CONCEPTS OF

NEONATAL
CARE

Reported by:

Genevieve Manrique
R.N.
INTRODUCTION

A newborn should have

a thorough evaluation
performed within 24 hours
of birth to identify any
abnormality that would alter
the normal newborn course
or identify a medical
condition that should be
addressed (eg, anomalies,
birth injuries, jaundice, or
cardiopulmonary disorders)
General Appearance of a
Normal Newborn:

• Well-flexed, full range of

motion, spontaneous
movement

Signs of potential distress or

deviations from expected
findings:

• Posture limp
• Asymmetry of movement
• Persistent tremor, twitching
HISTORY TAKING

• Review of this pregnancy, labor, and

delivery including screening tests
and risk factors for sepsis.

• Review of past pregnancies

including a history of congenital
anomalies, still births, and/or genetic
or syndromic conditions.

• Review of the mother's and father's

medical and genetic history. In
particular, maternal illnesses prior to
and during pregnancy,

• A review of maternal medications

should be performed
ASSESSMENT

• HEART RATE 120-160

• NORMAL RESPIRATIONS 30-60

• NORMAL TEMPERATURE 97.8-99

• NORMAL B/P 80/46

• NORMAL HEAD
CIRCUMFERENCE 13-14 IN

• CHEST CIRCUMFERENCE 30-33

CM 12-13 IN  
• LENGTH 18-22 IN

• WEIGHT 2500-4000 GM 5-9 LBS  

ASSESSMENT
• VERNIX CASEOSA WHITE CHEESY
SUBSTANCE FOUND ON SKIN

• LANUGO DOWNY FINE HAIR SEEN ON

PINNA, FOREHEAD

• ACROCYNOSIS PINK BODIES WITH BLUE

EXTREMITIES

• ERYTHEMA TOXICUM NORMAL

NEWBORN RASH BEEFY RED ON
ABDOMEN

• MILLIA SMALL PIN HEAD SIZE PEARLY

BALLS ON NOSE

• TELANGIECTATIC NEVI STORK BITE.

BLANCHES WITH PRESSURE. FOUND

• NEVUS FLAMMEUS PORT WINE STAIN-

RED/PURPLE, DOES NOT BLANCH
Introduction

Thermoregulation in
the neonate is a critical
physiological function that
is strongly influenced by
physical immaturity,
extent of illness and
environmental factors
GUIIDELINES

Monitoring - Peripheral
temperature should be
recorded hourly

Use of Incubator - Any neonate

less than 1.5 kg should be
nursed within an enclosed
incubator

Use of Baby Therm - Baby-

therms provide heat by a
combination of conduction
(from below via a gel
mattress) and radiation
Use of Open Basinette - A
well neonate, >1.5 kg,
who no longer requires
close monitoring or
intensive care and who can
maintain a stable central
temperature in 26-28°C
room temperature, can be
transferred to an open
bassinette or small cot.
Signs of Cold Stress:

• central temperature < 36.5°C

• increase in core-toe gap >
2°C
• mottled & pale
• increased capillary refill time,
i.e. > 2 seconds
• increased oxygen
requirements
• metabolic acidosis
• tachycardia
• hypoglycaemia
• apnoeas
• bradycardia
Intervention to Cold Stress:

• Place a neonate of < 1.5kg in

an incubator

• Use a baby-therm

• Increase the set temperature

by 1°C every 15 minutes
according to the neonate’s
response

• Take their temperature every

30 - 60 minutes until warmed
to an acceptable temperature
• Identify & eliminate any
environmental causes, e.g.
wet bed, over exposure,
handling

• Promote a flexed position

• Ensure ventilator gases are

adequately warmed to 37°C
Introduction

Prematurity is a birth that

is at least three weeks before
a baby's due date. It is also
known as preterm birth (or
less than 37 weeks — full
term is about 40 weeks).

Prematurity is the leading

cause of death among
newborn babies. Being born
premature is also a serious
health risk for a baby. Some
babies will require special
care and spend weeks or
months hospitalized in a
neonatal intensive care unit
(NICU).
Common Problems of
Prematurity

Premature babies often

have medical problems
because their organs and
body systems have not
developed sufficiently. The
lungs, brain, gastrointestinal
tract, and immune system are
most often affected and pose
the greatest risks for causing
long-term problems and death
 Complications of Very Premature Babies, by Birth Weight

Birth Weight: 501- 751- 1,001- 1,251-

750 1,000 1,250 1,500
gms gms gms gms
(1.1- (1.7-2.2 (2.2-2.8 (2.8-3.3
1.7 lbs) lbs) lbs)
lbs)
Complication: 24-26 26-28 28-30 30-32
Gestational age (weeks)
Respiratory distress syndrome 71% 54% 36% 22%
Moderate bleeding in the brain (Grade 3) 12% 9% 6% 4%
Severe bleeding in the brain (Grade 4) 13% 5% 3% 1%
Chronic lung disease 47% 33% 15% 6%
Inflammation or death of part of the GI tract 11% 9% 6% 3%
(necrotizing enterocolitis, or NEC)
General infection 44% 30% 17% 7%
Survival to 120 days or hospital discharge 56% 88% 94% 96%
Survival without any of these complications 36% 59% 79% 90%
THANK

YOU!!!