Newborn care & Nutrition Ch 17 & 18

What is the transition that is occuring in the first minutes of life?

• Transitining to extrauterine life

• Respiratory: Lung fluid clears; effective breathing expands alveoli and increases oxygenation.

• Circulatory: Pulmonary resistance falls; fetal shunts begin physiologic closure.

• Thermal/metabolic: Heat loss rises immediately; energy and glucose needs increase. → if baby is cold this can lead to glucoise drop as they have to use energy to keep them warm

What are the components of APGAR?

• Record at 1 and 5 minutes; continue per protocol if low.

• Appearance; Color: 0 blue/pale; 1 blue extremities(acrocyanosis); 2 pink overall.

• Pulse; Heart rate: 0 absent; 1 below 100/min; 2 at least 100/min.

• Grimace; Reflex response: 0 absent; 1 grimace; 2 active cry/withdrawal.

• Activity; Tone: limp/flexed/active.

• Respiration; Breathing: absent/slow or irregular/strong cry

What are the immediate nursing priorities of a newborn?

• Standard care follows the infant’s clinical status and local protocol.

• Assess respirations and heart rate; escalate apnea, gasping, or poor perfusion.

• Dry promptly; use warm blankets, a hat when appropriate, and skin-to-skin if stable.

• Support early parental contact and feeding; avoid unnecessary separation.

• Verify identification and security measures with the family.

• Administer indicated prophylaxis and complete ongoing transition assessments.

  • Vit K & erythomycin given at birth; for coagulation & treatment of bacteria that may have been contracted in birth canal

What are the appropiate vitals of a newborn?

• Respirations: Approximately 30–60/min; assess rate for a full minute, effort, and breath sounds.

• Heart rate: Often around 110–160/min; varies during sleep, crying, and transition.

• Temperature: Target normal axillary temperature roughly 36.5–37.5°C (97.7–99.5°F).

• Perfusion: Assess central color, capillary refill, pulses, activity, and feeding

What are the four routes of newborn heat loss?

• Evaporation; Wet skin after birth → dry immediately and remove damp linen.

• Conduction: Contact with a cold scale or surface → warm contact surfaces.

• Convection; Drafts or cool air → minimize exposure and keep room appropriately warm.

• Radiation; Cold nearby wall/window → move away from cold surfaces.

What is expected/observed in head to toe assessment of newborn?

• Overall appearance: tone, symmetry, color, cry, growth measurements.

• Head/neck: molding, caput vs cephalohematoma, fontanelles, palate, clavicles.

  • Capt when head is cone shaped, cephelohemotoma is collection of blood on head d/t ruptured blood vessels during birth

  • Clavicles can break during birth can’t cast it would imoblize arm or just not use that side to promote healing

• Cardiorespiratory: work of breathing, heart sounds, femoral pulses, perfusion.

• Abdomen and GU: cord, bowel sounds, genitalia, patent anus, urine/stool.

  • Immediatly after birth would not expect bowl sounds bc have not eaten yet

  • Genetalia may be swollen, female can have vaginal discharge, pseudomenses (from Moms hormones) or even mild from nipple (rare)

  • Teste may not have descended in male can happen would wait and see and if noit do sugery to bring them down

  • Want minimum 1 pee or poop within 24hrs

• Musculoskeletal/neurologic: hips, spine, extremities, Moro, rooting, suck, grasp

  • Refluxes indicate the neurological system is working as it should