Objective Time Content Av Teaching Evaluation

AIDS Learning
activities.
NEONATAL CARE:
Paediatric can be defined as the branch of medical science that deals with the care
of childhood from conception to adolescent in health and illness. It concerns with
prevention promotion curative and rehabilitative care of children

Define neonate 2min Chart Discussion What do you

Neonate: A newborn baby, specifically a baby in the first 4 weeks after birth. After
method mean by
a month, a baby is no longer considered a neonate. neonate?
The neonatal period (birth to 1 month) is a time of extensive and ongoing system
transition from uterine environment to external world that includes the initial period
after birth which is referred to as perinatal period.
Discuss 1min ANTHROPOMETRIC MEASUREMENTS: Ppt Discussion What is the
Anthropometric method anthropometric
Height -48-53cm
Measurements?
Weight -2.5 -3.5 kg
Head circumference -33-35cm
Chest circumference – 31-33cm
The newborn assumes the attitude of its intrauterine life
Head circumference: is a measurement of child’s head around its largest area. Its
measures the distance from above the eyebrows and ears around the back of the
head
Chest circumference:
Was measured by mean of a steel tape at the level of the nipples and the
measurements taken with the chest at round between maximum inspiration and
expiration.
What is the
Lecture importance of
method newborn care ?

ppt
Vital signs 1min Vital signs: ppt Lecture Vital signs?
method
Temperature 97.7 degree Celsius
Pulse normal 120-160 beats per min
Respiration normal 40-60 beats /min
Blood pressure: normal range 60-70
Posture: The newborn assumes the attitude of its intrauterine life
Extremities flexed and fists clenched
Vernix caseosa: Also know as vernix is the waxy or cheese-like white substance
found coating the skin newborn human babies it is produced by dedicated cells and
is through to have some protective roles during fatal development and for a few
hours after birth.
Lanugo is the hair that covers the body of some newborns. This downy
unpigmented hair is the first type of hair that grows from hair follicles. It can be
found everywhere on a baby body except on the palms lips, and soles of the feet.
Most foetuses’ develop lanugo around the fourth or fifth month of pregnancy.
1. Immediate Newborn Care
 - Skin-to-Skin Contact: Promotes bonding and regulates body temperature.
- Initial Assessment: Check the baby's breathing, heart rate, and general health.
- Clearing Airways: Ensure the baby's airways are clear if necessary.
- Umbilical Cord Care: Properly clamp and cut the umbilical cord.
2. Feeding
- Breastfeeding: Early initiation of breastfeeding, preferably within the first hour.
- Formula Feeding: If breastfeeding is not possible, introduce formula as per the
doctor’s recommendation.
- Feeding Frequency: Newborns typically need to feed every 2-3 hours.
3. Temperature Regulation:
 Maintain Warmth: Keep the baby warm to avoid hypothermia. Use
appropriate clothing and swaddling.
 Avoid Overheating: Ensure the baby’s room is not too hot, and the baby is
not overdressed.
Discuss of 2min Neonatal seizures: Ppt Lecture Neonatal
Neonatal method seizures?
 Most common type subtle seizure
seizures
 Least common type and worst prognostic seizure myoclonic seizure
 Best prognostic seizure focal clonic
 Most common cause of seizure is hypoxia.
 Drug of choice for neonatal seizures is phenobarbitone
 Most common cause of seizure among preterm babies intraventricular
haemorrhage,
 Vitamin deficiency of Vitamin B6 (pyridoxine) is responsible for neonatal
sizzle.
4.Hygiene and Bathing
First Bath: Delay the first bath until the baby's temperature is stable, preferably 24
hours after birth.
Umbilical Cord Care: Keep the umbilical stump clean and dry to avoid infection.
Gentle Cleaning: Use mild baby products for bathing and avoid harsh chemicals
5. Sleeping:
Safe Sleep Environment: Place the baby on their back to sleep in a crib with no
loose bedding to reduce the risk of SIDS (sudden infant death syndrome).
Sleep Duration: Newborns sleep between 16-18 hours a day, with frequent waking
for feeding.
6. Immunizations
Vaccination Schedule: Follow the vaccination schedule as advised by the
paediatrician to protect against common diseases.
7. Monitoring Growth and Development
Regular Checkups: Schedule paediatric visits to monitor the baby's weight, length,
and overall development.
Developmental Milestones: Keep an eye on milestones like head control and
response to stimuli.
8. Parental Support
Emotional Support: New parents should seek support from family, friends, and
professionals to manage the stress and changes of newborn care.
Rest and Recovery: Parents need to rest and take care of themselves to provide
optimal care for the baby.
9. Common Newborn Concerns
Jaundice: Monitor for yellowing of the skin and eyes. Seek medical attention if
necessary.
Colic: Crying spells are common, but seek advice if the crying seems excessive or
unusual.
Diaper Rash: Use a gentle diaper cream and keep the area dry to prevent irritation.
Neonates:
 Neonates are babies who all are less than 28 days after birth. In India, current
neonatal mortality rate is 23 per 1000 live births. (2018, SRS report)
 Early neonatal period: first 7 days of life
 Late neonatal period: 7th to 28 days of life
 Term normal neonate: Baby born between 37-42 weeks of gestation and
weighing more than 2500 g.
 Preterm neonate: Baby born before 37 completed weeks irrespective of birth
weight.
 Post term neonate: Baby born after 42 weeks of gestation irrespective of birth
weight.
  Low birth weight: Baby weighing less than 2500 g irrespective of gestational
age.
 Very low birth weight: Baby weighing less than 1500 g at birth.
 Extremely low birth weight: Baby weighing less than 1000 g at birth.
Small for gestational age: Neonate weighing less than 10th centile.
Ppt Lecture What scores
Enlist APGAR 2min APGAR Scoring method APGAR?
• A quantitative method to assess newborn's respiratory, circulatory and
neurological status.
• Introduced by Dr Virginia Apgar (1952).
The score is taken at one minute and five minutes after neonate birth.
Indicator 0 point 1 point 2 points
Blue, Pink Body Pink
Appearance Pale Blue
Extremities
Pulse Absent Below Over 100bpm
100bpm
Grimace Flaccid Minimal Prompt Response to
(reflex Response Stimulation
irritability ) to
Stimulation
Activity Absent Flexed Active
(Muscle arms Legs
tone)
Respiration Absent Slow, Vigorous cry
irregular
Severely depressed 0-3
Moderately depressed 4-6
Excellent condition 7-10
Enumerate 2min LEVELS OF NEONATAL CARE: Flash Lecture What are the
levels of cards method Levels of
neonatal care? neonatal care?

