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The newborn exhibits behavioral and physiologic characteristics that may at primary appear to be signs of stress. However, for the duration of the original 24 hours changes in heart rate, respiration, motor activity, color, mucous production, and bowel action take place in an orderly, predictable sequence, which is normal and indicatory of lack of stress. Distressed infants also progression through these stages but at a slower rate. First period After this initial stage of alertness and action the infant’s responsiveness diminishes. Heart and respiratory rates decrease, temperature proceeds to fall, mucous production decreases, and urine or stool is normally not passed. The infant is in a state of sleep and relative calm. Any undertake to stimulate him ordinarily elicits a minimal response. This second stage of the original reactive amount of time in general lasts 2 to 4 hours. Due to the continued decrease in body temperature, it is best to keep away from undressing of bathing the infant for the duration of this time. Second period After a discussion of the seemingly erratic patterns of behavings in the newborn, it is evident that, in order to distinguish abnormalities or signs of distress in the respiratory, cardiovascular, or neurological system, the doctor ought to exhaustively comprehend normal characteristics. Observation, not machines, is the doctor’s biggest tool for assessment, and the nursing goal is anticipation and preventative action of neonatal stress. The timing of nursing care is based on observation of the neonate’s physiologic status. For example, the infant will have to be dried without delay after deliverance to minimize heat loss from evaporation; the introductory bath ought to be postponed until after body temperature has stabilized; eye drops will have to be instilled after parents and child have conventional visual contact; and breast-feeding or bottle-feeding ought to be initiated for the duration of one of the two periods of reactivity.
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