1. MINOR DISORDER OF
NEWBORN AND ITS
Resp. Sandhya ma’am
Vmmc , con
Roll no -13
• Neonatal health problems are frequently found ranging from minor physical or physiological
peculiarities to the serious life threatening illnesses
• .Minor problems should not be ignored lightly without adequate assessment of the
conditions. Early diagnosis and management of the serious problems help to overcome life
long disability and to reduce neonatal morbidity and mortality.
• Nurses are responsible to manage the minor problems and to detect the serious problems
for early and prompt management along with appropriate nursing interventions and
support to the mother.
3. DIAPER DERMATITIS
Acute inflammatory reaction of the skin associated with
wearing of napkins .
Due to occlusive contact of urine and faeces.
Remove the contents , keep the diaper area dry.
Frequent diaper change.
Contamination by urine or feces should be rinsed gently
with warm water.
Topical antifungal if secondary infection present. Dry the
perianal area and exposed to air Apply coconut oil or
4. NEONATAL JAUNDICE
• It appears on the second day of birth, reaches peak on
the 4 th or 5th day and disappears by 8 to 10 days.
• It is a yellow color of skin usually appearing on the
face, chest, abdomen and legs, due to the excess
bilirubin in blood.
1. Exposing the baby to sunlight for about 10 to 20
2. While exposing the baby to sunlight, baby’s eyes and
perineal area should be covered.
3. Usually correct itself in a few days. If not then baby
should keep on phototherapy
5. • VOMITING
• Vomiting is a forcible ejection of the gastric contents. Most common cause of vomiting in 1
month old child: Aerophagy
• There are several causes of vomiting like gastric irritation, reflex vomiting, emotional
disturbances, due to faulty techniques of feeding.
1. The proper advice regarding feeding and burping must be imparted to all mothers.
2. Proper techniques of breast feeding in proper position.
3. Avoid bottle feeding.
4. Fluid & electrolyte balance should be maintained by monitoring the intake and output.
5. Antiemetic medication should be administered as prescribed.
6. FAILURE TO PASS MECONIUM AND URINE
All healthy babies must pass meconium within 24hrs of age.
Initial 2-3 days : black tarry stools (meconium)
Next 1-2 days : greenish stools (transition stools)
After 5 days : golden yellow stools ( mature stools)
Causes : hypothyroidism, intestinal obstruction, hirschsprungs disease ,meconium
ileus imperforate anus
Management: Infants who breastfeed are rarely constipated. Glycerin
suppositories or rectal stimulation with a lubricated rectal thermometer can be used
7. STUFFY NOSE
It leads to mouth breathing and excessive air swallowing
• nostrils cleaned by cotton wool soaked with normal saline
• nasal spray or drop can use to clear the nose
• Infant nasal bulb suctioning
8. OPHTHALMIC NEONATARAM
• Any purulent discharge from the eyes of an infant within 21 days of birth.
• The baby’s eyes are contaminated during passage through the birth canal from a
mother infected with either Neisseria gonorrhea or chlamydia .
• 1. The infected eyes are cleaned with sterile swabs, moistened with normal saline.
• 2. chloramphenicol is commonly used but erythromycin or gentamycin (0.5%)
ointments or 1% silver nitrate solution should be used for chlamydial infection.
• Baby develop increases frequency of stools if the mother is taking ampicillin, tetracycline
or certain laxatives.
• Intake of large quantities of glucose water and honey by the baby.
1. Avoid bottle feeding maintain hygiene,
2. Wash nipple after each feed.
3. Put on exclusive breastfeed.
4. Mothers who are breastfeeding might need to adjust their own diet to avoid any
foods that could trigger diarrhea in their babies. 5. Keep the diaper changing area
clean and discomfort.
10. ENGORGED BREAST
• Neonate may develop engorged breast due to high level maternal hormones
• Neonate may have swollen tissue around the breast
No treatment is required usually resolve in 2 weeks
Don’t squeeze the breast
11. CAPUT SUCCEDANEUM
•It is an edematous swelling on the babies scalp
•It may cross suture line.
•It will not grow
•It pits on pressure
•It disappear within 36 hours
Goes away in time
Psychological support to the mother
13. ORAL OR PERIANAL THRUSH
• • It is a fungal infection caused by candida albican
• . • It is characterized by white patches in the mouth and tongue.
