Lowdermilk: Maternity Nursing, 8th Edition Chapter 17: Assessment and Care of the Newborn and Family Key Points

– Print • Immediately after birth, the nurse focuses on assessing and stabilizing the newb orn’s condition, while the physician or midwife focuses on care of the mother. • The immediate assessment includes Apgar scoring and a general evaluation of phys ical status. • The Apgar score is based the nurse’s assessment of the neonate’s heart rate, respira tory rate, muscle tone, reflex irritability, and skin color. • The initial physical assessment includes a brief review of systems. • Immediately after birth, nursing care includes maintaining an open airway, preve nting heat loss, instilling a prophylactic agent into the eyes, administering vi tamin K intramuscularly, providing umbilical cord care, and promoting parent-inf ant interaction. • Gestational age and birth weight are related to perinatal morbidity and mortalit y rates. • A complete physical examination is performed within 24 hours of birth. • Common problems in neonates include soft tissue injuries, skeletal injuries, phy siologic jaundice, hypoglycemia, and hypocalcemia. • Common tests for neonates include newborn screening tests and measurements of bl ood glucose, bilirubin, and drug serum levels. • Ensuring a protective environment for the neonate includes following identificat ion procedures and taking precautions to prevent infection. • During phototherapy, the unclothed infant is placed under a bank of lights. • Suggested benefits of circumcision include a decreased incidence of urinary trac t infection and decreased risks of sexually transmitted infection, penile cancer , and human papillomavirus infection. • The goals of neonatal pain management are to minimize the intensity, duration, a nd physiologic cost of the pain and to maximize the neonate’s ability to cope with and recover from the pain. • To set priorities for discharge teaching, the nurse follows parental cues. • The nurse should teach parents the signs of illness in newborns, especially jaun dice in newborns discharged early. • All parents should be taught infant cardiopulmonary resuscitation.

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