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OB - Module 4 - Newborn Care Graded A+

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OB - Module 4 - Newborn Care Graded A+ WDL Newborn Temp 36.5-37.5 (97.7-99.5) Environmental influences, Crying may ↑ temp; If hyperthermic, unwrap and check again, if hypothermic put infant skin to skin with mom with warm blanket, or under warmer and recheck WDL Newborn HR 120-160 bpm...

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  • October 19, 2024
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  • OB - Module 4 - Newborn Care Graded A+
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OB - Module 4 - Newborn Care Graded A+

WDL Newborn Temp

36.5-37.5 (97.7-99.5)

Environmental influences, Crying may ↑ temp; If hyperthermic, unwrap and check again, if hypothermic
put infant skin to skin with mom with warm blanket, or under warmer and recheck

WDL Newborn HR

120-160 bpm

apical pulse

80-100 beats/min (sleeping) to 160 beats/min (crying)

Stabilizes in 8 - 10 hrs after delivery, may be irregular with crying

Some hospitals do initial rectal temp

NWDL:

Tachycardia: persistent, ≥180 beats/min (respiratory distress syndrome [RDS]; pneumonia)

Bradycardia: persistent, ≤80 beats/min (congenital heart block, maternal lupus)



WDL Newborn RR

30 - 60 bpm

Bilateral bronchial breath sounds, Moist breath sounds may be present shortly after birth

NWDL:

Apneic episodes: >20 s (preterm infant: rapid warming or cooling of infant; CNS or blood glucose
instability)

Bradypnea: <30/min (maternal narcosis from analgesics or anesthetics, birth trauma)

Tachypnea: >60/min (RDS, transient tachypnea of the newborn, congenital diaphragmatic hernia)

Breath sounds:

Crackles (coarse), rhonchi, wheezing

Expiratory grunt (narrowing of bronchi)

Distress evidenced by nasal flaring, grunting, retractions, labored breathing

,Stridor (upper airway occlusion)

Newborn Pain Scales

NIPS, CRIES, FLACC

WDL BP

70/45 - 50/30

may vary by hospital

NOT ROUTINELY DONE UNLESS OTHER VS are not WNL. Bradycardia, tachycardia, irregular or murmur
present,

Varies with change in activity level

Appropriate cuff size important for accurate reading

NWDL:

Difference between upper and lower extremity pressures (coarctation of aorta)

Hypotension (sepsis, hypovolemia)

Hypertension (coarctation of aorta, renal involvement, thrombus)

Initial Newborn Assessment - Overall

Do more annoying/irritating things LAST: temp, measurements and reflexes

color - pink, pale, acrocyanosis, jaundice

Skin condition - Umbilical cord, lesions or rashes

Activity, tone, sleep-wake

Newborn nutrition - Intake (method) & Output,

Daily weights changes- % change from birth weight,

Transcutaneous bilirubin

parent ed & attachment

WDL Term Birth Weight

2700-4000 g (6-9 lb)

Acceptable weight loss: 5%-10% or less in first 3-5 days

should regain birth weight by 2 wks

WDL Term Birth Length

48 - 53 cm (19 - 21 in.)

, WDL Head Circumference

32.5 - 37.5 cm (12.5 - 14.5 in.)

Transition

period of 3 stages during which the NB is becoming physiologically independent

First 6-8 hrs most critical

Transition: First Stage

Period of Reactivity

up to 60 min post-birth

- alert, spontaneous startle, tremors, crying, head movements from side to side

- Bowel sounds are audible and meconium may be passed

- Initial HR can be 160-180 bpm, Decreasing to 100-120 bpm after 30 minutes

- Respiratory rate 60-80 with normal variations: irregular rate, fine crackles, grunting, nasal flaring, and
retractions may occur but should resolve within the 1st hour after birth

Infant Feeding Cues:

Initiate breastfeeding as soon as VS stable

- Hand-to-mouth/Hand-to-hand

- Sucking motions

- Rooting

- Mouthing

Transition: Second Stage

↓ Responsiveness

Hours 1-2 post-birth; ~@hour 2 post-birth

pink color, with unlabored respirations up to 60/min

Bowel sounds audible

Infant sleepy and unlikely to sustain a latch

Transition: Third Stage

Second Period of Reactivity

Hours 2-8 post birth

Can last a few min to several hrs

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