New Born Care

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S.NO TIME SPECIFIC CONTENT TEACHING LEARNING A.

V EVALUATION
OBJECTIVES ACTIVITY ACTIVITY AIDS

INTRODUCTION

The healthy new born is defined calculated due


Introduce date. Healthy new born cries immediately after
The topic birth, establishes independent rhythmic respiration,
1 2min
quickly adapts with the extra uterine environment,
Lecture listening What is the
having an average birth weight & no congenital
Cum and ppt Introduction
anomalies.as one born anytime from 37 weeks to
discussion understandin
42 weeks or a few weeks before or after the
g

Nursing care of healthy new-born baby after birth


should be provided as immediate care of new born of
the neonates and daily routine care. Nurses play critical
roles in neonatal care at all levels of the health system.
1.Care for Term Baby:-
Define the
term baby
Definition of term baby:-
"Term" baby is defined as one born anytime
2 1min Lecture What is the
from 37 weeks to 42 weeks or a few weeks before Cum
listening Term baby
or after the calculated due date. discussion and
understandin
Define g
Immediate
Care of
New-born
(i)IMMEDIATE CARE:-
3
13min
Immediate basic care of the new born at birth
includes maintenance of temperature,
establishment of open airway, initiation of
breathing and maintenance of circulation.

Care of the Baby in the Delivery Room:-


Physical changes occur with birth. When the baby
is delivered, the umbilical cord is cut and clamped. What is the
Stimulating the baby to cry by massage and Lecture Immediate
stroking the skin can help bring the fluid up where Cum care of new-
it can be suctioned from the nose and mouth discussion listening born
and
understanding
Providing warmth for the new-
born:-A new-born baby is wet from the
amniotic fluid and can easily become cold. Placing
a baby skin-to-skin on the mother's chest or
abdomen also helps to keep the baby warm.

Cleaning of airway:-Immediately after What is the


birth the baby should cry and breathe. In order to Cleaning of
promote breathing, the airway to be cleared of Lecture Airway
mucus and any other secretions. Gentle suction of Cum
mucus should be done. If the baby does not cry discussion listening
and breathe within a minute, resuscitation must be and
done. understandin
g

Initial assessment:-The most essential


assessment is the “First cry”. Good cry helps in
establishment of satisfactory breathing. The
respiration, heart rate & skin colour are the basic
criteria which should be evaluate immediately to
determine the end for life saving support.
Immediate examination at birth:
Apgar score: Another significant assessment
of the neonates is Apgar score. Apgar score was
shown by Dr. Virginia Apgar. It is quantitative
assessment of neonate’s condition at birth. Five
objective criteria are evaluated at 1 minute & 5
minutes, after the neonates body is completely
born. it is the best available indicator to tell the
physiological status of the neonate and its ability to
adjust to the extra uterine life immediately.

Define the
Apgar

Total score = 10
No Depression: 7-10
Mild Depression: 4-6
Severe Depression: 0-3. Lecture
listening
Usually neonates have lower score at one minute, Cum and
than the score at 5 minutes due to the presence of discussion understandin
depression immediate after birth. The 5 minutes g
score has greater predictive value, since it
correlates with neonatal morbidity & mortality.

Explain the
Umbilical
Cord
Care of Umbilical cord:-
WHO recommendations- Umbilical cord cutting is
now after 2min of birth is recommended so that
child has the benefit of getting blood. The cord
should be cut with a sterile blade about 3-5 cm Lecture
away from the skin. The cord should be kept dry. Cum listening
Special instructions should be given to the mother discussion and
and family not to apply anything e.g. any oil, ash understandin
on the cord. g

Drying of Baby:-
The baby should be thoroughly dried to prevent
from getting cold. Blood or meconium on the
baby's skin should be wiped away however, the
vernix caseosa should not be wiped off.
The care of eyes include wiping of each eye from
inside to outside with sterile swabs, one for each
eye as the child is born before he opens the eye.
At the time of drying itself the baby should be
assessed. If the baby is not breathing well then the
steps of resuscitation have to carried out.

What is vital
Signs
Define the
Daily care of
New-born
13min
baby Normal vital signs:-

Temperature- 36.5 to 37.5 C


Pulse rate- 120-160 beat per min Lecture
Respiration rate :- 30 to 60 breaths per min Cum
B.P. - Average 60/40 mm Hg discussion listening
and
What daily
understanding
Care
(ii) DAILY CARE:-
4
The major goal of nursing care of the new born
infant is to establish and maintain homeostasis that
is stability in the normal physiological status.
Majority of the complications of the normal
neonates may occur during 1st 24 hrs. or within 7
days. The daily routine care of the neonates are as Lecture
follows: Cum
discussion listening
Warmth :-Warmth is provided by keeping the baby and
dry and wrapping the baby with adequate clothing understanding
in two layers ensuring head and extremities are
well covered .Baby should be kept by the side of
the mother, so that the mother's body temperature
can keep the baby warm.
Breastfeeding:-The baby should be feed on What is
Skin care
demand or in every 2-3 hours. Bottle feeding
should not be done as it is neither required nor safe
for the baby. Strict instructions should be given to
the mother and family.

Skin care :- The baby should be thoroughly


dried to prevent from getting cold. Blood or
meconium on the baby's skin should be wiped
away however, the caseosa vernix should not be
wiped off. Lecture
Cum
discussion listening
and
Baby bath:- Initially baby bath is not understanding
recommended but it can be given at hospital or
home following the instructions for bathing . It
should be given using warm water in a warm room
gently and quickly. The baby should be dried
immediately and wrapped in a dry warm towel.

