HIGH RISK NEWBORN: GOALS, CONCEPTS, PRINICPLES, ASSESSMENT. NURSING MANAGEMENT OF POST MATURE INFANT

DEFINITIONHigh risk newborn can be defined as a newborn, regardless of birth weight, size or gestational age who has a greater than average chance of morbidity especially within the first 28 days of life.

IDENTIFICATION

Birth weight less than 2.5kgTwinsBirth order 5 and moreArtificial feedingInfection

GOALS

Perinatal preventionResuscitation and stabilization

Evaluate and manageMonitoring and therapeutic modalities

Family centered care

ASSESSMENTInitial assessment apgar scoring

Clinical assessment

Transitional assessment first period of reactivity

second period of reactivityBehavioral assessmentPhysical assessmentReflexes

Post mature infantInfants born of a gestation that

extends beyond 42weeks as calculated from the mothers last menstrual period.

Predisposing factors

Pregnancy between the age of 15-19 yrs

Elderly womenWrong datesMultiple pregnancyFetal anomaliesHereditary

Clinical manifestation Absence of vernix caseosaLoose skin and little

subcutaneous fatAbsence of lanugoAbundent hair on the head

and long nailsSkin is wrinkles, cracked

and peelingUmbilical cord is thin

Diagnostic evaluation

History collectionFetal movement recordingElectronic fetal monitoringUltrasonograpyBiophysical profileDoppler flow study

managementImmediate care clear the

airway

Body temperature

Prevention of infection

Apgar score Breast feeding

Umbilical cord care

Eye care

Diaper care Hypoglycemic management

Vitamin k injection

Weight record