Nursing Care of a Neonate

Funom Makama By Funom Makama, 14th Nov 2011 | Follow this author | RSS Feed | Short URL http://nut.bz/2jy7vjim/
Posted in Wikinut>Family>Babies

The oropharynx and nostrils are suctioned with a bulb syringe as soon as the head is delivered. To avoid aspiration of amniotic fluid or mucus. The pharynx is cleared first. Then the nasal passages.

Nursing care

The main nursing goal for newborns is the promotion and maintenance of homeostasis or body equilibrium. Objectives of care for the newborn include:

1. establishment and maintenance of a patent airway
2. maintenance of a stable body temperature
3. protection from infection and injury
4. provision of optimum nutrition
5. promotion of infant-parent attachment.

Establish and maintain a patent airway
The oropharynx and nostrils are suctioned with a bulb syringe as soon as the head is delivered. To avoid aspiration of amniotic fluid or mucus. the pharynx is cleared first. Then the nasal passages. The bulb is compressed before insertion to prevent forcing secretions into the bronchi. A mucous trap can also be used. The doctor places one end of the tubing in the infant's mouth and the other end in his mouth. Air is then withdrawn through the tubing, creating suction at the other end. The mucus is trapped in the container in the middle of the tubing. The De Lee mucous trap is an easy and efficient method of collecting an uncontaminated specimen.

If more forceful removal of secretions is required, mechanical suction is used. The use of the proper size catheter and correct suctioning technique is essential in order to prevent mucosa damage and edema. Gentle suctioning is necessary to prevent reflex bradycardia, laryngospasm, and cardic arrhythmias from vagal stimulation. Suctioning should be done for approximately 10 seconds to prevent depletion of the infant's oxygen supply.

After the infant is completely born, suctioning is performed with the child in a position that facilitates drainage of secretions, such as lying on the side or abdomen, with the head slightly lower than the chest. Gentle patting over the lung provides a form of percussion with the postural drainage. In some delivery rooms the stomach is routinely lavaged (sometimes with a De Lee mucous trap) to remove amniotic flid that may cause abdominal distention and interfere with the establishment of respiration.

Vital signs
A suggested schedule for monitoring vital signs in normal neonates is every 15 minutes for at least 1 hour, every 2 hours for the next 8 hours, every 4 hours until 24 hours of age, and then twice a day until discharge. However, any change in the infant such as color, muscle tone or behavior necessitates more frequent monitoring of vital signs.

Maintain stable body temperature

Conserving the newborn's body heat is an important nursing goal. It requires an understanding of the causes of heat loss, mainly evaporation, radiation, conduction and convection. Nursing care is based on preventing these from occurring.

At birth, a major cause of heat loss is through evaporation, the loss of heat through moisture. The amniotic fluid that bathes the infant's skin favors evaporation, especially when combined with the cool atmosphere of the delivery room. Heat loss through evaporation is minimized by rapidly drying the skin and hair with a warmed towel and placing the infant in a heated environment.

Another major cause of heat loss is through radiation, the loss of heat to cooler solid objects in the environment that are not in direct contact with the infant. Loss of heat through radiation increases as these solid objects become colder and closer to the infant. The temperature of ambient or surrounding air in the Isolate or incubator essentially has no effect on loss of heat through radiation. This is a critical point to remember when attempting to maintain a constant temperature for the infant because even though the temperature of the ambient air is optimum, the infant can be hypo-thermic.

An example of radiant heat loss is the placement of the incubator close to a cold window or air conditioning unit. The cold from either source will cool the walls of the incubator and subsequently the body of the neonate. To prevent this, the infant is placed as far away as possible from walls, windows, or ventilating units. An ideal location in the delivery room is next to the mother. If heat loss continues to be a problem, a radiant warmer may be placed over the infant or the infant and mother.

Heat loss can also occur through conduction and convection. Conduction involves loss of heat from the body because of direct contact of skin with a cooler solid object. This can be minimized by placing the infant on a padded, covered surface and by providing insulation through clothes and blankets rather than by placing the infant directly on a hard table. Placing the newborn very close to his mother, such as in her arms or on her abdomen, is physically beneficial in terms of conserving heat as well as fostering maternal attachment.

Convection is similar to conduction, except that heat loss is aided by surrounding air currents. For example, placing the infant in the direct flow of air from a fan or air conditioner vent causes rapid heat loss through convection. Transporting the neonate in a crib with solid sides reduces airflow around the infant.

Tags

Conduction, Heat Loss, Mucous Trap, Nursing Care, Radiant Heat Loss, Rapid Heat Loss, Vital Signs

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author avatar Funom Makama
A medical Practitioner and a passionate writer. A proud published Author of 2 books, more than 2,000 articles online and 500 Poems!
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Comments

author avatar Egbes
20th Nov 2011 (#)

This article is very nice, I love it so much and indeed you are very good.

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author avatar Lambasted
20th Nov 2011 (#)

A great article really expressing the thoughts of the subject.

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author avatar pretty_writer
20th Nov 2011 (#)

A great Piece and a raw Talent. Keep it up Dr. Funom Makama

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author avatar Ivyevelyn, R.S.A.
22nd Nov 2011 (#)

Please keep writing. I am learning a lot.

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author avatar Barine Nakwaasah
2nd Mar 2012 (#)

great!

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author avatar Funom Makama
4th Mar 2012 (#)

Thanks and welcome to wikinut

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