Page 818 - Saunders Comprehensive Review For NCLEX-RN

bruising or bleeding episodes.
9. Watch for meconium stool and subsequent stools.

10. Administer intramuscular dose of

phytonadione to the newborn as prescribed to
prevent hemorrhagic disorders (usually 0.5 to 1 mg is
prescribed); administer in lateral aspect of the middle
third of the vastus lateralis muscle (see Chapter 41).
11. Assess the newborn’s hemoglobin and blood glucose
levels.
D. Renal system
1. The immature kidneys are unable to concentrate urine.
2. A weight loss of 5% to 10% during the first week of life
occurs as a result of water loss and limited intake;
birth weight should be regained by 10 to 14 days after
birth.
3. Weigh the newborn daily.

4. Monitor intake and output; weigh diapers if

necessary (1 g of diaper weight equals 1 mL of urine).
5. If the diaper requires weighing, record the weight
before putting it on the newborn; after the newborn
voids, reweigh the diaper and subtract the prevoided
weight.

6. Assess for signs of dehydration (dry mucous

membranes, sunken eyeballs, poor skin turgor,
sunken fontanels).
E. Immune system
1. Newborn receives passive immunity via the placenta
(immunoglobulin G).
2. Newborn receives passive immunity from colostrum
(immunoglobulin A).
3. Elevations in immunoglobulin M indicate infection in
utero.

4. Use aseptic technique and standard

precautions when caring for the newborn.
5. Ensure meticulous handwashing.
6. Ensure that an infection-free staff cares for the
newborn.
7. Monitor the newborn’s temperature.
8. Observe for any cracks or openings in the skin.

9. Administer eye medication within 1 hour after

birth to prevent ophthalmia neonatorum (see Chapter

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