Admission of Neonates in Nicu & Nursing Management

ADMISSION OF NEONATES IN
NICU & NURSING

MANAGEMENT
M.MOUNIKA
Msc(N)II YEAR
MEANING OF NICU
NICU is a very specialized unit where

critically ill neonates are cared to reduce the neonatal
morbidity and mortality.
CRITERIA FOR ADMISSION IN NICU
Indications for admission to neonatal intensive care unit are:-

Low birth weight
Large babies.
Birth asphyxia.
Severe jaundice.
Infants of diabetic mothers.
Neonatal convulsions.
Severe congenital malformations.
Injured neonates.
Babies born with premature rupture of membranes.
Meconium aspiration syndrome.
Neonates who needs cardio respiratory monitoring.
AIMS / GOALS OF NICU
To improve the condition of the critically ill neonates ,the

survival of the neonates so as to reduce the neonatal
mortality and morbidity.
To provide continuing inservice training to
medical and nursing personnel in the
care of newborn.
To maintain the function of pulmonary cardiovascular ,
renal and nervous system.
To administer precise amount of fluids and
minute quantities of drugs through intravenous
infusion pumps.
To check / observe the alarm signals ,to find
out the changes beyond certain fixed limits set
on monitors.
PREPARATION OF NICU
RADIANT WARMER INCUBATOR

ADEQUATE LIGHT SOURCE
RESUSCITATION TROLLEY
OXYGEN APPARATUS
PHOTOTHERAPY UNIT
CPAP VENTILATOR WITH CARDIAC MONITOR
PULSE OXIMETER
ADMISSION PROCEDURE IN NICU
All babies admitted in the neonatal unit should

have the following data recorded carefully within 24 hours of
admission.
History and examination
Maternal history.
Paternal history.
Previous obstetric history.
Details of present pregnancy, labour ,delivery and apgar score.
CARDIAC MONITOR
ON ADMISSION:-
Notify the doctor and the nurse incharge.
Resuscitate infant as necessary and maintain warmth.
Check infant’s identification band.
Quickly examine the neonate from head to toe for
obvious congenital abnormalities.
ANTHROPOMETRIC MEASUREMENTS
COMMON OBSERVATIONS
Temperature
Heart rate
Respiration
Colour
Activity
RECORD KEEPING
Birth history
Ward history-contains details about apgar score,

examination of the newborn, birth weight, feeding
sheet, progress sheet.
Compiled history-contains registration form,

progress sheet, intrauterine growth chart,O2 flow
sheet, fluid balance sheet.
LIFE THREATENING CONDITIONS WHICH REQUIRE NICU
Apnea
Baby with respiratory distress.
Birth asphyxia.
Convulsions.
Low birth weight babies.
Neonatal jaundice requring exchange blood
transfusion.
Sepsis and meningitis
HOW TO MAKE ROUND WITH THE CONSULTANT IN NICU
The nurse should have the following recording and reporting while making rounds
with the consultant.
Examine and evaluate each baby daily.

Record keeping.
Progress notes- it should reflect the present status of the neonates, the new and the
ongoing problems.
Problem list –a complete problem list is kept at the front of the progress notes.
This list must focus on current, new problems and should also note the resolved problems.
The problems should be collected from the
following areas:
General status.
Nutrition
Respiratory status.
Infection.
Apnea.
NURSING MANAGEMENT
The general care of newborn in NICU can be expressed

by:-”STABLE”.
SUGAR - Monitor blood glucose.
TEMPERATURE - Monitor temperature .
ASSISTED BREATHING - watch for apnea.
• BLOOD PRESSURE - Check perfusion by assessing capillary
refill time.
• LABWORK -investigations should be sent on time
and volume of blood at each draw should be recorded.
• EMOTIONAL SUPPORT - Baby should be cared in a quite
environment. Kangaroo mother care should be encouraged for
preterm babies.
PROVIDING A NEUTRAL THERMAL ENVIRONMENT:-
• Skin temperature should be maintained between 36- 37
degree celcius.
• Temperature of the neonate may be assessed by:
• Probes taped to the skin.
• Axillary temperature.
• Rectal temperature.
• Several types of equipments may be used for provision of heat
in the neonates like radiant warmer , heat shields etc.
• All equipments used must be checked thoroughly and
frequently for correct functioning .Temperature probes used
must be kept taped on the skin.
• All those who care the infants should always apply warm hands,
warm surface, warm oxygen.
• All procedures should be carried out in a warm area or under a
radiant heat source.
• Nurses should observe infants for signs of cold stress such as
tachypnea, apneic spells, color changes, hypoglycemia, and
metabolic acidosis.
MAINTAIN SKIN INTEGRITY
• The skin functions as a barrier against infection.

• It helps to regulate the body temperature.
• The preterm skin is extremely permeable to topical
ointments, so care should be taken with their application.
• Bathing should be decreased to one to two times a week
to maintain the acidity of the skin as a barrier of
infection.
PREVENTION OF INFECTION
The nurse is responsible for minimizing the

neonates exposure to invasive micro organism. The
prevention includes:-
• Hand washing
NUTRITIONAL SUPPORT
• Fluid therapy: peripheral or central Catheters can be used

for the administration of fluids.
• Feeding:-
• Formula feedings.
Feeding techniques:
• Gavage feeding.
• Trans pyloric feeding.
• Breast feeding.
• TPN
CARE OF THE PARENTS
• The parents of high risk neonates often have
adaptational needs or problems that necessitate
sensitive and thoughtful nursing care.
THANK
YOU

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Admission of Neonates in Nicu & Nursing Management

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ADMISSION OF NEONATES IN

NICU & NURSING

NICU is a very specialized unit where

Indications for admission to neonatal intensive care unit are:-

To improve the condition of the critically ill neonates ,the

RADIANT WARMER INCUBATOR

All babies admitted in the neonatal unit should

Ward history-contains details about apgar score,

Compiled history-contains registration form,

Examine and evaluate each baby daily.

The general care of newborn in NICU can be expressed

• The skin functions as a barrier against infection.

The nurse is responsible for minimizing the

• Fluid therapy: peripheral or central Catheters can be used

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