high risk newborn and intensive care

1. Nidhi Chauhan
M.sc nursing previous year Batch 2017
Govt. College of Nursing. Jodhpur
High risk newborn

2. introduction

3. definition
• Any neonate, regardless of
birth weight, size, or
gestational age, who has a
greater than average chance
of morbidity or mortality,
especially within the first 28
days of life.

4. classification

5. According to size
1. Low birth weight
2. Very low birth weight
3. Extremely low birth weight
4. Appropriate for gestational age
5. Small for date
6. Intrauterine growth restriction
7. Symmetric IUGR
8. Asymmetric IUGR
9. Large for gestational age

6. According to
Gestational age
• Preterm
• Full term
• Late preterm
• Post term (post mature)

7. according to
mortality
• Live birth
• Fetal death
• Neonatal death
• Perinatal mortality
• HIV mortality

8. Assessment of
high risk
newborn

10. General Anthropometric, shape, size, signs of distress, apparent
deformity, posture
Skin Mottling, erythma toxicum, cyanosis, birthmark, maningioma,
hematoma etc.
Head/Eyes/Ears/
Nose/Throat
Red reflex, hemorrhage, micorphthelmia, conjunctivitis, patent nare,
intact palate
Respiratory Shape and symmetry of chest, use of accessory muscles,
respiratory rate, auscultate breath sound, oxygen saturation
Cardiovascular Heart rate, sound, murmur, pulse, blood pressure, capillary refill,
Abdomen Abdominal distension, sign of regurgitation, characteristics of emesis
and stool, liver margine, bowel sound
Genitourinary Abnormality of genitalia, characteristics of urine, weight of the body
Rectum Tone, anus abnormality, meconium passage
Neuromuscular Movement of joints, position, flexion, extension, reflex actions, level
of consciousness, body size changes, pupillary response, hip
alignment

11. management

12. Temperature regulation
Nutrition and fluid maintenance
Testing and laboratory procedure
Intravenous lines and tubes
Procedures and equipments
Special care

13. Temperature regulation

15. methods of thermoregulation
• Immediate drying and warming after delivery

16. Radiant warmer Incubator/Isolette

17. Nutrition and fluid
maintenance

21. Enteral feeding

24. Testing and laboratory procedures
Blood group checking
Complete blood count
Arterial blood gas analysis
Blood sugar level
Electrolyte level
Blood smear test
X-ray

25. Intravenous lines and
tubes

27. Procedures and
equipments

28. Other equipments
Ultrasound
X-ray
Computed tomography
Magnetic resonance imaging
ECMO

29. Special care

31. Follow up schedule
• 2 weeks after discharge
• At 6,10,14 weeks of postnatal age
• At 3,6,9,12 and 18 months of
corrected age and 6 monthly visit
until at least 5 years

32. Follow up
• Assessment of feeding and dietary
counseling
• Growth monitoring
• Developmental assessment
• Immunization
• Ongoing problems
• Neurological assessment
• Eye evaluation
• Hearing evaluation