Nursing care of the neonate

  1. Changes in the cardiovascular systems
    • Ductus arteriosus =ligamentum arteriosum
    • Foramen ovale – closes and becomes fossa ovalisž
    • Ductus venosus constricts and becomes ligamentum venosumž
    • Umbilical vein – becomes ligamentum teresž
    • Proximal portions of the umbilical arteries persist.
  2. Central cyanosis
    • indicative of low blood O2
    • a blue hue to the lips, tongue and central trunk.
  3. acrocyanosis
    blue hue to the hands and feet related to perfusion.
  4. APGAR
    • Activity 
    • Pulse
    • Grimace
    • Appearance 
    • Respiration
  5. Cold stress of the newborn?
    hypothermia can lead to increased respirations causing increased need for O2, glucose, acidemia and surfactant production is impaired
  6. New born medications
    • erythromycin ophthalmic ointment-prophylactic treatment for ophthalmia neonatorum=one time dose
    • vitamin K=stimulates liver formation clotting factors. Eye prophylaxis and vitamin K are required by law in most states
    • Hep B vaccine administered within 12 hours of birth.
  7. Baby heat loss
    • radiation
    • convection
    • conduction 
    • evaporation
    • maintain warm environment
  8. newborn screening for metabolic disorders
    • Phenylketonuria
    • Cystic fibrosis
    • Galactosemia
    • Congenital hypothyroidism
    • Sickle cell trait
    • in oregon newborns are screened for 36 disorders.
  9. Neonate hyperbilirubinemia
    • Unconjugated bilirubin-by product of RBC breakdown-not in an excretable form-must be converted by liver.
    • Kernicterus-bilirubin encephalopathy
    • Total bilirubin serum is checked on newborns
  10. Kernicterus
    • caused by too much bilirubin in the newborn
    • jaundice can appear 24 hours or more after birth. caused by RBC breakdown and the inability of the liver to process, lack of intestinal bacteria, hydration

    Treatment: phototherapy and hydration
  11. Hemolytic disease of the newborn
    • seen at birth or up to 24 hours after
    • Mom with blood type O (ABO Incompatibility)
    • Rh negative mom and a positive baby

    Treatment: exchange transfusion
  12. Breast milk jaundice
    • bilirubin levels rise in the first week of life of the newborn
    • breast milk is high in free fatty acids-bilirubin will drop in 24-48 hours after cessation of breastfeeding.
  13. Neonatal hypoglycemia
    • glucose less than 40mg/dl
    • feeding will reverse this or possible D10 IV infusion
    • baby S&S-poor feeding, irritability, tremors, apnea, seizures, hypothermia, hypotonia-floppy baby syndrome
  14. Alert stages of neonate
    • sleep
    • deep 
    • quit
    • light

    • alert
    • drowsy
    • quit alert-most cooperative
    • active alert 
    • crying
Card Set
Nursing care of the neonate