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WEEK 6
WEEK 7
week 7
100

Newborn Transition > “CORD IS CUT” 2 THINGS to know

  • Respiratory gas exchange

    • Thermoregulation

100

Acquired disorders: 

Prematurity

  • Increased risk for ALL common neonatal problems including: 


    • ***Respiratory distress*** before 24 weeks no adequate lung tissue 

100

 Infants of substance abuse mothers:

  • Most common substances: tobacco, alcohol, and marijuana

  • Also  Opiates- heroin, methadone  Others- amphetamine 

  • Fetal alcohol syndrome: physical and mental disorders appearing at birth and remaining problematic throughout the child’s life 

  • Neonatal abstinence syndrome: drug dependency acquired in utero manifested by neurologic and physical behaviors

200

Factors affecting transition in the first few hours: what to prevent and what do we want


  • Prevention of cold stress

  • “SKIN TO SKIN!!”

200

What is RDS? management? 

   Etiology: ***Lack of surfactant                            

    - Weak respiratory muscles 

    - Compliant chest wall --  “hyaline membrane” forms from necrotic cell debris

  • Management: **prevention is KEY**

  • CPAP, mechanical ventilation 
200

 Hyperbilirubinemia: in 1st 24hrs:

  • Hyperbilirubinemia in general- Imbalance in rate of bilirubin production and elimination

Pathologic jaundice (within first 24 hours of life)     

300

-Nursing Care of newborn in Delivery and nursery:

  • EQUIPMENT:  bulb syringe (mouth first, then nose), stethoscope, ambu bag, oximeter, suction, 02, radiant warmer w/ skin temp. probe

  • APGAR

  • Umbilical Cord 2 Arteries 1 Vein

  • Eye Prophylaxis

  • Fontanels

  • Vitamin K Injection

  • (Phytonadione)Gestational Age Assessment (GAA)Measurements Birth weight Head Circumference

  • Length Considerations

  • Keep Warm, ID Bands







300

***MAS... what are babies at risk for 

how do we suction 

impaired gas exchange, don't want baby to cry!! resp risk !!! Mouth to Nose SUCTION

300

Nursing Care Hyperbilirubinemia: prompt recognition

  • ABO incompatibility

  • Notify provider

  • Obtain Bilirubin levels, Blood type, H/H

  •  Coombs testing (direct-presence of mom’s blood in newborn)

400

  • ***APGAR score - be able to determine based on scenario

  • Appearance 

  • Pulse

  • Grimace 

  • Activity 

  • Respiration 

400

IDM who's @ risk 

complications 

ALL infants of diabetic mothers AT RISK!!!! ***Degree of risk r/t level of glucose control*

complications (both types): 

- Macrosomia (LGA)         - Respiratory distress Syndrome

- BIRTH trauma/ asphyxia    - Hypoglycemia (first 1-3 h.) 

400

 TEF: Assessment

  • Polyhydramnios, Copious frothy bubbles of mucus and drooling; abdominal distention,  Coughing, choking, and cyanosis

  • Sometimes along with other defects- cleft palate/ NTDs/ cardiac defects

  • Nursing Management: Preparation for surgery and preoperative care, NPO- Do not feed!, IV fluids, Oxygen and suctioning equipment available, Reflux meds/ antacids,   TPN and antibiotics; oral feedings usually within 1 week

500

-Thermoregulation:

  • Potential Consequences: (more extreme than with mature infants)

***hypoglycemia, respiratory distress***

500

Neonatal Hypoglycemia how do we measure this ?

management /TX:

  • Glucose level <30 in the first 72 hours of life  

  • Heel stick <45- obtain a venous sample and send to lab

  • Tx:  early feedings, IV fluid /c Dextrose, neutral thermal environment
500

 open organ malformations (Gi/ bladder): what to do 

protect sac

maintain fluid loss