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.
NOTE: 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.
c. Blood Pressure.
The average blood pressure (BP) of an infant at birth is 72/42. A drop in systolic BP of about 15 mm Hg the first hour after birth is common. The newborn’s BP may be taken with a Doppler blood pressure device. This greatly improves accuracy.
d. Respirations.
The respirations of a newborn infant are irregular in depth, rate, and rhythm and vary from 30 to 60 beats per minute. Respirations are affected by the infant’s activity (that is, crying). Normally, respirations are gentle, quiet, rapid, and shallow. They are most easily observed by watching abdominal movement because the infant’s respirations are accomplished mainly by the diaphragm and abdominal muscles (see figure 7-1). No sound should be audible on inspiration or expiration.
