NURS 2866 Ch. 23 - Nursing Care of the Newborn and Family

What is the primary goal of immediate newborn care?

Successful transition to extrauterine life.

What are the priority assessments in the first two hours of life?

Respiratory function, cardiac function, and infant security.

When is the APGAR score assessed?

At 1 minute and 5 minutes after birth.

What are the five components of the APGAR score?

Heart rate, respiratory effort, muscle tone, reflex irritability, color.

What APGAR score range indicates severe distress?

0–3.

What APGAR score range indicates moderate distress?

4–6.

What APGAR score range indicates minimal or no difficulty?

7–10.

When is the gestational age assessment completed?

Within the first hours of life.

What does the gestational age assessment evaluate?

6 physical characteristics and 6 neuromuscular signs.

What does the initial physical assessment include?

Length, weight, head circumference, and vital signs.

Which vital signs are included in newborn assessment?

Axillary temperature, heart rate, respiratory rate, and BP (if cardiac issues suspected).

What does AGA stand for and mean?

Appropriate for Gestational Age; weight between 10th–90th percentile.

What does LGA stand for and mean?

Large for Gestational Age; weight >90th percentile.

What does SGA stand for and mean?

Small for Gestational Age; weight <10th percentile.

What defines a preterm newborn?

Less than 37 weeks gestation.

What defines a full-term newborn?

39 weeks to 40 weeks + 6 days.

What defines a late-term newborn?

41 weeks to 41 weeks + 6 days.

What defines a post-term newborn?

42 weeks or more.

What are key nursing interventions in the first 2 hours after birth?

Maintain airway, maintain body temperature, administer eye prophylaxis and Vitamin K.

What is the focus of ongoing newborn assessment after 2 hours?

Detect concerns or abnormalities, monitor for birth problems.

What is the most common birth injury?

Fractured clavicle.

Which infants are most at risk for birth injuries?

LGA (Large for Gestational Age) infants.

How often should newborns be assessed for jaundice?

Every 8 to 12 hours.

How is jaundice assessed?

Press fingertip on bony area, look for yellowing after release.

What should be done if jaundice is observed in the first 24 hours?

Check transcutaneous bilirubin; if elevated, get serum bilirubin via heel stick.

What is the treatment for jaundice?

Phototherapy.

What types of phototherapy exist?

Lamp, blanket, sleep sack-style devices.

How does phototherapy work?

Converts unconjugated bilirubin to an excretable form.

What nursing care is needed during phototherapy?

Eye protection, diaper only, reposition every 2–3 hours, monitor hydration.

What are risk factors for neonatal hypoglycemia?

Preterm, SGA or LGA, low birth weight, maternal diabetes, stress, cold or respiratory stress.

What is the glucose threshold in the first 72 hours?

40–45 mg/dL.

What are symptoms of neonatal hypoglycemia?

Jitteriness, lethargy, poor feeding, abnormal cry, low tone, hypothermia, respiratory distress, apnea, seizures.

What is the purpose of newborn screening?

Detect genetic disorders early to prevent complications.

How is newborn screening performed?

Heel stick at 24 hours; blood placed on filter paper and sent to lab.

What is the purpose of hearing screening in newborns?

Early detection of hearing loss.

When is hearing screening done?

Before discharge or by 1 month of age.

What is the purpose of congenital heart disease screening?

Detect hypoxia and congenital heart defects.

When is congenital heart screening done?

At 24–48 hours of age.

How is congenital heart disease screening performed?

Pulse oximeter on right hand and one foot.

What are the passing criteria for congenital heart screening?

≥95% O2 and <3% difference between extremities.

What are the failing criteria for congenital heart screening?

What are the components of a protective newborn environment?

Safe sleep education and infant security measures.

What are the guidelines for safe infant sleep?

Alone, on back, in crib with no blankets or toys.

What is the infant security system in hospitals?

Infant wears a security tag that sets off alarms if removed.

What vaccine may be given at birth with consent?

Hepatitis B.

When is circumcision usually performed?

Within the first few days of life.

What are two common circumcision methods?

Gomco clamp and Plastibell device.

What is essential nursing care after circumcision?

Monitor for bleeding and urinary output; educate parents.

What are behavioral signs of pain in newborns?

Crying, facial expressions, and body movements.

What facial expressions indicate pain in newborns?

Grimacing, brow contraction, eye squeeze, quivering tongue.

What pain assessment tool is used in newborns?

PIPP (Premature Infant Pain Profile) scale.

What non-pharmacological methods relieve newborn pain?

Swaddling, pacifier, oral sucrose.

What topics are covered in discharge teaching?

Thermoregulation, airway clearance, feeding, elimination, safe sleep, car safety, cord care.

How should parents be taught to maintain infant temperature?

How to check and regulate body temp.

What should parents know about using a bulb syringe?

Use for clearing airway during choking or spit-up.

What is taught about feeding and elimination?

When to feed, what stools/urine look like, frequency, and warning signs.

How is car seat safety addressed?

Teach correct car seat use.

What is taught about umbilical cord care?

How to clean and care for the cord stump.