Fetal and neonatal thermal physiology. Normal rectal temperature in term and preterm infants is 36.5 to 37.5 C. Although hypothermia is a core temperature < 36.5 C, there may be cold stress at higher temperatures whenever heat loss requires an increase in metabolic heat production. Identify who is at risk. However, there is no consensus in the literature as to what constitutes a conventional accepted normal temperature range, with varying values reported in different research. Please refer to specific department guidelines for further information. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. (pp. Nofri YanTi. Clinical Manual of Fever in Children (pp. The consent submitted will only be used for data processing originating from this website. Common forms of accidental hyperthermia include heat stroke, heat exhaustion, and heat cramps. NURSING CARE PLAN OF INEFFECTIVE THERMOREGULATION IN INFANTS POTENTIAL AND ACTUAL NURSING CARE PLAN OF INEFFECTIVE THERMOREGULATION. Comparison of rectal, infra-red tympanic and infra-red skin temperature in term neonates. Rectal measurements should be avoided within the oncology population and in patients with low platelets, coagulopathy, or perineal trauma and pelvic area surgery, due to the increased risk of bowel perforation. The average parameters that nurses use to examine the newborns vital statistics are listed below. Administer diuretics (e.g., mannitol, furosemide) as ordered. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. OConnor, J. P. (2017). A proper visitation schedule when the infant is hungry and eager to be fed can make the newborn drink breast milk adequately. The heart rate, respiration rate, muscle tone, reflex irritability, and color are the parameters to assess. Even full-term and healthy newborns may not be able to maintain their body temperature if the environment is too cold. As the infant struggles to stay warm, cellular metabolism increases, resulting in increased oxygen consumption, putting the baby at danger of hypoxia, cardiorespiratory problems, and acidosis. Any drop in temperature must be detected as soon as possible. Heat-related illness occurs when the body's thermoregulatory system fails. Nursing Diagnosis: Risk for Ineffective Tissue Perfusion related to inadequate oxygen in the tissues or capillary membrane. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. 6. Nursing Care Plan - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or view presentation slides online. Fetal and neonatal thermal physiology. 4m of CPD Thermoregulation is the ability to balance heat production and heat loss to maintain steady, normal body temperature, with a stable metabolic state where minimal rates of oxygen consumption or energy expenditure occur. P. RACTICE . 2. Emergency nursing resource: non-invasive temperature measurement in the emergency department. Ladewig et al. Body temperatures outside normal ranges may be indicative of underlying disease processes or clinical deterioration, and should be identified within a timely manner. Booties or leggings are less effective than a woolen cap. When assessing body temperatures, it is important to consider patient-based and environmental-based factors, including prior administration of antipyretics and recent environmental exposures. Group 10 Neonatus. Bathing a baby immediately after birth lowers the body temperature, potentially causing hypothermia and hypoglycemia. Press the thermometer button and wait for the beeps. Pulse oximetry is a helpful method for detecting oxygenation changes. Ensure clinical indicators are completed and active warming interventions are documented in EMR. 20. As a result of the hypoxia, a metabolic acidosis develops. Do not use alcohol as it can cool the skin rapidly and may cause shivering. Plan: to monitor newborn closely to maintain temperature and prevent hyperthermia and cold stress Goals: Long-term: Newborn will be able to sustain adequate/normal self thermoregulation. 1. During malignant hyperthermia, muscle cells are destroyed and the myoglobin that is released accumulates in the kidneys, obstructing urine flow (myoglobinuria). Simple and effective method to lower body core temperatures of hyperthermic patients. To support the mother in continuing to breastfeed as preferred. Regulate the environment temperature or relocate the patient to a warmer setting. The baby will be kept warm by the mothers body heat. A score of 4 to 6 suggests mild distress, whereas a score of 7 to 10 indicates severe respiratory distress. (3) Remove baby from under phototherapy and remove eye patches during feeding. Buy on Amazon, Silvestri, L. A. She has worked in Medical-Surgical, Telemetry, ICU and the ER. . thermoregulation newborn closely to temperature will axillary temperature maintains related to immature maintain remain within temperature at monitoring will adequate body temperature control temperature and normal axillary least every 8 identify temperature for and decreased prevent range, 36.5-37 hours; more adequate or 24 hours prior MHAUS can provide information and additional resources for patients with a history of MH. Temperature management remains a significant component of hospital care for all neonatal and paediatric patients. Advise clients to monitor symptoms of hyperthermia during times of high outdoor temperatures. Nursing Diagnosis: Failure to Thrive related to congenital digestive system disorders secondary to preterm birth, as evidenced by poor sucking, a weak cry, and altered measurement of weight, height , and head circumference. Pale and cyanotic (bluish discoloration) indicates that the newborn may be suffering from a lack of control over his central nervous system or a manifestation of congenital heart defects. International Emergency Nursing, 22(3), 