1.Primary Care (Level I) – Basic Newborn Care:

This level of care is provided at primary health centres, community hospitals, and
maternity homes.
It focuses on the basic needs of healthy newborns and includes:
 Immediate skin-to-skin contact after birth.
 Initiation and support for exclusive breastfeeding.
 Immunization (BCG, OPV, and Hepatitis B at birth).
 Thermal care (keeping the baby warm).
 Cord care and hygiene practices.
 Monitoring for danger signs (difficulty breathing, jaundice, poor feeding, etc.).
 Identification and referral of high-risk newborns to higher-level facilities.
Level I (Well Newborn Nursery)
Level I units are typically referred to as the well nursery.
These facilities have the capability to provide neonatal resuscitation at every
delivery; evaluate and provide postnatal care to healthy newborn infants; stabilize
and provide care for infants born at 35 to 37 weeks' gestation who remain
physiologically stable; and stabilize newborn infants who are ill and those born less
than 35 weeks' gestation until transfer to a facility that can provide the appropriate
level of neonatal care.
Required provider types for well newborn nursing include paediatricians, family
physicians, practitioners and other advanced practice registered nurses
Benefits of new born care
- Healthy full-term newborns.
- Babies with mild issues that do not require advanced medical care.
LEVEL -II (Special nursing care):
Secondary level of care level-II special newborn care unit (SNCU)

This care is provided at districts hospitals and well-equipped secondary level

hospitals with trained paediatricians and neonatal noses. It includes management of

low birth weight (LBW) and pretend babies who do not require intensive care

 Treatment of neonatal infections, jaundice and mild respiratory distress, Use

of radiant warmers for temperature regulation,

 Non- invasive respiratory support,

 Management of mild birth complications. Example, feeding difficulties,

Monitoring and stabilisation of babies before referral to tears centres if need

 Level II units are also known as special care nurseries and have all of

capabilities of a Level I nursery.

  These facilities are required to have pediatric hospitalists, neonatologists and

neonatal nurse practitioners, in addition to Level I health care providers.

