NCLEX Review Guide: Maternal Newborn Health - Care of the Newborn & Newborn Safety

Immediate Newborn Care

• APGAR scoring is performed at 1 and 5 minutes after birth to assess newborn's adaptation to extrauterine life. Score of 7-10 is normal, 4-6 requires close monitoring, and 0-3 indicates need for immediate resuscitation.
• Thermoregulation is critical as newborns lose heat rapidly through evaporation, conduction, convection, and radiation. Maintain skin-to-skin contact and use radiant warmers to prevent hypothermia.
• Vitamin K administration within 6 hours of birth prevents hemorrhagic disease of the newborn due to immature liver function and sterile gut.

Infection Prevention

• Eye prophylaxis with erythromycin ointment prevents ophthalmia neonatorum caused by gonorrhea or chlamydia transmission during delivery. Apply within 1 hour of birth to both eyes.
• Umbilical cord care involves keeping the cord clean and dry to prevent infection. The cord typically falls off within 10-14 days, and parents should report signs of redness, swelling, or discharge.
• Standard precautions must be maintained during all newborn care procedures, including proper hand hygiene before and after contact.

Safe Sleep & SIDS Prevention

1. Always place infants on their back to sleep for naps and nighttime
2. Use a firm sleep surface with a tight-fitting sheet
3. Keep the crib bare - no blankets, pillows, bumpers, or toys
4. Avoid smoke exposure during pregnancy and after birth
5. Breastfeed if possible and offer a pacifier at sleep time after breastfeeding is established

Quick Check Questions

• ☐ Can you list the 5 components of APGAR scoring?
• ☐ Do you know the difference between caput succedaneum and cephalohematoma?
• ☐ Can you identify normal vs abnormal newborn vital signs?
• ☐ Do you understand safe sleep guidelines?