Care of the umbilical cord:-. The


cord should be kept dry. Special instructions
should be given to the mother and family not to
apply anything e.g. any oil, ash or cow dung on the
cord. Such customs cause increases the danger of
tetanus infection. The cord dries, shrinks and falls
off within 5-8 days.
Care of the eyes:-The care of eyes include
wiping of each eye from inside to outside with
sterile swabs, one for each eye at birth and once
every day. Application of kajal must be avoided.

Clothing of the baby:- The baby should Lecture


be dressed with loose, soft and cotton cloths. Baby Cum
clothing should always be cleaned with light discussion listening
detergent that will be washed properly and sun and
dried. understanding

General care:- The baby should be kept


with the mother for continuous mothering in
hospital (bedding-in) or in home (rooming -in) in a
well-ventilated room. General cleanliness should
be maintained. Tender loving care should be given
to the baby.
Observation:- The baby should be Lecture
thoroughly observed twice daily for early detection Cum
Define the of any abnormalities Discussion listening
Preterm and
Baby Weight recording:- The average daily understanding
weight gain healthy term babies is about 30g/day
2min in first month of life. It is about 20g/day in the
second month and
.

10g/day afterwards during the first year of life.

Explain the  Immunization:


Management
Of preterm
baby Immunization is beneficial for baby. Schedule as What is the
15min follows:- Preterm
baby

2.CARE OF PRETERM BABY:-


Preterm baby: Preterm is defined as babies born
alive before 37 weeks of pregnancy are completed.
There are sub-categories of preterm birth, based on
gestational age: Lecture
5
extremely preterm (<28 weeks) Cum
very preterm (28 to 32 weeks) discussion
moderate to late preterm (32 to 37 weeks). What is the
listening
management
and
Management:- understanding
of preterm
baby
Care of preterm at birth:-
Efficient resuscitation and prevention of
hypothermia is important aspects of care at birth.
Delayed cord clamping is helpful to prevent
anaemia.
6 Warm chain:- The “warm chain” is a concept Lecture
introduced to describe a set of interlinked Cum
procedures, which will minimize the likelihood of discussion

hypothermia. Failure to implement any one of


them will break the chain and increase the listening
possibility of undesirable cooling of the infant. and
understanding

The link in the “warm chain” includes:


(1) Warm delivery room
(2) Immediate drying
(3) Skin-to-skin contact
(4) Breast-feeding
(5) Postpone bathing and weighing of the new-
born
(6) Appropriate clothing and bedding
(7) Keeping mother and baby together
(8) Warm resuscitation
(9) Training and awareness

(b)Maintenance of breathing:-
Baby should be positioned with neck slightly
extended and air passage to be cleared by gentle
suctioning.O2 inhalation can be given if Lecture
necessary. Cum
discussion

(c)Maintenance of stable body


listening
temperature:- and
Baby should be received in a pre-warmed radiant understanding
warmer or incubator. Baby’ temperature should be
maintained 36.5-37.5 C. Kangaroo mother care can
be given when the baby’s condition stabilizes.

Kangaroo mother care:-


KMC is a special way of caring LBW infants by
skin to skin contact. It promotes their health and
welling by effective thermal control, breastfeeding
and bonding.
KMC has three parts: Lecture
Skin-to-skin contact between the baby's front and Cum
the mother's chest. discussion

Exclusive breastfeeding
listening
Support to the dyad and
understanding

(d)Maintenance of nutrition and


hydration:-Calorie needs of non-growing
preterm babies during 1st week of life are
60kcal/kg/day. After 1st 1-2 weeks of life most
preterm babies require 120 to150 kcal/kg/day to Lecture
maintain satisfactory growth. Cum
discussion

(e)Prevention of infection:-Preterm
babies are prone to infections due to poor listening
immunity so clean and aseptic techniques should and
be used while taking care of babies. understanding

(f)Gentle rhythmic stimulation:-


Sensory stimulation to be provided to the preterm
babies by talking, singing, gentle touching during
care

(g)Prevention, early detection and


prompt management of
complication:-The baby be should be
observed for respiration, skin temperature, heart
rate, skin colour, activity, cry, feeding behaviour,
passage of meconium or stool and urine, condition Lecture
of umbilical cord, eyes and oral cavity, any Cum
abnormal signs like edema, bleeding, vomiting etc. discussion

(h)Rooming in, discharge


listening
planning ,follow-up:-Rooming in:- and
Mothers with babies who have spent time in the understanding
Neonatal Critical Care Unit are encouraged to
room-in for 24 to 48 hours prior to being
discharged from hospital.

Summary:
In new-born care define the term and preterm care
of new-born.
Provide the proper care of the new-born such as
warmth provide to the baby and oxygen to the
preterm baby ,cord care of the baby and proper
management of the preterm baby and check the
apgar score of the new-born to identify the any
abnormalities present in the new-born

Lecture
Cum
discussion

listening
and
understanding

Conclusion
At the end of the class student were able to
introduce the topic new-born care.
So I far took the class ,conclude that student has
understand the topic and I achieve positive
feedback from them.
Bibliography :-

D.C Dutta’s. “Text book of Gynaecology and


obstetrics” New Central Book Agency 6th edition
Pp. 444-466
Wong’s , essential of pediatric nursing 8th edition
page no 20-40
Parul Datta “Pediatric Nursing” Jaypee Brothers
Publications Pvt Ltd 3rd edition pp-50-
110Meharban Singh (2004), Care of New born ,
6th edition, Sager Publications
B. T. Basavanthappa(2006), Text book of
Midwifery & Reproductive Health Nursing, 1st
edition , Jaypee Brothers Publications Pvt Ltd

Littleton, L.Y., & Engebretson, J.C. (2005).


Maternity nursing care. Clifton Park, NY:
Thomson Delmar Learning

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