 Provide care for infants born 32 weeks gestation or older and weighing more

than or equal to 1500g who have physiologic immaturity or who are

moderately ill with problems that are expected to resolve rapidly and are not

anticipated to need subspecialty services on an urgent basis.

Discuss Benefits of newborn care: Ppt Lecture What are the

benefits of 2min method benefits of
newborn care - Babies born preterm or with low birth weight but not requiring ventilators. newborn care?
- Babies with moderate infections or jaundice needing phototherapy.

3. Tertiary Care (Level III) – Neonatal Intensive Care Unit (NICU)

This is the highest level of neonatal care, provided at specialized hospitals and

medical colleges with advanced technology and neonatal specialists. It includes:

- Ventilator support for babies with severe respiratory distress.

- Intensive management of extremely premature (less than 32 weeks) or critically

ill newborns.

- Surgical care for congenital abnormalities (e.g., heart defects, intestinal

blockages).
- Advanced monitoring (oxygen levels, heart rate, brain activity).
- Total Parenteral Nutrition (TPN) for babies who cannot feed orally.
- Kangaroo Mother Care (KMC) support for preterm babies after stabilization.
Benefits newborn baby:
- Critically ill newborns requiring intensive life support.
 - Babies with major birth defects needing surgery.

- Extremely low birth weight infants (<1.5 kg).

Explain 1min Ppt Lecture What is the
antenatal care ANTENATAL CARE FOR A NEWBORN BABY: method Antenatal care
for newborn for a newborn
baby? Antenatal care (ANC) refers to the medical attention, guidance, and support given baby?

to a pregnant mother to ensure the health and well-being of both the mother and

the baby before birth. Proper antenatal care reduces the risk of complications and

promotes a safe delivery

1. Importance of Antenatal Care

- Ensures the mother and baby’s health is monitored.

- Helps in early detection of complications.

- Provides essential nutrition and supplements.

- Educates the mother on childbirth and newborn care.

- Reduces the risk of maternal and infant mortality.

2. First Antenatal Visit

The first visit should ideally be within the first 12 weeks of pregnancy. The
healthcare provider will:
- Confirm the pregnancy.
- Check medical and family history.
- Perform physical and blood tests.
- Calculate the expected due date (EDD).
- Provide nutritional advice and prenatal supplements (like folic acid).
3. Regular Antenatal Check-ups
The frequency of visits depends on the stage of pregnancy:
- First Trimester (0–12 weeks): Monthly visits.
- Second Trimester (13–28 weeks): Every 4 weeks.
- Third Trimester (29–40 weeks): Every 2 weeks until 36 weeks, then weekly visits.
Assessments During Check-ups
- Monitoring of blood pressure and weight.
- Blood and urine tests.
- Ultrasounds to check fetal development.
- Screening for gestational diabetes and anemia.
- Checking fetal heart rate and movements.
4. Nutrition During Pregnancy
A healthy diet is crucial for the baby’s growth and development.
Essential Nutrients:
- Folic Acid: Prevents neural tube defects (e.g., spina bifida).
- Iron: Prevents anemia and ensures oxygen supply.
- Calcium: Strengthens baby’s bones and teeth.
- Protein: Supports fetal growth.
- Omega-3 Fatty Acids: Helps brain development.
Foods to Include
- Green leafy vegetables, dairy products, lean meats, eggs, and whole grains.
- Fresh fruits and plenty of water.
Foods to Avoid
- Raw or undercooked meat and seafood.
- Excess caffeine and alcohol.
- Unpasteurized dairy products.
- Processed and junk food.
5. Prenatal Supplements
Doctors usually prescribe:
- Folic Acid (400-600 mcg daily) – Essential for fetal brain and spinal cord
development.
- Iron Supplements– To prevent anemia.
- Calcium and Vitamin D – For bone development.
- Omega-3 Fatty Acids– Supports brain growth.
6. Exercise and Lifestyle Modifications
- Regular Exercise*: Walking, yoga, and pelvic exercises improve circulation and
reduce pregnancy discomforts.
- Adequate Rest: 7-9 hours of sleep is essential.
- Avoid Smoking & Alcohol: Reduces the risk of birth defects and preterm labor.
- Stress Management: Practicing relaxation techniques like deep breathing and
meditation.
7. Common Pregnancy Complications and Their Management
 Gestational Diabetes: Managed with diet control and medications if needed.
 High Blood Pressure (Preeclampsia): Requires regular monitoring and
possible hospitalization.
 Anemia: Treated with iron-rich foods and supplements.
 Preterm Labor: Early contractions before 37 weeks need immediate medical
attention.
8. Preparing for Labor and Delivery
Birth Plan: Discuss preferences for delivery (natural, C-section, pain relief
options).
- Hospital Bag: Pack essentials like baby clothes, mother’s clothing, and
documents.
- Recognizing Labor Signs: Contractions, water breaking, and back pain.
Explain post - 2min POST NATAL CARE: Chart Lecture What is
natal care method postnatal care?

