neonatal Care
Craniotabes ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Craniosynostosis ,[object Object],051104 Neonatal Care
Face/Eyes/Ears/ Nose /Mouth
What to Assess ,[object Object],[object Object],051104 Neonatal Care                    
Eyes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care                                                                                                                            
Nursing Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Nose ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Ears ,[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care Low set ears
051104 Neonatal Care Accessory tragus:  remnant of 1 st  branchial arch Congenital preauricular sinus: ends blindly risk for infection ,[object Object]
Mouth ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],051104 Neonatal Care
Neck ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Chest ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Abdomen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Daily Cord Care ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care
Transitional Stool ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Nursing Considerations ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Genitals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care ,[object Object]
Back ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Extremities ,[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care click !
051104 Neonatal Care                                                                                                      
051104 Neonatal Care                                                              
[object Object],051104 Neonatal Care
[object Object],[object Object],051104 Neonatal Care ,[object Object]
Neurologic System
Reflexes
Sucking/ Rooting ,[object Object],[object Object],[object Object],051104 Neonatal Care
Extrusion ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Swallowing ,[object Object],[object Object],[object Object],051104 Neonatal Care
Tonic Neck/ Fencing ,[object Object],[object Object],[object Object],051104 Neonatal Care
Palmar(Grasping)/ Plantar ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Moro ,[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],051104 Neonatal Care
Startle ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Babinski ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Stepping/ Walking/ Dancing ,[object Object],[object Object],[object Object],051104 Neonatal Care
Assessment of Gestational Age ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Usher’s Criteria 051104 Neonatal Care FINDINGS 0-36 WKS 37-38 WKS 39 WKS AND OVER Sole creases Anterior transverse crease only Occl creases in ant 2/3 Sole covered with creases Breast nodule diameter (mm) 2 4 7 Scalp hair Fine and fuzzy Fine and fuzzy Coarse and silky Ear lobe Pliable; no cartilage Some cartilage Stiffened by thick cartilage Testes and scrotum Testes in lower canal; scrotum small; few rugae Intermediate Testes pendulous, scrotum full; extensive rugae
Ballard’s Scoring ,[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care Physical maturity
051104 Neonatal Care Neuromuscular Maturity
051104 Neonatal Care Scoring
051104 Neonatal Care Physical maturity 19
051104 Neonatal Care Neuromuscular Maturity 17
051104 Neonatal Care Scoring 19+17=36 36 39
Other Nursing Responsibilities ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Newborn Screening ,[object Object],[object Object],051104 Neonatal Care
[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
051104 Neonatal Care Disorder Screened If not screened If screened Congenital Hypothyroidism Severe mental retardation Normal Congenital Adrenal Hyperplasia Death Alive and Normal Galactosemia Death or Cataracts Alive and normal PKU Severe mental retardation Normal G6PD Deficiency Severe Anemia, Kernicterus Normal
Infant Care Skills ,[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Football Hold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Cradle Hold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
Shoulder Hold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],051104 Neonatal Care
The end 081007 Neonatal Care

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