Page 810 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 27

Care of the Newborn

http://evolve.elsevier.com/Silvestri/comprehensiveRN/

Priority Concepts
Development, Health Promotion

I. Initial Care of the Newborn

A. Assessment
1. Observe or assist with initiation of respirations.
2. Assess Apgar score.
3. Note characteristics of cry.
4. Monitor for nasal flaring, grunting, retractions, and
abnormal respirations, such as a seesaw respiratory
pattern (rise and fall of the chest and abdomen do not
occur together).
5. Assess for central cyanosis and acrocyanosis.
6. Obtain vital signs.
7. Observe the newborn for signs of hypothermia or
hyperthermia.
8. Assess for gross anomalies.
B. Interventions
1. Suction the mouth first and then the nares if needed
with a bulb syringe.
2. Dry the newborn and stimulate crying by rubbing the
back.
3. Maintain temperature stability; wrap the newborn in
warm blankets and place a stockinette cap on the
newborn’s head.
4. Keep the newborn with the mother to facilitate
bonding.
5. Place the newborn at the mother’s breast if breast-
feeding is planned, or place the newborn on the
mother’s chest for skin-to-skin.
6. Place the newborn in a radiant warmer.
7. Ensure the newborn’s proper identification.
8. Footprint the newborn and fingerprint the mother on
the identification sheet per agency policies and
procedures; initiate other agency identification and

810