Normal Neonates This is the slideshare about normal neonates with perspective of B.Sc. Nursing students. #Slideshare on Normal Neonates for Bsc Nursing students. #Assessment and management of Normal Neonates in Obstetrics #Education #Nursing # Initial, daily assessment of normal neonates and physiology of neonate. #Minor disorders of normal newborn and their management

1. ASSESSMENT &
MANAGEMENT OF NORMAL
NEONATES

4. INITIAL AND DAILY ASSESSMENT
• 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. Thishelpsidentifybabiesthat have difficultybreathingor have other problemsthatneed furthercare.
• Contour, proportions, and postures
• The body of a normal newborn is essentially cylindrical; head circumference slightly exceeds that of the chest. For
a term baby, the average circumference of the head is 33–35 cm (13–14 inches), and the average circumference
of the chest is 30–33 cm (12–13 inches).5 The infant's sitting height, measured from crown to rump, is
approximately equal to the head circumference. These values may vary somewhat, but their relation to each
other is normally constant. Values should be plotted on an appropriate preterm or term growth chart to evaluate
the neonate's head for the presence of microcephaly or hydrocephaly.
• During the first few days of life, the infant's posture is largely the result of its position in utero. The normal infant
who was delivered from a vertex presentation tends to assume a relaxed fetal position. During the first days of
life, it is the “position of comfort” for the infant. Crying episodes can often be ended by taking the infant from the
crib and gently curling him or her into the fetal position.
• Other postures are associated with more unusual infant positions. After a footling breech presentation, the thighs
are abducted in the “frog-leg” position. Infants born in the frank breech position tend to keep their knees in the
jackknife posture. After a brow or face delivery, the head is extended and the neck appears elongated, but
posture of the spinal column is normal. Normal postures depend on normal muscle tone, which may be visibly
diminished in hypoxic infants, who do not maintain intrauterine postures but remain in almost any position
imposed on them.

27. Newborn

43. MINOR DISORDERS OF NEWBORN

70. THE CLASSIFICATIONS OF LEVELS OF NICU IS DEFINED ACCORDING TO
THE LEVEL OF COMPLEXITY OF CARE PROVIDED:
• LEVEL I NEONATAL CARE (BASIC)
• This is a well-newborn nursery: and has the capability to:
• Provide neonatal resuscitation at every delivery
• Evaluate and provide postnatal care to healthy newborn infants
• Apgar score < 6
• Stabilize and provide care for infants born > 34 weeks' gestation who remain
physiologically stable
• Stabilize and provide care for infants born > 34 weeks' gestation < 2 k g
• Stabilize and provide care for physiologically unstable full term infants who require
hemodynamic or respiratory support and birth weight < 2 k g
• Stabilize newborn infants who are ill and those born at <34 weeks' gestation until
transfer to a facility that can provide the appropriate level of neonatal care.

71. LEVEL II NEONATAL CARE (SPECIALTY)
• Special care nursery:
• level II units are subdivided into 2 categories based on their ability to provide assisted
ventilation including continuous positive airway pressure
Level IIA: has the capabilities toResuscitate and stabilize preterm and/or ill infants before
transfer to a facility at which newborn intensive care is provided
• Provide care for infants born at >30 weeks' gestation and weighing </= 1500 g
– Apgar score 4 to 6
– who have physiologic immaturity such as apnea of prematurity, inability to maintain body
temperature, or inability to take oral feedings or
– who are moderately ill with problems that are anticipated to resolve rapidly and are not
anticipated to need subspecialty services on an urgent basis
• Provide care for infants who are convalescing after intensive care

72. LEVEL II CONTD..
• Level IIB: has the capabilities of a level IIA nursery and the
additional capability to provide mechanical ventilation for
brief durations (<24 hours) or continuous positive airway
pressure.

73. LEVEL III: (SUBSPECIALTY) NICU:
• Level III NICUs are subdivided into 3 categories
• Level III A: has the capabilities toProvide comprehensive care for infants born at >28 weeks' gestation and
weighing >1000 g
• Apgar Scores 3 and below are generally regarded as critically low
• Provide sustained life support limited to conventional mechanical ventilation
• Perform minor surgical procedures such as placement of central venous catheter or inguinal hernia repair
• Level III B NICU: has the capabilities to provideComprehensive care for extremely low birth weight infants
(</=1000g and </= 28 weeks' gestation)
• Advanced respiratory support such as high-frequency ventilation and inhaled nitric oxide for as long as
required
• Prompt and on-site access to a full range of peadiatric medical subspecialists
• Advanced imaging, with interpretation on an urgent basis, including computed tomography, magnetic
resonance imaging, and echocardiography

74. LEVEL III CONTD.
• Pediatric surgical specialists and paediatric anesthesiologists on site or at a closely
related institution to perform major surgery such as ligation of patent ductus
arteriosus and repair of abdominal wall defects, necrotizing enterocolitis with bowel
perforation, tracheoesophageal fistula and/or esophageal atresia, and
myelomeningocele
• Level III C NICU: has the capabilities of a level IIIB NICU and is located within an
institution that has the capability to provide Extracorporeal membrane oxygenation
and surgical repair of complex congenital cardiac malformations that require
cardiopulmonary bypass