Child Health Nursing

1. By
Mrs. Pooja Rani

2. Neonate/ Neonatal period- 0 to 28 days of life
Neonatal Period
Early neonatal period Late neonatal period
(first week of life) ( 7th to 28th day of life)

3.  Term baby- neonate born between 37-42
weeks of gestation
 Pre term- neonate born before 37th weeks of
gestation
 Post term- neonate born after 42 weeks of
gestation

4.  A healthy new born infant born at term
between 38 and 42 weeks, cries
immediately after birth, establishes
independent rhythmic respiration, quickly
adapts with the extrauterine
environment, having an average birth
weight and no congenital anomalies.

5.  Weight - 2.5 kg-3.9 kg (Average 2.9 kg)
 Length – 48 cm-53 cm (Average 50 cm)
 Head circumference –33cm -37cm
(Average 35 cm )
 Chest circumference – 3 cm less than
Head circumference

6.  Upper segment to lower segment ratio -1.8:1
 Midpoint of length/ stature - at the level of
umbilicus
 Trunk is relatively larger and extremities are
short
 Abdomen is prominent with short neck and
large head
 Neonate lies in partial flexion attitude as in
utero
 Skin may be covered with vernix caseosa and
lanugo hair
 Ear cartillage shows elastic recoil

7.  The breast nodule is palpable, measuring
over 5 mm in diameter
 The scrotum shows adequate rugae with
deep pigmentation and palpable testes
 Labia majora covers labia minora
 The sole of foot shows prominent deep
creases

8.  The healthy neonate cries almost
immediately after birth and establishes
satisfactory and spontaneous respiration.
 Respiratory rate - 30-60 breaths per minute
(Average 40 breaths per minute)
 Heart rate – 120-160 beats per minute
(Average 140 beats per minute)
 Blood pressure-60 -80 mm Hg/ 25-40 mm
Hg (Average 60/40 mm Hg)
 Body temperature -36.5- 37.5 degree
celcius

9.  Rooting, suckling and swallowing reflexes
are well developed.
 The energy requirement initially is 55
cal/kg/day increases to 120 cal/kg/day at
the end of the 1st week of age
 The neonate loses 7-8% of body weight
during 1st week of life but regains the birth
weight by 10th day and then continue to
gain weight about 20-30 gm/day for next 3
months of age
 The baby passes urine and stool
(meconium) shorly within 24 hrs

10.  Blood volume – 80 ml/kg of body weight
 RBC – 6-8 Million/cubic mm
 Hb % - approx18 gm
 WBC – 10,000 -17,000 per cubic mm
 Platelets –approx. 3,50,000 per cubic mm
 ESR is markedely elevated and poor
clotting power is seen due to deficient
vitamin K.

11. It includes,
a) Initiation of respiration and oxygenation
of arterial blood
b) Temperature regulation
c) Initiation of feeding

12. Respiratory system
 Thermal stimulus due to sudden chilling of
infant excites sensory impulses in skin are
sent to respiratory center.
 Level of carbon dioxide is increased and ph is
decreased

13. Circulatory system
 Blood starts flowing through the lungs due to
pressure changes in lungs, heart and major
vessels
 Functional closure of fetal shunts- foramen
ovale, ductus arteriosus, and ductus venosus

14. Neurological system
 Most neurologic functions are primitive
reflexes
 Myelination of nerves occurs following
cephalocaudal and proximodistal pattern
which leads to mastery of fine and gross
motor skills

15. Digestive system
 Rooting, sucking and swallowing reflexes are
present by birth
 Increased amount of saliva in first two
months
 Cardiac sphincter is immature leading to
regurgitation and frequent vomiting
 Immature liver leads to physiologic jaundice.

16. Renal system
 Ability of the immature kidneys to
concentrate urine is less
 Bladder capacity of newborn is about 15 ml
 Neonate may void about 15-20 times a day

17. Endocrine system
 Posterior pituitary gland produces
inadequate amount of antidiuretic hormone
(ADH) due to which the neonates are prone
to develop dehydration.
 Due to effect of maternal sex hormones labia
are hypertrophied and breast secret milk
(witch’s milk)
 Sudden drop of oestrogen and progestrone
cause pseudomenstruation in female babies.

18. Musculoskeletal system
 Bones of neonate are cartilaginous and
undergo ossification gradually.
 Skull bones are soft and not well fused