Chapter 26: Newborn Nursing Care & Family Education

Clinical priority is initially placed on establishing effective respirations, assessing the heart rate to ensure it remains (greater than) 100 beats per minute, and maintaining thermoregulation through immediate skin-to-skin contact. The Apgar score is utilized at one and five minutes post-birth to rapidly evaluate the newborn’s heart rate, respiratory effort, muscle tone, reflex irritability, and skin color to determine their physiological status. Nurses perform comprehensive physical assessments to monitor neurological development through various reflexes, cardiovascular stability, and respiratory health, ensuring the absence of complications like nasal flaring or retractions. Identifying risks based on birth weight and gestational age—classifying infants as preterm, term, or post-term—is crucial for predicting mortality risks and guiding specialized management. Preventative treatments are standard, including intramuscular Vitamin K to prevent hemorrhagic disease and erythromycin ointment for eye prophylaxis, although Canadian practices regarding the latter are evolving to prioritize maternal screening. Significant attention is given to the detection and treatment of neonatal jaundice through universal bilirubin screening and phototherapy to prevent brain damage from high bilirubin levels. Additionally, the text covers the management of metabolic instabilities such as hypoglycemia, particularly in late preterm infants, and provides protocols for diagnostic screenings for hearing and critical congenital heart disease. Procedural care for heel sticks, venipuncture, and circumcisions is detailed, with a major emphasis on alleviating pain using non-pharmacological methods like swaddling and oral sucrose alongside pharmacological agents. As the family prepares for discharge, nurses provide vital education on safe sleep environments to prevent Sudden Infant Death Syndrome (SIDS), proper car seat safety, umbilical cord hygiene, and the recognition of early signs of illness such as fever or lethargy to promote a safe transition home.