BAPTIST HEALTH School of Nursing
NSG 3016A Women’s Health
Nursing Assessment and Care of the Newborn
During Transition and Adaptation to Extrauterine Life
Kathy Marcussen, RNC, MSN
Lecture Objectives:
1.
Describe the newborn’s physiologic changes and adaptations to extrauterine life that
occur at birth and in the transition period.
2.
Apply physiologic adaptations to assessment findings in the newborn.
3.
Outline a newborn physical and gestational assessment to determine deviations from
normal.
4.
Develop a nursing care plan for a normal newborn using priority nursing diagnoses,
assessments, and interventions.
5.
Promote health education and infant safety to parents through appropriate teaching and
anticipatory guidance.
Required Reading:
Wong, Chapters 24 and 25.
Lecture Outline:
I.
Newborn
A.
Transition Period - adaptation/instability/reactivity
B
Immediate Physiologic Adaptions at Birth
C.
1.
Respiratory - first breath!
2.
Cardiovascular - changes in circulatory pattern
3.
Thermogenic - heat production and loss, neutral thermal environment,
temperature regulation
Changes in functioning of systems/Physical Assessment normals/ deviations
1.
Hematopoietic - normals
2.
Renal - fluid balance, urine production
3.
GI/Abdo - flora in gut, stomach capacity
II.
4.
Hepatic - nutrient stores, bilirubin conjugations, physiologic jaundice
5.
Immune - passive immunity
6.
Integumentary - many unusual looks
7.
Reproductive - hormonal influence
8.
Skeletal - more cartilage than bone
9.
EENT
10.
Neuromuscular - intact CNS
Physical Assessment
A.
B.
C.
D.
E.
F.
G.
H.
General appearance
Vital signs
Measurements/proportions
Skin
Head
Chest/Abdomen
Back, extremities
Genitalia
III.
Nursing Care of the Newborn
A.
Estimation of gestational age
Dubowitz, Ballard scales
1.
Neuromuscular
2.
Physical maturity
3.
Calculations
IV.
Care in the Transitional Period
A.
Ineffective airway clearance
B.
Impaired gas exchange
C.
Ineffective thermoregulation
D.
Risk for infection
E.
Risk for hemorrhage
F.
Risk for ineffective family coping
G.
Risk for hyperbilirubinemia
H.
Risk for hypoglycemia/hypocalcemia
I.
Risk for inborn errors of metabolism (hereditary)
J.
Risk for impaired parent-infant attachment; interrupted family processes, etc.
K.
Risk for injury....
V.
Discharge Planning/ Parent Teaching
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
Circumcision care
Temperature
Respirations
Rashes
Car Seat Safety
Bathing
Cord Care
Feeding
Safety/positioning
Follow up care