Newborns must quickly adapt to life outside the womb by breathing, keeping warm, and feeding. They lose heat easily and have immature immune systems. Your priorities are the airway, temperature, blood sugar, infection prevention, and teaching parents safe care.
A · AssessmentD · DiagnosisP · PlanningI · InterventionE · Evaluation
Each care plan below follows the nursing process (ADPIE).
CARE PLAN 1 · NURSING DIAGNOSIS
ASSESSMENT
Risk for Ineffective Thermoregulation
Risk factors
PLANNING · EXPECTED OUTCOMES- Large body surface area for their size
- Little body fat
- Wet skin after birth
- Cool room or exposure during care
Short-term goals
- Axillary temperature stays between 36.5 °C (97.7 °F) and 37.5 °C (99.5 °F)
Long-term goals
- Parents keep the newborn warm safely at home
- Axillary temperature as ordered
- Signs of cold stress such as cool skin, fussiness, poor feeding, and low glucose
- Room temperature and drafts
| INTERVENTION | RATIONALE |
|---|---|
| Dry the newborn right away and remove wet linens | Wet skin loses heat quickly through evaporation. |
| Place skin-to-skin with the mother or under a radiant warmer | Direct skin contact and warmers prevent heat loss. |
| Put a hat on and swaddle when not skin-to-skin | The head is a large source of heat loss. |
| Check blood glucose per protocol if the newborn is cold | Cold stress burns glucose and can cause hypoglycemia. |
EVALUATION
- Temperature stays in the normal range
- No signs of cold stress
- Parents show how to dress and swaddle the newborn
CARE PLAN 2 · NURSING DIAGNOSIS
ASSESSMENT
Risk for Infection
Risk factors
PLANNING · EXPECTED OUTCOMES- Immature immune system
- Umbilical cord stump
- Exposure during birth
Short-term goals
- Newborn shows no signs of infection during the hospital stay
Long-term goals
- Parents use good hand hygiene and cord care at home
- Temperature instability, poor feeding, or lethargy
- Cord stump for redness, odor, or drainage
- Eyes for drainage
- Maternal risk factors such as GBS status
| INTERVENTION | RATIONALE |
|---|---|
| Use strict hand hygiene and teach parents and visitors | Hands are the main way germs spread to newborns. |
| Give erythromycin eye ointment as ordered | Prevents eye infections from bacteria picked up during birth. |
| Keep the cord stump clean and dry and folded below the diaper | Clean, dry stumps heal faster and resist infection. |
| Teach parents to call for fever, poor feeding, or a red, smelly cord | Early signs of infection in newborns can be subtle. |
EVALUATION
- Newborn is free of signs of infection
- Cord stump is dry and healing
- Parents demonstrate hand hygiene
Quick answers
Why is vitamin K given to newborns?
Newborns have low vitamin K because their gut lacks the bacteria that make it, so a shot helps prevent bleeding.
Jaundice appears in a newborn at 12 hours of age. What does this suggest?
Jaundice in the first 24 hours is not normal and needs to be reported, since it may signal a blood type problem or other disorder.
For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.