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A. Growth – quantitative increase in physical size of a structure or whole. Two Parameters of Growth: 1.

Weight – the most sensitive parameter of growth  Doubles (2x) in 6 months  Triples (3x) by 1 year  Quadruples (4x) by 2 – 2 ½ years 2. Height / Length – increase by inch per month  Increase 1 inch/month for the 1st 6 months  Increases ½ inch/ month by 7 – 12 months  Average increase in height during 1st year of life is 50%  Approximately ½ of adult height is reached at 2 years. B. Development – increase in the skill or ability (capacity) to function; qualitative change How to measure development? 1. Observe the ability of a child to do a particular task 2. Note the parents description of the child’s progress 3. By DDST (Denver Developmental Screening Test) and MMDST (Metro Manila Developmental Screening Test, Philippine Counterpart) DDST or MMDST’s 4 Main Rated Categories 1. 2. 3. 4. Language – ability to communicate Personal or Social – ability to interact Fine Motor Adaptive (prehensile ability) – ability to use hand movements Gross Motor Skills – ability to use larger body movements.

Immediate Care of the Newborn
8 Priorities of the Newborn in the first days of life 1. 2. 3. 4. 5. 6. 7. 8. Initiation and Maintenance of Respiration Establishment of Extrauterine Circulation Control or Regulation of Body Temperature Intake of Adequate Nourishment Establishment of Waste Elimination Prevention of Infection Establishment of Infant – Parent Relationship Developmental care that balances rest and stimulation for mental development.

Initiation and Maintenance of Respiration 1. How to initiate airway? Support head and remove secretions 2. Proper Suctioning With a Catheter a. Place the head of the baby at the side to facilitate drainage b. Suction the mouth first then the nose (Newborns are obligatory nasal breathers – to prevent aspiration) c. Suction for 5 – 10 secs only. Suction circularly, quickly, and gently. Prolonged suctioning of more than 5 – 10 seconds can cause the ff: 1. Hypoxia ( decreased o2) 2. Bradychardia ( due to vagal nerve stimulation) 3. Laryngospasm or Spasm of the Larynx (larynx contracts & can’t relax) Establishment of Extrauterine Circulation a. Tangential Foot Slap  To increase pulmonary circulation  So the baby will cry and lungs will expand Cry  Expand of Lungs  Increase pressure on the Left Side of the Heart causes the closure of Foramen Ovale. b. Assess the characteristics of the Newborn’s Cry  Normal Cry: Strong, Vigorous, Lusty Cry  Abnormal: a. Cri – Du chat Cry (Cat Like Meow Syndrome) b. Hypoglycemia (↓ glucose in brain) or Increased ICP – high – pitched, shrill cry (low tone cry)  Never stimulate baby to cry while secretions aren’t fully removed to prevent aspirations Best Position of the Baby - right side lying to increase pressure on the left side of the heart to facilitate closure (Foramen Ovale and Ductus Arteriosus closes within 24 hours)

Control or Regulation of Temperature
 Maintain Normal Temperature: 36.4 – 37.2 Celsius  Deviations: a. Hypothermia or Cold Stress (<36.4C) b. Hyperthermia (>37.2) Factors that leads to Hypothermia 1. 2. 3. 4. Thin skin Inability to shiver Inadequate Subcutaneous tissue (insulators) Prematurity (immaturity of thermoregulatory system of the body --- Hypothalamus)

Problems Related to Hypothermia or Cold Stress 1. Hypoglycemia – due to utilization of glucose  Normal: 45 – 55 mg/dl of sugar in newborns  Average: 40 mg/dl of sugar in newborns 2. Metabolic Acidosis  Due to catabolism (breakdown) of the brown fats leading to the formation of ketone bodies  Increases Lactic Acid  Brown Fats are special tissue of newborns; best insulator 3. Kernicterus  Accumulation of bile or biliburin in the brain leading to irreversible brain damage soon as cerebral palsy. 4. Additional Fatigue added to already stressful heart. Process of Heat Loss 1. 2. 3. 4. Convection Conduction Radiation Evaporation

Nursing Interventions to Prevent Hypothermia or Cold Stress 1. Dry and Wrap baby in a blanket (to prevent Evaporation Heat Loss) 2. Mechanical Measures (to prevent Conduction Heat Loss)  Radiant Warmer  Place in ISOLETTE or BASINETTE or INCUBATOR  Pre – warmed first 3. Prevent unnecessary exposure and cover areas not being examined 4. Skin to Skin contact, Embrace the baby, Kangaroo Care – body touch against the mom’s skin.