cPreventive measures include iWarming hands before touching the newborn

Cpreventive measures include iwarming hands before

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c.Preventive measures include: i.Warming hands before touching the newborn ii.Drying thoroughly after birth and removing wet blankets iii.Placing a cap on the head iv.Placing the newborn “skin-to-skin” with the mother and placing warm blankets over the newborn d.Treatment includes: i.Ensure adequate oxygenation and ventilation, performing chest compressions if needed. ii.If glycemic, administer D10W. iii.Administering warm IV fluids if indicated. iv.Once stabilized, the critically ill newborn should be placed in a prewarmed incubator. v.If not available, place on mother’s chest and cover with a blanket. vi.Continue until temperature reaches normal or the feet are not cold. VIII. Pathophysiology, Assessment, and Management of Common Birth Injuries in the Newborn A.Birth trauma comes from injuries resulting from mechanical forces during the delivery process. 1.Most are self-limiting with a favorable outcome. a.Birth injuries account for 2% to 3% of all infant deaths. b.Newborn injuries can occur because of: i.Newborn size
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ii.Position during labor and delivery c.Conditions associated with a difficult birth include: i.Primigravida (first pregnancy) ii.Prolonged labor iii.Cephalopelvic disproportion iv.Rapid labor v.Abnormal presentation vi.Large size vii.Shoulder dystocia viii.Prematurity ix.Low birth weight 2.Birth trauma injuries include: a.Those that can involve instruments used during delivery i.Abrasions ii.Lacerations iii.Bruises iv.Subcutaneous fat necrosis b.Excessive molding of the head and overriding parietal bones c.Caput succedaneum: Swelling of soft tissue of the scalp from pressing against the dilating cervix i.Usually disappears in a day or two after birth d.Cephalhematoma: Area of bleeding between the parietal bone and the covering periosteum i.Often appears several hours after birth as a raised lump on the head ii.May take 2 weeks to 3 months to resolve iii.Do not try to drain because it may worsen or prolong bleeding. e.Linear skull fractures i.Avoid pressure to involved areas. ii.Displaced fractures need neurosurgical evaluation. f.Brachial plexus injuries i.Usually occurring in large newborns ii.Erb palsy (most common)—involvement of C5, C6 iii.Klumpke paralysis (rare)—involvement of C7, C8, T1 (a)Results in intrinsic hand muscle weakness g.Facial nerve palsy i.Findings include asymmetric faces when crying. ii.Full resolution of cranial nerves may take several weeks. h.Diaphragmatic paralysis i.May occur from cervical root injury or a brachial plexus injury ii.Symptoms may include: (a)Respiratory distress with hypoxemia (b)Hypercapnia (c)Acidosis i.Laryngeal nerve injury resulting from intrauterine posture
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i.Presents with stridor or hoarse cry ii.Paralysis often resolves in 4 to 6 weeks.
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