CHARACTERISTICS OF THE TYPICAL NEWBORN INFANT
The nurse is in a unique position to aid the newborn infant in the stressful
transition from a warm, dark, fluid-filled environment to an outside world filled with light,
sound, and novel tactile stimuli. During this period of the newborn adjusting from
intrauterine to extrauterine life, the nurse must be knowledgeable about a newborn's
normal biopsychosocial adaptations to recognize any deviations. To begin life as an
independent being, the baby must immediately establish pulmonary ventilation in
conjunction with marked circulatory changes. These radical and rapid changes are
crucial to the maintenance of life. All other neonatal body systems change their
functions or establish themselves over a longer period of time. The nurse performs an
initial assessment to evaluate the neonate, its immediate postbirth adaptations, and the
need for further support.
VITAL SIGNS OF THE NEWBORN INFANT
a. Temperature Regulation.
(1) The infant's body temperature drops immediately after birth in response
to the extrauterine environment. His internal organs are poorly insulated and his skin is
very thin and does not contain much subcutaneous fat. The infant's heat regulating
mechanism has not fully developed. His temperature rapidly reflects that of his
environment. The flexed position that the infant assumes is a safeguard against heat
loss because it substantially diminishes the amount of body surface exposed.
(2) Nursing implications are centered on regulating an environment to
provide constant body temperature of a neutral thermal environment. The infant is
placed in blankets, hat, and a controlled temperature environment after birth to
counteract the drop in body temperature that occurs immediately after birth. After
admission to the nursery, the infant is placed in isolation (isolette) and a temperature
probe may be used for continuous monitoring. The infant's axillary temperature is
maintained at 36.4 to 37.2o C.
An isolette is a self-contained unit that controls the temperature, humidity, and
oxygen concentration for an infant.
b. Pulse. The normal pulse range for an infant is 120 to 140 beats per minute
(bpm). The rate may rise to 160 bpm when the infant is crying or drop to 100 bpm when
the infant is sleeping. The apical pulse is considered the most accurate.