Newborn care Medical Presentation

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Published on : Apr 19, 2019 | Views : 2663 | Downloads : 10

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HIGH RISK NEW BORN PRESENTED BY, R.NITHYAPRIYA, M.Sc NURSING 1 ST YEAR, CHN SPEACIALITY, KGNC.
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INTRODUCTION
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FACTORS TO DEFINE HIGH RISK NEWBORN Demographic social factors Past medical history Previous pregnancy Present Pregnancy Labor: and delivery Neonate Medical illness of the mother.
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PREDISPOSING FACTORS CAUSES OF HIGH RISK SCREENING OF HIGH RISK CASES GOALS
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DEFINITIONS NEONATE: From birth to under four weeks of the life (< 28 days ), the infant is called neonate or newborn from the 1st week of life (< 7 days or <168 hours) is known as an neonatal period. Late neonatal period extends from 7th day of life to <28th day.
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CONTD-- LIVE BORN: A live-born neonate is a production of conception, irrespective of weight or gestational age after separation from the mother, shows any evidence of life such as breathing, heartbeat, pulsation umbilical cord or definite movement of the involuntary muscle.
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CONTD-- STILLBIRTH: A fetal death is a product of conception that, after separation from the mother, does not shows any evidence of life. A fetal death at a gestational age of 20 to 40 weeks of more or weighing more than 500 gm is designed as still-birth/ still born.
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CONTD-- TERMBABY: Any neonate born between 37 to <42 weeks (259 – 293 days) of pregnancy irrespective of the birth weight. PRETERM BABY: Any neonate born before 37 weeks of gestation (<259 days) of pregnancy irrespective of the birth weight.
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CONTD-- POST TERM: A neonate born at a gestation age of 42 weeks or more (294 days or more) irrespective of the birth weight. LOW BIRTH WEIGHT: Any neonate weighing less than 2500 gm at birth irrespective of the gestational age. VERY LOWBIRTH WEIGHT: Any neonate weighing less than 1500 gm at birth irrespective of the gestational age.
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CONTD-- EXTREMELY LOW BIRTH WEIGHT: Any neonate weighing less than 1000gm at birth irrespective of the gestational age. PERINATAL PERIOD: Prenatal period extends from 22nd week of gestation to less than 7 days of life after birth. NEONATAL MORTALITY RATE: Death of infants under the first 28 days of life per 100 live births per year. POST-NEONATAL PERIOD: Period of infancy from 28 days to under 365 days of life.
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IDENTIFICATION OF HIGH RISK NEWBORNS Early detection of a sick newborn is the key to successful management and improving neonatal outcome. Who is sick newborn? Not feeding well Lethargic Has any systemic illness Has poor weight gain These are infants who require additional support such as oxygen, IV fluids etc.
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CLASSIFICATION OF HIGH RISK NEWBORN
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CLINICAL MANIFESTATION OF HIGH RISK NEWBORN
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MANAGEMENT OF HIGH RISK NEWBORN Assessment of maternal & fetal wellbeing Organizational aspect of management According to their condition the high risk newborn
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NURSING CARE OF NEWBORN IMMEDIATE CARE OF NEW BORN ESSENTIAL CARE OF NEW BORN
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PURPOSES OF NEWBORN CARE
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IMMEDIATE CARE OF NEWBORN
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DEFINITION OF NEWBORN CARE A healthy infant born at term (between 38 -42 weeks) should have an average birth weight for the country(usually exceeds 2500gm),cries immediately following birth, establishes independent rhythmic respiration and quickly adapts to the changed environment.
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TWO CLASSIFICATION CARE AT BIRTH CARE AT NURSERY
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CARE AT BIRTH Soon after delivery, baby should be covered with clean dry linen. Air passage should be cleared of mucous & liquor by gentle suction. APGAR rating should be done clamping & ligature of umbilical cord. Clamping and ligature of the cord Tie identification card Identification of newborn Administration of vitamin k injection Initiation of breast feeding
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ESTABLISHMENT OF OPEN AIRWAY
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MAINTENANCE OF TEMPERATURE
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APGAR SCORE
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SCORE INTERPRETATION
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CLAMPING AND LIGATURE OF THE CORD
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IDENTIFICATION OF NEWBORN
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VITAMIN K INJECTION
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INITIATION OF BREAST FEEDING
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CONTD--
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CARE AT NURSERY
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ADMISSION AT NURSERY
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ROUTINE NURSERY CARE
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MECHANSIM OF HEAT LOSS
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DAILY OBSERVATION CARE
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CONTD--
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CONTD--
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PROVIDE WARMTH
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BREAST FEEDING PREPARATION AND BREAST FEEDING TECHIQUES
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PHYSICAL CARE
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CONTD--
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CONTD--
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HARMFUL TRADITIONAL PRACTICES FOR THE CARE OF NEONATES
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MINOR DISORDERS IN NEWBORN
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NURSING DIAGNOSIS Ineffective airway clearance related to nasal and oral secretions from delivery. Ineffective thermoregulation related to environment and immature ability for adaptation. Risk for injury related to immature defenses of the newborn. Risk for infection related to immature immune system. Risk for impaired gas exchange related to prenatal/intrapartal stressors. Risk for imbalanced nutritional status less than body requirement related to increased metabolic rate/high caloric requirement/ blood glucose level. Risk for constipation related to inadequate fluid intake/ intestinal obstruction. Risk for deficit fluid volume related to delayed feeding/limited oral intake
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