Define Flash Lecture Define post-

DEFINITION:
postnatal care 1min card method natal care?
According to world health organization postnatal care is detail as a care given to the
mother and her newborn baby immediately after the birth of the placenta and for
the first six weeks of life
Ppt Lecture What are the
AIMS AND OBJECTIVES:
Explain aims 1min method Aims and
and objectives  To assess the health status of the mother. Medical disorder like diabetes, objectives
of post-natal
hypertension should be reassessed. care
  To detect and treat at the earliest any gynaecological condition arising out of
obstetric legacy.
 To note the progress of the baby including the immunization schedule for the
infant.
 To impart family planning guidance. ppt Lecture Which
Explain 1min PROCEDURE: method procedure need
Procedure post natal care?
 Examination of the baby and advice
 Psychological counselling to the mother
 Examination of the mother
EXAMINATION OF MOTHER
 Routine examination

 Pelvic examination

 Laboratory investigations depending on clinical needs

Assess post- 2min POSTNATAL ASSESSMENT: ppt Lecture What is the
natal method postnatal
 BUBBLE is a acronym used to denote the components of the postpartum
assessment method?
maternal nursing assessment
 Breast
 Uterus
 Bladder
 Bowel
 Lochia episiotomy
Breast evaluation:
 Size
 Shape
 Firmness
 Redness
 Symmetry
UTERUS:
Size, Weight, location and firmness
Immediately after delivery, the uterus begins the process of involution reduction in
size.
At the end of 6th week weighs 50-100g.
A bulky uterus may indicate the presence of blood clots or retained placental beats.
Normally uterus should be contracted, hard and not painful if touched.
The height of uterus should be measured.
After the 1st postpartum day, the fundus involute 1-2 cm. Per day.
BLADDER
In the immediate postpartum period, the bladder is congested, oedematous and
hypotonic from the effect of labour.
After delivery, the client should urinate within 4 hours, at least 300 ml, with
completely emptying the bladder.
Ask mother when last voided
BOWELS:
 The patient should be encouraged to drink should be 6 to 8 glasses of water
daily
  Eat a high fiber diet (whole grains legumes vegetable and fruits
 Sitz bath
 Enema may be given

