The first 24 hours of life is a very significant time due to critical transition from intrauterine to extra uterine life

1. Assessment and immediate care of
New-born
STUDENT TEACHER
Mukesh Chand meena NAME OF SUPERVISOR
M.Sc.. Nursing (pre.) Dr. Subhash Sharma
LECTURER
GOVT COLLEGE OF NURSING, JAIPUR

2. 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
Objectives-
• To establish and maintain respiration.
• To ensure warmth.
• To prevent infection.
• To provide care to the eyes.
• To provide care to the umbilical cord.
• To provide care to the skin.
• To make observation and documentation.
• To make identification and transfer.

4. CARE AT BIRTH
Wipe mouth and nose of secretion after delivery of the
head with clean sterile gauze pad.

5. Suction
• Gently suctioning with bulb syringe and short catheter
• Starts in the mouth then, the nose to prevent aspiration

6. Airway & Breathing
• Stimulate crying by rubbing
• Position properly- side lying /Provide oxygen when necessary

7. 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)

8. Wrap and dry the neonate in a warmed
towel

9. Vitamin K Injection
• Administer 1mg. Vitamin K by I.M injection.
• Route- IM into the lateral anterior thigh

10. Identification of the new-born
• Identification of the new-born which place on wrist & ankle
(mother name, hospital no, sex, weight of new-born).
• Before transferring to nursery, ID tag should be applied.

11. Place the neonate in a radiant warmer.

12. Position-
• Trendelenburg- Head lower than the body.
• Side Lying position- to permit drainage of mucus from the
mouth.
• Place a small pillow or rolled towel at the back to prevent
new-born from rolling back to supine position.

13. Eye care-
• Clean the eye lids é sterile warm sterile water and
cotton.
• Wipe from inner to outward.
• Wipe the excess of solution by clean cotton.

14. • One minute APGAR Score&- reassess at 5 minutes.
• Neurological examination by checking common
reflexes of the new-born.
• Vital signs pulse, respiration & temperature.
• Growth measurement include length, weight, head &
chest circumferences.
• Assess for any gross abnormality, congenital defects
in head,
• Eyes, ears, chest, spine,. face, nose, abdomen, anus,
external genitalia &extremities.
• Assess for any signs of eye infection.
Assess the new-born's condition

15. 1. Apgar scoring is described by Dr Virginia Apgar.
2. It is useful to quantitative assessment of new-born's
condition at birth especially for the respiratory,
circulatory and neurological status.
3. Five objective criteria are evaluated at 1 minute and 5
minute, after the new-born body is completely born.
A ppearance/ Skin Color
P ulse/ Heart Rate
G rimace/ Reflex Irritability/ Responsiveness
A ctivity/ Muscle Tone
R espiration/Breathing
APGAR SCORE

17. • 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
• 0-3 points- the baby is serious & in danger and need
immediate resuscitation.
• 4-6 points- the baby’s condition is guarded and may
need more extensive clearing of the airway and
supplementary oxygen.
• 7-10 points are considered good and in the best
possible health.

18. Dressing/ Wrapping
• “Mummy”
• Wrap in warm blanket
• Cover head with stockinette cap

19. 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- 90mm/hg for systolic pressure and 40 – 50
mm/hg for diastolic pressure .

20. • HEAD CIRCUMFERENCE - 33-35cm
• CHEST and ABDOMEN - 31-33cm
• LENGTH - 47-54cm
• WEIGHT - 2500-4000 grams
ANTHROPOMETRIC MEASUREMENT

21. • Leave the baby between the mother's breasts to
start skin-to-skin care for at least an hour.
• Cover the baby's head with a cap. Cover the
mother and baby with a warm cloth.
• Encourage mother to initiate breastfeeding
(within half an hour of birth in normal delivery)
& (after 2 hrs. in LSCS)

22. Mukesh Chand Meena
http://www.nursingawareness.c
om/
9414631576
THANKS