Nursing Care Of Newborn With Special Needs

Front 1

Perinatal asphyxia

Back 1

Assessment fetal distress bradycardia deceleration low apgar score potential meconium passage into the amniotic fluid nursing implications possible problem assess for maternal risk factors initiate resuscitation measures immediately at birth

Hint 1

we're going to resuscitate

Front 2

Thermoregulation

Back 2

Irritability high-pitched cry skin cool to touch cyanosis of hands and feet wheezing crackles retraction restlessness lethargy hypotonia quit Qui seizures poor feeding grunting acidosis

Hint 2

Eliminate source of heat loss dry dry newborn wrap in warm blanket used radiant heat source

Front 3

Hypoglycemia

Back 3

Less than 40 do early feeds check it if does not work give IV of d-10

Front 4

Meconium

Back 4

Initiate resuscitation suction Airway and support ventilation post term likely to have it due to hypoxia

Front 5

Hyperbilirubinemia

Back 5

Adequate hydration early feeding administer phototherapy

Front 6

Birth trauma

Back 6

Assessing clavicles humorous plexus injury assess Moro reflex

Front 7

Polycythemia

Back 7

Goal is greater than 60% hydration partial exchange transfusion albumin or normal saline IV to reduce RBC volume and increase fluid volume blood is viscous

Front 8

Hypoglycemia with large

Back 8

Early feed

Front 9

Post term newborn

Back 9

Postern is not working New born less than normal due to placental function dry cracked peeling wrinkled skin vernix serosa and lanugo or absent long thin extremities creases that cover the entire soles of the feet wide I'd alert expression abundant hair on scalp then umbilical cord long fingernails limited vernix and lanugo meconium stained skin and fingernails

Front 10

Preterm respiratory system

Back 10

Surfactant deficiency leading to the development of respiratory distress unstable chest wall leading to atelectasis immature respiratory control centers leading to apnea smaller respiratory passage leading to an increase risk for obstruction inability to clear fluids from passages leading to transient tachypnea

Front 11

Preterm cardiovascular system

Back 11

Increased incidence of congenital anomalies associated with continued fetal circulation Peyton ductus arteriosus and an open Forum in Oro Valley in addition impaired regulation of blood pressure and preterm newborns may cause fluctuation throughout the circulatory system one of the special note is cerebral blood flow which may predispose the fragile blood vessels in their brain to rupture causing intracranial hemorrhage may have murmurs

Front 12

Newborns gastrointestinal system

Back 12

Babies can't suck swallow and breathing regimen accessory for sufficient calorie and fluid intake to support growth so baby will have enteral feeding involves the introduction of small amounts usually so perfect to 1 ml enteral feeding to induce urges formulas given via gavage tube feed prepares the gut to absorb future introduction

Front 13

Resuscitating the newborn determining the need for suscitation I perform a rapid assessment

Back 13

What is the newborns heart rate what is the gestational age of the newborn was the amniotic fluid clear all meconium is the newborn breathing or crying now does the new one have good muscle tone resuscitation is done until newborn has a post about 100 a good healthy cry or good breathing effort and a pink tongue

Front 14

To stimulate respiration

Back 14

Successful breathing back the newborn if not breathing Place pulse oximeter on newborns right hand to determine oxygen saturation ventilation if needed access heart rate chest compression if needed administration of epinephrine or volume expansion

Front 15

Pain management

Back 15

Signs of pain facial expression body movement and physiologic changes such as oxygen saturation give appropriate size pacifier for Comfort during painful procedures administration of oral sucrose with and without not interested suction and warmth is also frequently used as a non pharmacology intervention for procedural pain relief in neonates the recommended sucrose concentration is 24% solution

Front 16

Psychometric tools used to assess pain in the newborn

Back 16

includes p i p p premature infant pain profile which assesses heart rate and oxygen saturation cries tool which is cry requires oxygen increase Vital Signs expression and sleeplessness and the neonatal infant pain scale nips which evaluate respiratory pattern most are based on facial expressions crying pattern change in Vital Signs and body movements

Front 17

Suspect pain if the newborn exhibits the following

Back 17

Sudden high-pitched cry facial grimacing following of brow and craving chin increased muscle tone oxygen desaturation increase in heart rate body posture and so just squirming kicking arching lamp withdrawal and thrashing movements increase blood pressure pulse and respiration fussiness and irritability