Hi everyone Here is the ppt of newborn and its normal physiology. immediate care and general care. Easy wording, Easy to understand. Everything in details. * Specially for medical related students * Gynea and obstetrics *Midwifery I hope u like it and get help from this Thanking u in anticipation. #SamraKhan

1. UNIT: 12
New Born Baby
Presented By:
• Samra Khan
• Shameera Alim

2. OBJECTIVES:
• Introduction
• Define Newborn.
• Normal Physiology Of newborn
• Immediate Care Of Newborn
• Nursing Care

3. INTRODUCTION:
NEW BORN BABY

4. DEFINITION:
• A baby from birth to 28 days of
age is called newborn.

5. PHYSIOLOGY OF NEWBORN
• The physiology of new born baby is
fundamentally different then
physiology of older children and
adults.
• Due to adjustment from
intrauterine to extruterine life.

6. Respiratory Adaptation:
• The most critical and immediate
physiologic change required of newborn
is onset of breathing.
• The stimuli that help to initiate first
breath are:
Primarily , Chemical And Thermal Stimuli.

7. Conti......
• Chemical Factor in Blood: ( low Oxygen,
high carbon dioxide, low PH) initiate
impulses in respiratory center in
medulla.
• The primary thermal stimulus: this
change in temperature excites sensory
impulses in the skin that transmitted to
respiratory center.

8. • Tactile stimulation: it also assist in
initiate respiration.
• Acceptable method of tactile
stimulation are: Tapping or flicking the
soles of feet, Gently rubbing the
newborn back, trunk or extremities.

9. Conti....
• During vaginal births, the pressure of passing
newborn through the birth canal squeezes
some of fluid out of their lungs through nose
and mouth.
• After complete delivery chest air enters upper
airway to replace lost fluid.
• Remaining lung fluid is absorbed by
pulmonary capillaries or lymphatic vessels.

11. Thermogenesis in Newborn
• Thermogenesis is the process of heat
production and heat loss to maintain
normal body temperature.
There are four mechanisms by which
heat is lost
1) conduction,
2) convection,
3) radiation,
4) evaporation

12. 1. Convection: occurs when baby is
exposed to movement of cool air__
for example air conditioning current.

13. 2. Radiation: occurs when baby is exposed
to cool objects thats the baby is not in
direct contact with (windows/walls)

14. 3. Evaporation: occurs when baby is
wet and exposed to air.

15. 4. Conduction: occur when baby come in
contact with cold objects.

16. Cardiovascular Adaptation:
• Decreased pulmonary vascular resistance
and increased blood flow.
• Increased systemic pressure and closure of
ductous venosus.
• Increased left atrium and decreased right
atrium pressure.
• Closure of foramen ovule.
• Closure of ductus arteriosus.

17. Liver Adaptation:
• Iron Content stored in liver.
• low carbohydrates reserve
• Main source of energy is glucose.
• Liver begin to conjugate bilirubin.
• Lack of intestinal Flora result in low level of
Vitamin K.

18. Gastrointestinal System:
At birth, abdomen is flat and
bowel sound are absent.
Abdomen become rounded
and soft with onset of
respiration.
• Bowel sound usually
audible within 15 minutes
of birth.

19. Conti.......
• Digest and absorb food less efficiently.
• Salivary glands are immature.
• Cardiac sphincter is immature.
• Stomach has capacity of 50-60ml

20. Fetal Laboratory Value Changes:
• Leukocytosis.
• Increased HB concentration.
• Physiologic Anemic of Infancy.
• Decreased Erythropoietin production.
• Decreased percentage of neutrophills.

21. Normal Newborn Lab Values.

22. Newborn Urine Analysis Values
• Protein less than 5-
10mg/dL
• WBC less than 2-3/hpf
• RBC 0
• Casts 0
• Bacteria 0
• Urine Color Pale Yellow

23. Fluid And Electrolyte Balance:
• Less able to concentrate urine.
• Limited reabsorption of water.
• Limited excretion of solutes.
• Limited dilutions capabilities.

24. Newborn Senses:
• Vision: infant sees 9-12 inches away from eyes. Sees
black and white.
• Hearing: turn towards sound and can discriminate
parents voices.Mother's preferred.
• Taste: can taste. Prefers sweet over salty.
• Smell: Highly sensitive to strong odor.
• Touch: Very sensitive to touch and pain.

