© goodheart-willcox co., inc.. 7 the newborn © goodheart-willcox co., inc. key terms neonate apgar...
TRANSCRIPT
© Goodheart-Willcox Co., Inc.
Key Terms
• neonate• Apgar test• Brazelton scale• pediatrician• anemia• phenylketonuria
(PKU)• jaundice• intensive care
nursery (ICN)
• neonatal intensive care units (NICUs)
• neonatology• well-baby checkup• reflexes• rooting reflex• sudden infant
death syndrome (SIDS)
• colic
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Objective
• Give examples of medical care and tests newborns receive at birth.
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Medical Care and Testing
• Neonate is the medical term for a baby from birth to age one month
• Immediately after birth,– fluid is suctioned from nostrils and mouth– cord is clipped– baby is dried with warm towels
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The Apgar Test
• Apgar test checks the baby’s chance of survival– pulse, breathing, muscle tone,
responsiveness, skin color– given one minute and five minutes
after delivery• five-minute score should be higher
– most healthy babies score 6 or 7 at 1 minute, then 8 to 10 at 5 minutes
continued
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The Apgar Test
• After the Apgar test,– antibiotic drops are put into the eyes– thermometer is attached to the chest– most newborns receive a vitamin K
injection to help their blood clot– some newborns receive a penicillin
injection to fight possible strep infection– sample of cord blood is taken to know the
baby’s blood type and antibody status
continued
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The Apgar Test
• Before baby leaves the delivery room,– footprints are made– name bands are
placed around wrists and ankles
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Neonatal Behavioral Assessment Scale
• Brazelton scale helps identify problems as early as possible– interaction with environment– motor processes– control of physical state– response to stress
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Other Screening Tests
• A pediatrician cares for infants and children until adulthood
• Screening programs vary for each state– up to 55 disorders– 29 are treatable
continued
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Other Screening Tests
• All states check for– anemia– phenylketonuria (PKU)
• Parents can request tests not required by the state, but must pay for them
• Jaundice is checked using blood from a heel prick or by a painless monitor– treated by placing baby under bright lights
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Care for Premature Babies
• Over 12% of babies born premature• Intensive care nursery (ICN)• Newborns who need intensive care live in
neonatal intensive care units (NICUs)– heated, completely enclosed beds
• Neonatology is a branch of medicine concerned with the care, development, and diseases of newborns
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Circumcision
• Surgical removal of the foreskin of the penis
• 65% of newborn boys• Generally for religious or cultural
reasons
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Well-Baby Checkup
• Well-baby checkup is a routine medical visit for new babies
continued
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Well-Baby Checkup
• Medical personnel will– explore for signs of good health and
proper growth– examine baby– answer questions– make recommendations for care– ask for family health history– measure baby’s length, head, chest– weigh baby
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Did You Know?
The vast majority of newborn deaths take place in developing countries where access to health care is low. Most of these newborns die at home, without skilled care that could greatly increase chances for survival.Learn more about this issue by visiting the World Health Organization Web site.
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Physical Traits of a Newborn
• Size– weigh about 7 pounds and are about
20 inches long• boys slightly larger
– lose weight after birth, gain after about 10 days
– grow one inch and 1½ pounds during first month
– have little body fat
continued
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Physical Traits of a Newborn
• Body proportion– head ¼ of total length
• adults 1/8
– rounded chest– protruding stomach, narrow pelvis
and hips– legs drawn up and appear bowed– legs short when compared to arms– almost no neck
continued
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Physical Traits of a Newborn
• Face– broad, flat nose– tiny jaw and chin– facial features
help them suck
continued
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Physical Traits of a Newborn
• Cranium– fontanels
• soft spots that allow for compression during childbirth
• fill with bone by one to two years of age• membrane that covers fontanels may move
as baby breathes
– bones of skull are soft• may be elongated during childbirth
continued
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Physical Traits of a Newborn
• Skin– thin, dry, blotchy, visible blood vessels– skin on feet loose and wrinkled– wrists have deep creases– scalp skin loose– languno on ears, shoulders, back,
forehead, cheeks (especially premature babies)
– rash one to several days after birth
continued
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Physical Traits of a Newborn
• Skin– stork bites– Mongolian spots
• African, Asian, Mediterranean descent
– may be slightly jaundiced
continued
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Physical Traits of a Newborn
• Eyes– appear small– usually dull gray-blue until about
six months– tears are not produced until about
three months– may cross at times, begin to work
together at about six months
continued
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Physical Traits of a Newborn
• Mouth– puffy cheeks because of sucking pads
inside cheeks– short tongue, cannot extend past gums– lining of lips may peel– most are toothless
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Reflexes
• Reflexes are automatic, unlearned behaviors
• Some triggered by outside stimuli• Clue to health of nervous system• Needed for survival• Some stay throughout life, others leave• Practice for voluntary movement
continued
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Reflexes
• Rooting reflex• Palmar (grasping)• Plantar (grasping)• Babinski• Moro (startle)• Walking
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Objective
• Identify a newborn’s physical, intellectual, and social-emotional needs.
