1) The first 24 hours of life require immediate care of the newborn to establish respiratory function, provide warmth, and ensure safety from injury and infection. 2) Key aspects of immediate newborn care include clearing the airway, maintaining temperature, assessing with the APGAR score, and providing identification. 3) Procedures like drying, positioning, suctioning, cord clamping and eye care help support the newborn's transition to extrauterine life. Vital signs, reflexes and growth are also assessed.

1. Prepared By /lamiaa Elsayed
Pediatric Nursing
Immediate care of newborn 1

2. The
1st 24 hours
of Life
The first 24 hours of life is a very significant
time due to critical transition from
intrauterine to extra uterine life .

3. Immediate care of newborn 3

4. Purposes of immediate
care of newborn
• Establish and maintain respiratory
function.
• Provide warmth and prevent
hypothermia.
• Ensure safety from injury and infection.
• Identify actual and potential problems
that might require immediate action.
Immediate care of newborn 4

5. Immediate
Care of the
Newborn
• Airway
• Breathing
• Temperature
• APGAR
• IDENTIFICATION

6. Implementation:
• Oro-pharengeal Suctioning:
• 1.Wipe the neonate’s mouth with a
piece of gauze around your index finger
once his head has been delivered.
• Wrap and dry the neonate in a warmed
towel.
• Suction the neonate’s mouth with a
disposable Suctioning.
Immediate care of newborn 6

7. Implementation:
• Place the neonate in a radiant warmer.
• Replace the wet towel and wrap the
neonate in another dry towel.
• Place newborn in trendlenburng position.
• Do suction of oropharyngeal canal.
• Oxygen may be given.
• Continue suction as fluid is aspirated.
Immediate care of newborn 7

8. Dry the Baby
• Hypothermia is common
• Wet newborns rapidly lose
heat
• Use a warm, dry, soft towel
• Any absorbent material:

9. Replace the Wet Towels
• Then let the mother
hold the baby
• Her body heat will
help keep the baby
warm
• Cover the head to
prevent heat loss

10. POSITIONING OF THE
NEWBORN
• Positioning
Right side lying
1. promote
drainage secretion
2. fasten gastric
emptying time
• good airway.

11. Airway & Breathing
• Suction gently & quickly
using bulb syringe or
suction catheter
• Starts in the mouth then,
the nose to prevent
aspiration
Immediate care of newborn 11

12. Suction first from Mouth and then from
Nose Use a by use of bulb syringe

13. Airway & Breathing
• Stimulate crying by rubbing
• Position properly- side lying /
Provide oxygen when
necessary
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14. Assess the newborn’s
condition
A- One minute APGAR Score&- reassess at
5 minutes.
B-Neurological examination by checking
common reflexes of the newborn.
C-Vital signs pulse, respiration &
temperature.
D-Growth measurement include length,
weight, head & chest circumferences.
Immediate care of newborn 14

15. Assess the newborn’s
condition
E-Assess for any gross abnormality, congenital
defects in head,
F- eyes, ears, chest, spine,. face, nose,
abdomen, anus, external genitalia &extremities.
G-Assess for any signs of eye infection.
Immediate care of newborn 15

16. Apgar score
• The Apgar score is determined by
evaluating the newborn baby on five
simple criteria on a scale from zero to
two and summing up the five
values.The resulting Apgar score
ranges from zero to 10.
Immediate care of newborn 16

17. APGAR Scoring System
A ctivity/ Muscle Tone
P ulse/ Heart Rate
G rimace/ Reflex Irritability/ Responsiveness
A ppearance/ Skin Color
R espiration/ Breathing
1 2 3 4 5
Immediate care of newborn 17

18. APGAR

19. Apgar score
Sign 0 1 2
Heart rate(pulse Absent Below 100 Above 100
Respiratory Absent Weak cry Good , strong cry
effort
Muscle tone none Some flexion of Active motion ,
extremities extremities well flexed .
Reflex No Grimace Cry
irritability response
Color Blue or Body pink , Pink
pale extremities blue
Immediate care of newborn 19

20. Significance of Apgar score
• Healthy newborn: 7-10 at both 1 and 5 minutes .
• Moderately depressed newborn : 3-6 ( Need
resuscitation )
• Severely depressed newborn : 1-2 ( Intensive
resuscitation )
Immediate care of newborn 20

