NUR 134 NEO114
M. Johnston, RN-BC, M.Ed.
OB Clinical Instructor
NSCC
Immediate Post
Delivery
Establish Airway:
Suction with bulb syringe
Stimulate
Check Color:
Acrocyanosis
Prevent Hypothermia:
Clean, stimulate
Provide dry blankets
Check Tone:
Flexion of extremities
Drying to prevent hypothermia
Apgar Scoring
Five categories:
score 0-2
Assessed at:
1 minute
5 minutes
Apgar Scoring Charts
Apgar Scoring
Dr. Virginia Apgar
"Nobody, but nobody, is going to stop breathing on
me!"
Weight
Measure length
Head circumference
Newborn Exam
Warm, dry surface
Adequate lighting
Calm infant
Check vital signs
HR range 110-160
bpm
Resp rate 30-60 min
Temp. 36.5 – 37.5 C
Umbilical cord
3 vessels
2 arteries, 1 vein
(AVA)
Wharton’s jelly
Umbilical Cord
Healing
7-10 days
 Keep clean and dry
Observe for infection
Fontanels
anterior
posterior
Sutures
Head Molding
Vernix
Caseosa
Sebaceous gland
secretions
White, cheesy
protective coating
Develops 3rd
trimester
Decreases as fetus
develops
Milia
sebaceous glands, usu. found on face, nose and chin
subsides spontaneously , reassure parents
Telangiectatic
Nevi
“Stork Bites”
Erythema
Toxicum
Most common face,
trunk, extremities
Found in 70% of
newborns
Peaks at 24-48 hours
old
Lanugo
Fine, downy hair
Develops after 20 wks
gestation
Mostly disappears by 40
wks gestation
Meconium
Mongolian spots
Moro or
Startle Reflex
Normal Newborn Reflexes
Neonatal
Jaundice
Physiological
 Pathologic
 Phototherapy
Phototherapy
Cephalohematoma
Does not cross suture line
Caput Succedaneum
extends across the suture line
usually disappears in 3-4 days
Tongue-tie occurs
in approx. 4% of
infants
Simian Crease
(Single palmar crease)
Club Foot
(Talipes
Equinovarus)
Pilonidal opening
Sacral skin tag
Preterm Neonates
Maternal Infant Bonding
Family Bonding