• • Perianal thrush may cause soreness of the buttocks and is secondary to oral
• • The skin is extremely red and affected area may extend as far as the umbilicus.
Management Topical application of Nystatin or Amphotericin, cream,
Miconazole suspension is swabbed inside the infants mouth three times a day for 4-
5 days. Oral application of 0.5% solution of gentian violet after each feed. After each
feed clean the baby’s mouth and mothers nipple.
14. ABDOMINAL DISTENTION
• Baby with periodic distension should causes by complication of severe
gastroenteritis, constipation with ineffective peristalsis, intestinal obstruction.
Signs and symptoms include vomiting, increased respiration, refusal of feeds.
1. A flatus tube may be inserted to remove excessive gas, if present.
2. Dehydration should be treated.
3. In case of obstruction, naso gastric tube aspiration and continuous drainage may
help to decompress the stomach
15. NEONATAL CONSTIPATION
• • Due to insufficient fluid or milk intake. • More common in bottle fed infant.
Give proper breast fed.
Apply lubricant over anal region.
16. NEONATAL MASTITIS
• The enlargement of breast occurs in full term babies of both sexes on 3rd or 4th day
and may last for few days or even weeks.
• Lack of inactivation of progesterone and estrogen after birth due to immaturity of
neonatal liver, leads to further rise in their levels thus resulting in hypertrophy of breast.
1. If an abscess forms incision and drainage are done.
2. Antibiotics therapy- clinadamycin and vancomycin, oxacillin (100-200 mg/kg/day in 4
3. Antiseptic compresses, local massage should be given and mother reassured.
17. TONGUE TIE
• It is found as a thin broad membrane or thick fibrous frenulum with a notch at the
tip of the tongue
snipping after 3 months (frenotomy)
18. UMBILICAL GRANULOMA
Sign – area around umbilical cord becomes moist and may swell and bleeding may
treat with silver nitrate.
19. NASO PHARYNGITIS
• It is an acute infection of the respiratory tract which is usually caused by air borne
organisms transmitted by parents visitors or staff to the baby.
• Symptoms are running nose, excessive cry, coughing, sneezing.
Signs & symptoms include sleep disturbance, swelling, enlargement, tenderness
and nipple discharge.
1. Mother and baby should be nursed in a single room and the baby should be given
extra fluid. 2. Nostrils cleaned by cotton wool soaked with normal saline and nasal
spray or drops can use.
• Frequently feed the baby
• Frequently change the diaper or wet clothes
• Check for urine and motion
• Cover the baby from insects
22. UMBILICAL GRANULOMA
• It presents as a small flesh like pale nodule at the base of the umbilicus with discharge
• Treatment: cauterization with silver nitrate
• Apply common salt
• Local antibiotics
23. CRADLE CAP
• Cradle cap is found as seborrhic crusting over the scalp
• apply coconut oil over the affected part at night followed
by shampoo with cetrimide
24. OBSTRUCTED NASOLACRIMAL DUCT
• Persistent tearing from one or both the eyes with out any infection
• Cause: simple congenital obstruction of nasolacrimal duct
• massage the lacrimal sac area(between the eyes and nose) from below upwards
withinward pressure for 15-20times per day
• This will get corrected within four months
• •It is the collection of blood in between the periosteum
and flat bones of the skull It is incompressible, cystic,
circumscribed swelling limited by suture lines
• It is not present at the time ofbirth
27. • It tends to grow larger
• Treatment: no treatment is required
• Administer vitamin K, 1-2 mg IM
• In case of infected hamatoma, incision and drainage can be done
• Administer antibiotics and monitor haematocrit values
29. PEELING SKIN
• It is found in post term babies
• Dry scaly skin can be seen after 2-3 days of birth
• Treatment: apply olive oil, cream etc
30. ROLE OF NURSE
• Screen out high risk and babies and use of elective LSCS in case of contracted pelvis
• In normal delivery the nurses should check the following
• Continuous foetal monitoring to know the foetal distress
• Episotomy should be done carefully to prevent injury to the scalp
• To administer vit k 1 mg for prevent haemorrhage