21. Cord Care
Immediate care of newborn 21

22. Cord Care
• Use sterile plastic clamp or ligature, the
first ligature is placed about 2.5-3 cm
from the abdomen & second ligature is
placed about 1cm from the first ligature.
• Press between the two ligatures.
• Cut the cord by blunt sterile scissor
after the second clamp.
• Examine umbilical cord structure (two
arteries and one vein)
Immediate care of newborn 22

23. Cord Care Continue
• Paint the end of the stump with alcohol.
• Clean the cord at the base of cord
firstly, then the stump from down to up
with one direction and cleaning the cord
clamp.
• Let the cord exposed not covered by
the diaper.
• Assess the signs of cord healing and
signs of infection (erythema edema tenderness).
Immediate care of newborn 23

24. Cord Care
Immediate care of newborn 24

25. Eye care:
• Clean the eye lids é sterile warm sterile
water and cotton.
• Wipe from inner to outward.
• Install one drop of solution of isophenicol.
• Wipe the excess of solution by clean
cotton.
Immediate care of newborn 25

26. Vitamin K Injection
• Administer 1mg. Vitamin K by I.M
injection.
• Route: IM into the lateral anterior thigh
(Vastus lateralis).
Immediate care of newborn 26

27. Vitamin K Administration
Immediate care of newborn 27

28. Identification of the
newborn
• Identification of the newborn which
place on wrist & ankle (mother name,
hospital no, sex, weight of newborn).
• Before transferring to
nursery, ID tag should be
applied.
Immediate care of newborn 28

29. Dressing/ Wrapping
• “Mummy”
• Wrap in warm
blanket
• Cover head with
stockinette cap
Immediate care of newborn 29

30. Assessment of vital signs
•temperature : the axillary method is the safest .
Normal axillary temperature is 36 – 36.5 °C
•Heart Rate ( HR ) :
HR is counted for 60 seconds at the apex of the heart (Range
from 100- 160 b/m immediately after birth ) .
•Respiratory Rate ( RR ) :
RR varies from 30- 60 b/m when the infant is not crying .
•Blood Pressure ( BP ) :
Not routinely assessed in healthy term infants .
The range of normal blood pressure in term infants is 60- 90
mmhg for systolic pressure and 40 – 50 mmhg for diastolic
pressure . Immediate care of newborn 30

31. ANTHROPOMETRIC
MEASUREMENT
• HEAD CIRCUMFERENCE : 33-35cm
• CHEST and ABDOMEN : 31-33cm
• LENGTH : 47-54cm
• WEIGHT : 2500-4000 grams
Immediate care of newborn 31

32. Assessment of Growth
Immediate care of newborn 32

33. Immediate care of newborn 33

34. Neurologic System

35. Neonatal Primitive Reflexes
Immediate care of newborn 35

36. Reflexes
Include the Moro , startle , palmer and planter
grasps, sucking and rooting and swallowing
reflexes, tonic neck reflex ,stepping , and
babinski sign .
Immediate care of newborn 36

37. Moro Reflex or startle reflex
• quick change in the infant's position will cause the infant to throw the
arms outward, open the hands, and throw back the head .
Immediate care of newborn 37

38. Palmer grasp
• Palmar and plantar grasp - the infant's fingers or toes
will curl around a finger placed in the area
Immediate care of newborn 38

39. planter grasp
• Palmar and plantar grasp - the infant's fingers or toes will curl around a
finger placed in the area
Immediate care of newborn 39

40. Babniski reflex
• the infant's foot is stroked, the toes will extend upward .
Immediate care of newborn 40

41. Rooting reflex
•
This reflex begins when the corner of the baby's mouth is stroked or touched .
Immediate care of newborn 41

42. Sucking reflex
• When the roof of the baby's mouth is touched, the baby will begin to suck.
Immediate care of newborn 42

43. Asymmetric tonic neck
reflex
Tonic neck reflex - When a baby's head is turned to one side, the arm on that
side stretches out and the opposite arm bends up at the elbow.
Immediate care of newborn 43

44. Dance or step reflex
• This reflex is also called the walking or dance reflex because a baby appears to take steps
or dance when held upright with his/her feet touching a solid surface.
Immediate care of newborn 44

45. Immediate care of newborn 45