a nurse is planning care for a newborn who is receiving phototherapy This is a topic that many people are looking for. newyorkcityvoices.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, newyorkcityvoices.org would like to introduce to you Nursing Care of the Newborn and Family. Following along are instructions in the video below:
This lesson. We will be discussing the overall care management of the newborn in the the family. Okay so were gonna discuss care management birth through the first two immediately the care after birth will include apgar scoring an initial assessment the immediate physical assessment will include the general appearance vital signs baseline measurement of physical growth in neurologic assessment the first initial assessment is going to include where they are termed gestation or the breathing or the crying do they have good tone.
Heres an algorithm that you can follow if no then you want to warm clear. The airway if necessary dry and stimulate. If yes they could stay with the mother and then you start to provide the routine care you can follow that through its just a basic that most generally all your labor and delivery.
Nurses will use with the newborn. The nurse will also assess the neuromuscular maturity. Looking at the square window of the wrist.
The arm recoil. The popliteal angle. The scarf sign in the hill to ear the physical maturity would look at skin the lanugo.
The plantar surface breast the eyes ears.
The genitals of mel or female and they are based upon a scoring system. And then the measurements of the gestational age and birth weight. Okay so a newborn classification by gestational age and birth weight.
If you look you have the aga. Which is appropriate for gestational age lga. Which is large for gestational age.
And there bud the 90th percentile and then we had the sga. Which is small for gestational age. And that means that there below the 10th percentile early term infant refers to 37 to 38 weeks increase may be due to elective inductions and cesarean births.
Then there is the late preterm infant. 34. To 36 weeks.
Theyre known as the great impostor because often they the weight in the size is generally the same as a full term infant they could have respiratory distress temperature instability feeding difficulties in hyperbilirubinemia interventions for these infants will be airway maintenance maintaining body temperature.
Immediate interventions will be i prophylactics and vitamin k. Prophylaxis and promoting parent infant interaction. Okay were going to continue from two hours after birth until discharge.
What some common newborn problems are first we have birth injuries. These could be soft tissue injuries skeletal injuries or lacerations then the physiological problems can include jaundice. Which will need therapy for hyperbilirubinemia.
These. Include photo therapy or exchange. Transfusions.
Then we also have hypoglycemia and hypocalcemia. Lets talk a little bit about the laboratory and diagnostic tests we used a universal newborn screening checking for genetic diseases inborn errors of metabolism critical congenital heart disease and the newborn hearing screening the collection of specimens is done by a heel stick venipuncture or obtaining a urine specimen so lets continue with some of the interventions we want to provide a protective environment environmental factors infection control factors preventing infant abduction. We will also provide intramuscular injections for immunizations and then circumcision interventions thatll depend on recommendations parental decisions.
What type of procedure was done and then well actually provide to care.
The newly circumcised infant okay so lets discuss neonatal pain. It used to be believed that newborns and infants. Didnt actually experience pain.
And all. The research has finally indicated that they do experience pain. Neonatal.
Responses to pain are actually located in box. 23. 5.
On page 618 of your textbook. It can actually be signs of like butt drawing back reflexes crying grimacing. So you want to assess neonatal pain.
And the best way to do that is to refer to table.
23. Six page 619 in your textbook. That will give you the steps how to assess neonatal pain.
There are two ways to manage neonatal pain. There is the non pharmacologic in the pharmacologic way you can refer to those on page 621 of your textbook and 620. And these will give you the best evidence based practice.
So lets look at the nurses role in promoting parent infant interaction. You want to promote early interactions between the parents and the newborns assess attachment behaviors. Provide support in education and avoid over stimulation of the infant.
There are many topics youre going to discuss with the parents for the discharge planning and teaching these topics will include procedures for checking the temperature respirations feeding patterns elimination positioning and holding rashes clothing car seat safety non nutritive sucking bathing umbilical cord care infant follow up care cardiopulmonary resuscitation and practical suggestions. This concludes. The brief summary of the lesson of nursing care management of the newborn and family.
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