Gaza City

The Normal Newborn
Goal for the Care of the neonate

Goals
Establish and maintain airway and respiratory status
Provide warmth and prevent hypothermia
Provide safety from injury or infection
Identify actual or potential problems that require immediate intervention.

Risks Assessment

Ante-partal information:
Lack of pre-natal care
Maternal weight gain   30 pounds
Medical conditions
Complications
Test results

Intra-partum course:
Pre-term labors < 37 weeks
Post-term dates > 42 weeks
Duration of labor, precipitous or prolonged labors

Intra-partum factors:
PROM >>24 hours
Maternal conditions
Fetal positions
Indicators of fetal distress
Method of delivery

Risks Assessment—Gestational Age
Scalp hair
Breasts nodules
Earlobes
Testicles / scrotum
Muscle tone
Soles/creases
Other

Physical assessment—Central Nervous System
Head circumference (FOC)
Normal between 13.2—14.8 cm
About ¼ the length of the newborn
Shape—noting any “molding”
Caput succedaneum
Cephalhematoma
Fontanels—shape, size, character
Anterior/posterior
Taste and smell are present.
Vision—can see and fixate.
Hearing—is present at birth, prefers high-pitched female voice.
Outer ear has very little cartilage.
Important to teach care of the ears
Sleep patterns—16-20 hours/day
Awakens only for feedings

Normal newborn reflexes should be noted:
Sucking/swallowing
Rooting
Moro/startle
Tonic neck reflex/”fencing”
Dancing/walking
Sneezing
Physical Assessment (cont’d)

Signs of possible infection involving the CNS:
Lethargy or irritability
Jitteriness, or hypo-reflexia, hypotonia
Tremors or seizures
Full, bulging fontanels

Physical Assessment—Respiratory System
First hour of life is most critical.
Physician will assist by suctioning nose & mouth.
Important nursing priority is to dry infant & provide warmth.
Monitor for normal respiratory rates.
Watch for signs of respiratory distress.

Physical Assessment—Circulatory System
Fetal shunts... [continues]

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