Explain  Stool softener

Postnatal care 2min POSTNATAL CARE:
Ppt Lecture What is post -
 Depending upon the variation of the color of the discharge it is names as method natal care
 Lochia rubra
 Lochia serosa
 Lochia alba (10-15 days pale white
Episiotomy:
 Sitz bath with warm water may be given.
 The perineum should be cleaned after each voiding.
 Change pad frequently.
 Perform perineal exercises such as Kegel exercise.
 Care of the vulval hematoma includes applying ice
Homan`s Sign
 Should be perform leg exercise to teach the client to flex and extends the both
leg and feet alternatively
 Keeping the leg uncrossed while seated
 Padding pressure points during lithotomy position
Emotional status:
 The immediate postpartum period is an emotional roller coaster
 Mother is exhausted and need sleep and rest to restore their bodies to health
 In this taking in phase mother wish to meet their own rest and nutritional
needs before focusing their energy on newborns
 Enquiry of the mother: -
 Any exercise perineal bleeding
 Puerperal pyrexia
 Puerperal sepsis
 Involution of the uterus
-
 Breast
Examination of the baby:
 Head to toe examination
 New born reflexes
 Exclusive breast feeding
 Keep baby warm
 Dry and wrap
 Immunization
Common breastfeeding positions Ppt
Discuss
common 2min  Laid back nursing position Lecture What is
breastfeeding  Football hold method common breast
positions feeding
 Cross cradle hold positions?
 Cradle hold
  Side lying hold
ppt
BREAST OF EXERCISE:
Discuss Breast 1min  It increases Lecture What breast of
of exercises method exercise?
 Muscle tone
 Venous return from the legs and lower abdomen
 Drainage of the lochia
 Voiding of urine
Types of exercises
 Abdominal exercises
 Circulatory exercises
 Pelvic Floor exercises
Self: measures to improve her general health
 Perineal care
 Breast care
 Care of breast during breast engorgement
 Postnatal exercises
 Gradual return to day-to-day activities
 Return for 6th week post-partum check up
Baby:
 Breastfeeding
 If being bottle feed care and preparation of bottles and nipples or container
 Hold the baby during feeding
 Baby bathing and dressing including care of genital area
 Cord care
 Prevention and treatment of diaper rash
 Checking babies’ temperature
 Recognizing baby`s needs
 Check up and immunization for the baby
MANAGEMENT:
 Cover mother and baby together using prewarmed clothes.
 Provide warmth,
 Vitamin K injection for newborn babies, if not given earlier.
 Reassess after 15 minutes, if temperature does not improve, provide
additional heat
 Encourage breastfeeding
Summary:
Till now we have discussed about antenatal care, antenatal diet, antenatal exercises
and post-natal care, postnatal diet, postnatal exercises and discuss about neonate
care and Levels of neonatal care
Conclusion:
 Neonatal care is a critical component of healthcare that requires a comprehensive
and tiered approach to ensure the best possible outcomes for newborns. The three
levels of neonatal care - Level I, Level II, and Level III - provide a framework
for healthcare providers to assess the needs of newborns and provide appropriate
care.
 Level I care provides basic care for healthy newborns, while Level II care
provides specialized care for newborns who require close monitoring and
 treatment. Level III care provides advanced care for critically ill newborns who
require life-sustaining interventions.
 Effective neonatal care requires a multidisciplinary team approach, with clear
communication and collaboration among healthcare providers. It also requires
access to advanced technologies and equipment, as well as ongoing education
and training for healthcare providers.
 By providing high-quality, tiered neonatal care, healthcare providers can
improve outcomes for newborns, reduce morbidity and mortality, and support
the health and well-being of families.
Textbooks
1. "Neonatology: Clinical Practice and Procedures" by Gary P. Steven (2020)
2. "Pediatric Nursing: An Introductory Text" by Margaret J. Bull (2020)
3. "Neonatal Care: A Practical Approach" by Anne Greenough (2019)
4. "Pediatrics: A Clinical Guide" by Thomas K. McInerny (2019)
5. "Neonatal and Pediatric Pharmacology: Therapeutic Principles in Practice" by
Michael R. Jacobs (2018)
Online Resources
1. American Academy of Pediatrics (AAP): http://www.aap.org/
 2. World Health Organization (WHO): http://www.who.int/
3. National Institute of Child Health and Human Development (NICHD):
http://www.nichd.nih.gov/
Journals
1. Pediatrics: Official journal of the American Academy of Pediatrics
2. Neonatology: Official journal of the European Society for Paediatric Research
3. Journal of Pediatrics: Official journal of the American Academy of Pediatrics
4. Archives of Disease in Childhood: Official journal of the Royal College of
Paediatrics and Child Health

Determine
post-natal care
 LESSON PLAN
ON
THREE TIRED SYSTEM OF NEONATAL
CARE AMONG POSTNATAL MOTHER
AND ANTENATAL MOTHERS

SUBMITTED TO SUBMITTED BY

Mrs. Arpana madam L. Triveni

Lecturer MSc(N) II Year

Owaisi College of Nursing Owaisi college of Nursing

Kanchan Bagh Kanchan Bagh

 OBJECTIVES

General objectives: By the end of my session the group of Mothers will be able to describe Three tired system of neonatal
care among postnatal and antenatal mothers.

Specific objectives: By the end of the session students will be able to

 Define antenatal care during pregnancy
 Explain importance of antenatal care
 Discuss first antenatal visits
 Discuss about regular antenatal check-ups
 Explain nutrition during pregnancy
 Discuss about foods to avoid
 Discuss about prenatal supplements
 Explain exercises and life style modifications
 Discuss common pregnancy complication and their management
 Explain about preparing for labour and delivery
 Explain postnatal care of immediate newborn care
 Discuss APGAR score
 Discuss postnatal