Adequate newborn nutrition is essential for human life, and the process of infant feeding is linked with the formation of lasting attachment with the caregiver and stimulates psychosocial development. Parents need extensive education in the basics of newborn feeding to ensure adequate growth during the infancy period. Dehydration is more common in the newborn period and can either be associated with inadequate fluid intake or dehydration that can occur with increased fluid loss. This chapter helps the nurse to identify the nutritional components, including vitamins and minerals that are essential for normal growth and development in the newborn and infant. It discusses the importance of fluid and electrolyte balance in the newborn period and risk factors for hypoglycemia in the newborn. The chapter helps the nurse to list adverse outcomes associated with hypoglycemia and to identify potential causes of dehydration in the newborn period.
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Respiratory, cardiovascular, and hematological issues represent the most serious and commonly occurring complications in the neonatal intensive care unit (
NICU). The nurse plays a vital role in the identification, monitoring, and management of these complications. Expertise in monitoring and ongoing assessment enables the nurse to identify changes in the newborn's condition that may warrant more intensive management strategies. This chapter helps the nurse to compare and contrast the different types of mechanical ventilation. It discusses common strategies for monitoring respiratory effort and status in the high-risk newborn. The chapter delineates when to use certain types of blood products for various conditions encountered in the NICUand outlines the treatment for the infant experiencing shock.
Each infant undergoes an initial physical examination in the delivery room immediately after birth to detect gross abnormalities and birth defects and to assess the newborn's transition to extrauterine life. A comprehensive examination is then typically performed within the first 2 hours of birth, once the newborn enters the nursery. The nurse performs the initial assessment in the delivery room and then completes the comprehensive examination. The pediatric care provider is then notified of the infant's status. Any abnormalities identified may warrant prompt intervention or referral for additional assessments from specialty providers. This chapter discusses the importance of documenting the initial neonatal weight and measurements. It describes normal newborn appearance. The chapter helps the nurse to identify the routine measurement data that are obtained during a comprehensive newborn examination. It discusses normal skin variations present in newborn infants and compares and contrasts normal and abnormal physical characteristics in the newborn.
Certain conditions occur commonly in the newborn period. Respiratory alterations are among the most commonly occurring disorders in the immediate neonatal period and warrant prompt identification and intervention. Nurses working with newborns need to have a comprehensive understanding of the pathophysiological processes that put a newborn at risk for certain commonly occurring respiratory conditions. Prompt identification of adverse conditions and proper nursing care to identify specific complications and prevent further complications are required. This chapter helps the nurse to compare and contrast the differences between newborn asphyxia and hypoxia. It outlines appropriate nursing interventions for respiratory distress and describes the adverse effects associated with apnea related to prematurity. The chapter helps the nurse to identify potential long-term effects that may occur as a reperfusion injury. It discusses the potential complications related to meconium aspiration syndrome.
Congenital cardiac defects occur when there is an abnormality in the structure of the heart. Critical congenital heart defects are more severe and typically require surgical intervention in infancy. The nurse may detect a potential defect in the first few minutes of life based on abnormal color, vital sign alternations, abnormal cardiac sounds, or difficulty with adaptation to extrauterine life. This chapter helps the nurse to compare and contrast the difference between congenital cardiac defects and critical congenital heart defects. It lists the different types of critical congenital heart defects. The chapter differentiates the different clinical treatments and expected outcomes of the various congenital cardiac defects. It outlines nursing interventions for infants with cardiac defects. Congenital cardiac defects are abnormalities in the heart's structure that occur as a result of incomplete or abnormal development in utero or as a result of a genetic defect.
Promotion of health and wellness for the newborn and infant begins immediately following birth and continues into the first year of life. Nurses play a crucial role in providing parental education about infant injury and illness prevention. By identifying at-risk parents, additional support and interventions can be implemented to support families with limited resources. This chapter helps the nurse to identify risk factors in the home that can result in infant injury. It discusses components of home safety that can be utilized to protect the childbearing family from environmental risks. The importance of home safety cannot be stressed enough. A safe home environment safeguards the infant from risk and harm. There are multiple environmental factors that can predispose infants and young children to harm in the home setting. The chapter reviews the principles of a proper thermal environment and describes the importance of performing an environmental risk assessment.
The birth of a baby is typically seen as a happy event, with the expectation that the newborn will be healthy. Although some parents will know beforehand of a potential birth defect, others may become aware of their newborn's medical complications only after delivery. When a baby is born with a genetic or congenital defect or when an unexpected birth outcome occurs, parents are often devastated and in need of intense psychosocial support and education. The nurse plays a key role in providing education about the newborn's condition, short- and long-term care needs, and referrals for immediate and long-term, community-based support services for the family. This chapter describes the most common types of birth disorders that occur in the newborn population. It helps the nurses to identify possible etiological factors for specific birth disorders. The chapter discusses possible complications that may occur as a result of specific birth disorders.
In the United States, there are almost 4 million births each year. Of these, 2.7% will have birth defects incompatible with life. Critically fragile newborns are at a lifetime risk for adverse outcomes and disabilities. Parents may be faced with the option of making complicated decisions regarding the continuation of pregnancy in these circumstances. The nurse provides support and education when a family is facing the death of an infant. Perinatal hospice can provide support, neonatal care, and comfort measures for dying newborns. This chapter delineates the factors that need to be considered when making decisions related to the care of neonates born on threshold of viability. It also delineates the adverse outcomes associated with critically fragile neonates. The chapter analyzes the needs of families following a neonatal death and describes the purpose of perinatal hospice care. It lists ethical resources that are available for care providers involved in ethical decision-making.
Infant feeding practice decisions involve a variety of factors, including comfort with breastfeeding, modesty, family values, and cultural norms. Some women will not feel comfortable breastfeeding and will choose formula feeding. These women should be fully supported in their decision-making and should receive educational information on proper formula preparation and storage. Premature infants require special attention and may warrant supplemental feedings. Prematurity and low birth weight put some infants at risk for poor postnatal growth in the newborn and early-infancy period. This chapter describes nursing interventions that help support successful breastfeeding in the early postpartum period and lists the benefits of breastfeeding. It discusses challenges associated with breastfeeding in the neonatal intensive care unit. The chapter helps the nurse to identify the contraindications for breastfeeding and proper pumping and storage guidelines for breast milk. It reviews the discharge preparation for infant feeding instructional information.
The early newborn period marks a dramatic transition from intrauterine to extrauterine life. Early neonatal conditions, such as cold stress and hypoglycemia, can occur in the first few hours after birth. Ongoing assessment is needed to ensure that the newborn is adapting appropriately after birth. Jaundice is common in many newborns, but when it occurs in the first 24 hours can warrant more intensive assessment, laboratory studies, and interventions. Persistent pulmonary hypertension requires intensive care and monitoring. This chapter helps the reader to identify adverse outcomes that may occur as a result of cold stress and list the criteria for bilirubin toxicity in the newborn. It determines risk factors for hypoglycemia that warrant blood sugar monitoring in the immediate newborn period. The chapter explains the pathophysiological process that leads to newborn jaundice. It describes interventions for the newborn with persistent pulmonary hypertension.