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Nursing Management of Normal Newborn - Coggle Diagram
Nursing Management of
Normal Newborn
General Nursing Management of newborn
1.Admission care
Id
History taking
Physical assessment
Vital signs
Weight -length
General appearance
Gestational age
Prevent hemorrhage
(Vit.K)
2.Vital signs
(taken twice a day)
3.tempreature maintenance
4.Growth measurements
(Lose up to 10% weight in first few days)
•limited food intake
•withdrawal hormone mother
•passage meconium -urine
5.observation
•meconium pass within 48
•urine pss within 24h
•umbilical cord (hemorrhage -infection)
•anyabnormalities(hypothermia)
6.B.C.G vaccination
7.steps of bonding
•breast feeding within first hour after birth
•rooming in mathor - infant
•skin to skin
System Assessment of newborn
Gastrointestinal system
•cleft lip
•cleft palate
Moconium
(First stool)
Genito-Urinary system
a.urinary system
Urine volume/24h=200-300ml
b.Genital system
Female
•labia- clitoris edematous
•vernix caseosa between labia
Male
•Testes palpable in each scrotum
Endocrine system
Swollen breasts
•breast secretion (white milk)
•appears on 3rd day of birth
•male-female
Pseudo menstruation
•tiny menstrual flow
•apper in diaper for 1-2day
•female only
Assessment Criteria of newborn
1.Initial Assessment
APGAR scoring
Appearance
Pulse
Grimace
Activity
Respiration
2.Transitional Assessment
First period
Initial stage
(First 30min)
Second stage
(last 2-4 h)
Second period
When newborn aweke from deep sleep
(last 2-5 h)
3.Gestational age Assessment
Physical & neurological examination
L.M.P
Obstetric history
Lab test
Fetal ultrasonic scanning
Physical maturity score
Muscular maturity score
Classification newborn based on
Maturity & Intrauterine Growth Chart
LGA
AGA
SGA
Systemic physical examination
General Measurements
Birth weight
(2700-4000g)
Head circumference
(33-35.5 cm)
Chest circumference
30.5-33 cm)
Head to heel length
(48-53 cm)
Vital signs
Temp
(36.5-37.6 C°)
Heart rate
(130-140 b/min)
Respiratory rate
(30-60 breath/min)
Blood pressure
(65/41 mmHg)
General appearance
Posture & behaviour
Complete flexion result in utero position
Skin
Vernix caseosa
(White cheesy substance)
Lanugo hair
(Long soft hair on forehead - shoulder -back)
Mongolia spots
(normal bluish areas of the skin)
Desquamation
(Pealing of the skin)
Physiological jaundice
(appears 2-3 day after delivery)
Milia
(Small pinpoint white papules on nose-chin)
Head
(6 bones: Frontal
Occipital,
2 parital,
2temporals)
anterior fontanel
•larg size
•diamond shape
•close:12-18 month
Posterior fontanel
•small size
•triangular shape
•6-8 weeks
Caput Succedaneum
(edema of the scalp)
Cephalichematoma
(hemorrhage under periosteum)
Immediate care of newborn
1.Clear airway
Suction from mouth first then nose
2.Establish Respiratory
Slapping the heel
Flicking the sole
Rubbing the back gently
3.Maintenance body temperature
Radiant warmer
Warm incubator
Factors predispose excessive heat loss
1.Newborn's large surface area facilities heat loss to environment
2.Newborn's thin layer of subconscious fat
3.Newborn's mechanism for producing heat is different from that of the adult
Method of heat loss and gain
Conduction
Convection
Radiation
Evaporation
(heat loss only)
4.protection from hemorrhage
Administration single IM dose(0.5-1mg)vit.k
5.Identification
Tow identify
(Wrist -ankle)