25. Goals:
• To establish, maintain and support
respiration.
• To provide warmth and prevent
hypothermia.
• To prevent infection.
• To provide safety and prevent injury.
• To identify actual or potential problem that
require immediatel attention.

26. Management:
1. Establishment Of Respiration:
• Check for breathing.
• Clear the newborns airway immediately after
birth to help the newborn breath effectively.
• Suction done immediately if required.

27. 2. Care Of Cord:
• It is an important part in the immediate care
of new born. The cord of newborn is
clamped and cut with sterile scissor or blade
within 30sec after birth.
• Apply Nothing to Cord. It should left to dry
and fall naturally.
• It dries and fall off within 7-10 days.

28. CONTI........
• Make sure that cord is not wet with water
or urine. Advise the mother to fold the
diaper below to prevent from getting wet.
• Note for any kind of discharge, bleeding,
Redness, Foul odor, Inflammation, wet cord
and report immediately to doctor.

29. Cord
Healing

30. 4. APGAR Score:
• This is most important part of immediate
care of newborn. APGAR is done
immediately after birth.
• It includes Heart Rate, Respiration,
Reflexes, Skin Color and muscle tone.
• The normal APGAR score is 7-10 which
signifies that newborn in in good health.

33. • Keeping the baby dry with adequate
clothing.
• Baby should be kept to side of mother so
that mother body temperature keep the
baby warm.
• Bathing at first day is avoided to prevent
hypothermia.

34. 5. Initiation Of Cry:
• Normally 99% of
baby cry
immediately after
birth.
• It is considered a
good sign as a
crying infant is a
breathing infant.

35. • If baby does not cry after birth or cry is weak
then slightly stimulate the baby to cry.
• Never slap the buttocks instead rub the sole of
feet to stimulate cry.
• The loud and husky infant cry is considered
normal.
• Observe newborn abnormal cry:
• Hight Pitched Cry ( due to hypoglycemia)
• Weak cry (Prematurity)
• Hoarse Cry (Laryngeal stridor)

36. 6. Care Of Eye:
• Eye should be wiped with sterile cotton
swab.
• Do not clean the both eye with one swab.
Use separate swab for each eye.
• Application of kajal in eyes must be
avoided to prevent from infection and
poisoning.

37. • The eye should be observed for redness,
discharge or excessive tearing for early
detection of problem and prompt
management.
• Erythromycin
opthalmic ointment
is applied within 24
hour to newborn
baby to prevent
from bacterial eye
infection.

38. 7. Vitamin K
• Vitamin K is needed for blood to clot.
• At birth, babies have normally little vitamin
K stored in their bodies because bacteria
(lactic acid) which produce vitamin K are not
yet present in the newborn's intestines.
• If your baby’s blood doesn’t clot, they may
have severe bleeding or a hemorrhage.

39. CONTI........
The American Academy
of Pediatrics (AAP) in
1961 has recommended
that a single 0.5 mg to
1.0 mg dose of vitamin K
be administered
intramuscularly (IM) to
all newborns shortly
after birth to prevent
vtamin K defficiency
bleeding(VKDB).

40. General Nursing Care:
1. The newborn should be kept with mother in a
well ventilated room.
2. Initiate Breast feeding.
3. Prevent from infection. No infected person
should take care or touch the baby.
4. General cleanliness and surrounding to be
clean.
5. Wet nappies should be changed .
6. The baby should be throughly observed twice
daily for early detection of any abnormality.

41. Conti.....
7. Temperature, Pulse, Respiration, sleep
pattern, feeding behavior, stool, urine should
be assessed.
8. Mouth, eyes, cord and skin should be looked
for any infection.
9. Assess daily weight in healthy term babies
weight which is about 30gm/day.
10. Health education should be given to
mother regarding proper hygiene, breast
feeding, clothing, warmth , immunization and
follow up.

42. CONT........
11. Harmful cultural practices should be
discouraged.
12. The mother should be informed about
National immunization schedule and explain
about importance of complete immunization
(BCG or polio vaccine) which is done in first
week of life.
13. Care at home should be discussed and
demonstrate to the mother and family.