NURSING CARE OF THE NEWBORN AND FAMILY: BIRTH TO TWO HOURS OF
LIFE
transitioning from intrauterine to extra-uterine living
there are certain processes critical to extra-uterine survival
,-VERY ATTENTIVE TO ABC'S AND T'S
-AIRWAY (suctioned immediately)
-BREATHING
-CIRCULATION
-TEMPERATURE REGULATION
-baby has 3 holes inside heart when intrauterine:
-have to close when baby is born!
-foramen ovale
-ductus arteriosus
-ductus venous
Promoting skin to skin (put immediately on mothers bare chest after birth)
-help promote warmth
-regulate RR
-promoting breast feeding
-blood glucose regulation
Maintaining airway, circulation and temperature
-stimulate baby "patting" on back (strong)
-want baby to cry and take nice deep breath
-causes 3 holes in heart to shut with change in vascular system pressure
,-baby's blood will then start circulating on its own, delivering oxygenated blood
through body
Encouraging breast feeding
Eye prophylaxis
-erythromycin : to prevent STD/other infection from delivery (gonorrhea/chlamydia)
-parent always has right to decline meds for baby, needs to be documented
Vitamin K prophylaxis
- thigh (vastus lateralis)
-needle size 27 gauge (5/8 inch)
-essential to cascade that leads to appropriate/adequate CLOTTING
-does not transfer well through placenta in enough quantities
-baby has been receiving nutrients through umbilical vein, so gut is STERILE
-prevent intracranial bleeds
Hep B vaccine
-different site than Vitamin K
-immunization
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APGAR scoring
-done at 1 min and at 5 min
-total maximum score is 10
-if baby scores 7 or less at 5 min, do another at 10 min
-tells how well baby is adjusting to extrauterine life
-score of 7 or less :
- intervention = resuscitate the baby with stimulation
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