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Meeting the Newborn’s Physical Needs
• Feeding• Clothing and
dressing• Diapering• Bathing• Sleeping• Exercising• Scheduling
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Feeding
• Newborns grow quickly, nutrient needs are important
• Breast- or formula-feeding– American Academy of Pediatrics
recommends breast-feeding for first year
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Breast-Feeding
• Advice for mother– eat a balanced diet– drink at least eight
8-ounce glasses of fluid per day
continued
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Breast-Feeding
– may need supplementary vitamin D, iron, and fluoride for baby
– certain foods may upset baby’s stomach– prescription and/or over-the-counter
drugs can affect baby– rest and avoid stress– consult with a doctor, nurse, or lactation
consultant if needed– use breast-feeding time to bond
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Formula-Feeding
• Parents choosing to formula-feed– consult with
doctor regarding formula to use
– report digestive problems or rashes to baby’s doctor
continued
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Formula-Feeding
– if formula is mixed with water, ensure that water is safe
– avoid making formula at home• Food and Drug Administration oversees
commercially-prepared formulas
– feed newborns the correct amount, such as two to 2½ ounces per pound of body weight every 24 hours
continued
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Formula-Feeding
– keep utensils, bottles, and nipples completely clean
– keep ready-made formula refrigerated– check nipples for clogs or tears– throw away all unfinished formula– cuddle while feeding to enhance bonding– avoid propping the bottle
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Burping the Baby
• To burp a newborn, – place baby in a sitting position with a hand
on the collarbone and under the chin
continued
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Burping the Baby
– lay baby face down across lap with baby’s face toward adult’s knees
– lightly pat baby’s back once in position (pat below the ribs for two or three minutes unless baby burps sooner)
– burp baby before, midway, and after feeding
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Clothing and Dressing
• Should be comfortable, easy to put on and take off, appropriate for weather
• Must be flame-retardant– indicated on manufacturer’s tag
• American Academy of Pediatrics recommends no blankets for first year
• Interact with baby as dressing and undressing to enhance bonding
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Diapering
• Cloth or disposable diapers– both have
advantages and disadvantages
• cost• convenience
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What Do You Think?
• There are often complaints about the impact of disposable diapers on the environment.
• Cloth diapers are often seen as an alternative that is more environmentally friendly; however, they must be laundered, often in harsh chemicals.
• What are your thoughts on this issue?
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Bathing
• Sponge baths recommended until the navel completely heals– up to three
weeks after birth
• Keep cord stump dry and never pull on it
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Sleeping
• Average 17 hours per day– as many as 23 hours and as few as 11
hours
• Light sleepers– seven or eight naps– wheeze, gurgle, suck while sleeping
• Firm mattress needed• Avoid toys and pillows in bed
continued
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Sleeping
• Place baby on back• Clean pacifier
recommended– sudden infant death
syndrome (SIDS), baby dies without warning while sleeping
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Exercising
• Important for muscle development, coordination, and relaxation
• May become a daily, lifelong habit• Way to have fun with babies and
develop a warm relationship
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Scheduling
• Feeding and sleeping should be done on the newborn’s schedule– nurse newborns about every two hours– arouse sleeping newborns every three
or four hours for feedings
• Most babies begin to develop eating-sleeping patterns in a few weeks
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Meeting the Newborn’s Intellectual Needs
• Parents are child’s first teachers• Babies respond to human speech
– 12 to 24 hours after birth can move arms and legs rhythmically to human speech
– show preference for parent’s voice over a stranger’s voice
• Imitation of others is common
continued
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Meeting the Newborn’s Intellectual Needs
• Parents should stimulate babies– stimulation comes
from closeness to caregivers
• Newborns learn through their senses– enjoy looking at and
listening to
continued
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Meeting the Newborn’s Intellectual Needs
• Newborns visual preferences include– designs and patterns that are bold,
horizontal, spiral– objects that move– circular-shaped objects– faces
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Meeting the Newborn’s Social-Emotional Needs
• Babies learn best when alert
continued
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Meeting the Newborn’s Social-Emotional Needs
• Some babies cry one-sixth to one-fourth of the day
• Colic is a condition in which the baby has intense abdominal pain
• Attempts to soothe are important– newborns cannot be “spoiled” by attention– babies may not stop crying, but will benefit
from soothing attention of adults
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Meeting the Parents’ Needs
• Rest• Organize tasks• Take care of new business
– birth certificate, social security card
• Spend time with other adults
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What Would You Do?
• Parents today have been called “helicopters” because of their tendency to hover around their children, hindering independence.
How would you encourage parents to make a life for themselves outside of their role as caregivers of children?
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• anemia. Condition that occurs when the level of healthy red blood cells, which carry oxygen to all parts of the body, becomes too low.
• Apgar test. Test that checks the baby’s chance of survival.
Glossary of Key Terms
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• Brazelton scale. Test used to determine whether a baby has problems interacting with the environment, handling motor processes, controlling his or her physical state, or responding to stress.
• colic. Condition in which a baby has intense abdominal pain and cries inconsolably.
Glossary of Key Terms
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• intensive care nursery (ICN). Special nursery that can provide immediate intensive care just after birth for babies who need it.
• jaundice. Liver condition that can make the skin, tissues, and body fluids look yellow.
Glossary of Key Terms
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• neonatal intensive care units (NICUs). Heated, completely enclosed beds for newborns who need intensive care.
• neonate. Medical term used to describe the baby from birth to one month of age.
• neonatology. Branch of medicine concerned with the care, development, and diseases of newborns.
Glossary of Key Terms
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• pediatrician. Doctor who cares for infants and children until adulthood (age 21 or 22) when physical growth is complete.
• phenylketonuria (PKU). Disease that can cause mental retardation if left untreated by diet.
• reflexes. Automatic, unlearned behaviors.
Glossary of Key Terms
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• rooting reflex. Reflex that helps babies search for food by turning the head and moving the mouth in response to a touch on the cheeks or mouth.
• sudden infant death syndrome (SIDS). Syndrome in which a baby dies without warning in his or her sleep.
Glossary of Key Terms