THE NEONATE AT 1 WEEK FOLLOWING DISCHARGE

THE NEONATE AT 1 WEEK FOLLOWING DISCHARGE -...

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THE NEONATE AT 1 WEEK FOLLOWING  DISCHARGE At 1 wk of age, the newborn continues to adapt to extrauterine life, both physiologically and behaviorally. Within  this adaptation period are many normal variations. Review prior assessments for risk factors or deviations from  expected norms. NEONATAL ASSESSMENT DATA BASE Activity/Rest May be wakeful/fussy between feedings May sleep more or less than the customary 17 hr/day Circulation Heart rate ranges from 110–160 bpm; is strong and regular. Ego Integrity (Parents) May verbalize unrealistic expectations of themselves and of neonate May express feelings of ineptness or inadequate knowledge Elimination Urine pale and straw-colored, with output of 6–10 wet diapers per day. Abdomen soft with bowel sounds in all four quadrants. Defecation pattern varies; stool formed, yellow/brown, and passed 2–3 times per day in neonate fed cow’s-milk  formula; mustard-colored, loose, and passed initially with each feeding, then possibly every few days, in  breastfed neonate. Food/Fluid May have difficulty adjusting to breast or bottle feeding; oral intake may be inadequate or on occasion, excessive. Weight gain averaging 1 oz/day. Neurosensory Facial expression symmetrical Reflexes associated with feeding (sucking, swallowing, gag, and rooting) present and strong Moro, grasp, and stepping reflexes present with strong, symmetrical response Uncoordinated motor and reflex activity present (continued development of the neurological system) Muscle tone good; head lag present Pain/Discomfort Irritability, crying associated with colic may occur. Respiration Respiratory rate 30–60/min with no signs of difficulty (e.g., grunting, retraction, or nasal flaring). Normal alternation between rapid and slow rate occurs in response to stimuli. Cry strong, lusty, demanding, and purposeful. Lungs bilaterally clear; breath sounds equal. Safety Skin pink and warm to the touch, with good skin turgor; free of rashes; transitory color change or mottling may appear 
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in response to cold. Skin may appear slightly dry or peeling in folds. Slight jaundice involving only upper body or upper extremities may be present, peaking at day 4 or 5, subsiding within  7 days of onset. Temperature stable; axillary/pacifier, 97.6°F–98.6°F (36.5°C–37°C); rectal, 97.8°F–99°F (36.6°C–37.2°C). Umbilical cord stump drying, with no evidence of inflammation; slight bleeding may be noted with detachment 7–14  days after birth.
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THE NEONATE AT 1 WEEK FOLLOWING DISCHARGE -...

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