IMMEDIATE CARE

OF THE NEWBORN
MENDEZ , MORALES, PALIN, PINSOY, QUIMCO,
ROBLE, SIGATON, SUSI, TACBAD, UY, WONG, LUCHAVEZ
 Assessments for Newborn Babies

● After birth, newborn babies are carefully checked for problems or

complications. Throughout the hospital stay, physicians, nurses, and other
care providers continually assess each infant for changes in health and signs
of illness.
● One of the first assessments is a baby’s Apgar score. At one minute and five
minutes after birth, infants are checked for heart and respiratory rates,
muscle tone, reflexes, and color. This helps identify babies that have
difficulty breathing or have other problems that need further care.
Your Baby’s Maturity

Maturity assessment is helpful in meeting a baby’s needs if the dates of a pregnancy are uncertain. For example, very small babies
may actually be more mature than they appear by size and may need different care than premature babies.

An examination called the Dubowitz/Ballard Examination for Gestational Age is often used. This check evaluates a baby’s
appearance, skin texture, motor function, and reflexes. The physical maturity component of the exam is conducted within the first
two hours of birth. This looks at your baby’s skin, eyes, ears, chest, genitals, and feet, since these areas of the body look different at
different stages of maturity.

Next, within 24 hours after delivery, the Dubowitz/Ballard Examination looks at six aspects of the baby’s neuromuscular system.
These include:

 Posture

 How far the hands can be flexed toward the wrist

 How far the arms spring back to a flexed position
 How far the knees extend
 How far the elbows can be moved across the chest

 How close the feet can be moved to the ears?

Additional Tests
After birth, all newborns receive eye drops or an antibiotic ointment in their eyes. This is required
by law to protect the baby from an unknown gonorrhea infection in the mother.
Most babies also receive a vitamin K injection in the upper thigh. Vitamin K is an essential
component of blood clotting. The injection helps prevent a serious problem called vitamin K
deficiency bleeding.
Finally, nearly all babies will have a simple blood test to check for disorders that are not apparent
immediately after delivery. Some of these disorders are genetic, metabolic, or blood- or hormone-
related. Your newborn may also undergo a hearing test.
All of these examinations are important ways to learn about your baby’s well-being at birth. By
identifying any problems, your baby’s physician can plan the best possible care.
 
B.NURSING
DIAGNOSIS
Complete Physical Exam

Because birth weight is an important indicator of

health, babies are weighed daily in the nursery.
This indicates their growth, as well as their fluid
and nutritional needs. Newborn babies may lose
as much as 10 percent of their birth weight.
In addition, each newborn undergoes a complete
physical examination. Care providers evaluate vital
signs, including temperature, pulse, and breathing
rate. They also check the infant’s general
appearance from head to toe, looking at
everything from soft spots on the skull to
breathing patterns to skin rashes to limb
movement. Your baby’s head circumference,
abdominal circumference, and length will also be
measured
PLANNING AND INTERVENTION
The Apgar scoring is done during the first 1 minute and 5 minutes of life. The heart rate, respiratory
rate, muscle tone, reflex irritability, and color are evaluated in an infant. Apgar score is the baseline
for all future observations.

Indicator 0 1 2

A Activity Absent Flexed arms and legs Active

P Pulse Absent Below 100 bpm Over 100 bpm

Minimal response to Prompt response to

G Grimace Floppy
stimulation stimulation

Pink body, blue

A Appearance Blue; pale Pink
extremities

R Respiration Absent Slow & irregular Vigorous cry

 Each parameter can have the highest score of two and the lowest is 0.
 The scores of the five parameters are added to determine the status of
the infant.
 EVALUATION
 With every newborn contact, respiratory evaluation is necessary because this is the
highest priority in newborn care.

 The Silverman and Andersen index can assess respiratory distress and its varying degrees.
 There are five criteria to evaluate the newborn: chest movement, intercostals retraction,
xiphoid retraction, nares dilatation, and expiratory grunt.
 The highest score for each criterion is 2, and the lowest is 0.
 The lowest overall score is 0, which indicates that there is no respiratory distress.

 A score of 4 to 6 shows moderate distress and 7 to 10 indicates severe distress.

 The scores of the Silverman and Andersen index are opposite the Apgar scoring.
 DOCUMENTATION

 Physical examination is done to detect any observable conditions and physical defects.
 This assessment is done quickly by the healthcare provider while noting important findings and at the same time
avoids overexposing the newborn.
 The most important assessment before anything else is the respiratory assessment.
 The newborn’s height and weight can determine their maturity and establish baseline data of their height and weight.
 The newborn is weighed daily at exactly the same time to note any abnormal weight loss or gain.
 Some of the laboratory tests performed for newborns is the heel-stick test for blood studies.
 Glucose measurement is also possible through the heel-stick test to detect hypoglycemia.
 The newborns are also subjected to behavioral capacity assessment where term newborns are physically active and
emotionally prepared to interact with the people around them than preterm newborns.
THANK YOU…