165-168. doi:10.1016/j.ienj.2013.09.003, Knobel, R. B. The healthcare provider can learn about the parents feelings about the situation by interviewing them. A peaceful and private environment encourages successful newborn feeding. When not in use, thermometers should be kept dry to avoid cross-infection. I thought. A thorough assessment of preoperative patients is necessary for prevention. Upon delivery, the newborn is normally covered in vernix caseosa, a white cream cheese-like substance. But the main reason for swaddling is that it helps reduce the startle reflex, preventing babies from waking themselves up. doi:10.1139/h09-011. It is a state wherein the body's core temperature falls below the normal limits of 36C. Extremes of age or weight increase the risk of the inability to control body temperature. The Newborn Thermoregulation Market Report provides a preliminary review of the industry, definitions, classifications, and enterprise chain shape. To ensure that adequate milk production and the breastfeeding process are maintained. Hostler, D., Northington, W. E., & Callaway, C. W. (2009). Oral care is administered to avoid dryness-related injuries. 41 Ice water immersion. London: Royal College of Obstetricians and Gynaecologists. Ackley and Ladwigs Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning CareWe love this book because of its evidence-based approach to nursing interventions. Assess for hyperthermia signs and symptoms, including flushed face, weakness, rash, respiratory distress, tachycardia, malaise, headache, and irritability. Reduced blood supply to the mesentery can result in GI dysfunction, such as loss of peristalsis. Fluid resuscitation may be required to correct dehydration. The prevention of skin breakdown, which is the bodys first line of defense against infections, is made easier with proper skin examination and documentation. Desired Outcome: The patient will exhibit enhanced perfusion as evidenced by warm and dry skin, strong peripheral pulses, acceptable vital signs, adequate urine production, and the absence of swelling. Desired Outcome: After discharge, the mother will be able to recognize and show strategies to improve the newborns behavioral organization, and the parents will be able to have mutually satisfying interactions with their infant. If skin temperatures drop just one degree from the ideal 97.7 F (36.5C), a baby's oxygen use can increase by 10 percent. Administer 100% oxygen with a non-rebreather mask. Nurses are one of the first healthcare practitioners to interact with them when they are delivered. Nursing Diagnosis: Risk for Hyperthermia related to developing thermoregulation. Hyperthermia is defined as elevated body temperature due to a break in thermoregulation that arises when a body produces or absorbs more heat than it dissipates. Severe hypothermia (body temperature is less than 32C). A digital thermometer can be used to monitor the core axillary temperature in hypothermic patients. The healthcare provider does this assessment swiftly while documenting crucial observations and avoiding overexposure of the newborn. Keep clothing and bed linens dry. A newborn can have a variety of skin colors. Hyperventilation with 100% oxygen will help lower end-tidal carbon dioxide and flush out volatile anesthetics. However, there is no consensus in the literature as to what constitutes a conventional accepted normal temperature range, with varying values reported in different research. Initiate active warming via forced air warming (Bair Hugger) if neonatal patient temperature is Socially, babies born to low-income households and/or countries with limited resources are more likely to be socially and economically disadvantaged. Place the patients arm securely against their body. Dab a small amount of lubricant on end of thermometer. Ineffective thermoregulation secondary to maximum exposure related to need for close observation. Gray color an indication of an infection process, Jaundice (yellowish discoloration) If it emerges on the second or third day of life as a result of the disintegration of fetal red blood cells, it is deemed normal. Administration of diazepam may reduce the shivering threshold without compromising respiratory or cardiovascular function. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). All babies who are at risk of hypothermia should have their skin or axillary temperature monitored. see https://allnurses.com/general-nursing-student/newborn-nursing-diagnosis-346647.html for information on thermoregulation of temperature in newborns and nursing interventions. 10. Retrieved from https://www.nice.org.uk/guidance/cg160, Oguz, F., Yildiz, I., Varkal, M. A., Hizli, Z., Toprak, S., Kaymakci, K., Unuvar, E. (2018). Bathing the baby shortly after birth and/or massaging the baby with essential oils after birth are two common actions that may contribute to neonatal hypothermia. Cover ice packs with a towel and regularly adjust the site of application to mitigate skin damage. Because the surface area of the scalp is big, the brain produces a lot of heat, and there is little hair for insulation, the baby infants head loses a lot of heat by radiation. body temperature 2. Body temperatures falling outside normal ranges should be monitored and further managed where appropriate until normothermia is achieved. Start intravenous normal saline solutions or as indicated.Intravenous normal saline solution replenishes fluid losses during shivering chills. Assess for signs of dehydration as a result of hyperthermia. In a study, rapid IV infusion of cold normal saline with 20 mg of intravenous diazepam results in a 0.2C to 1.5C decrease in core temperature without increasing oxygen consumption during cold saline infusion (Hostler et al., 2009). Prematurity, low birth weight, and intrauterine growth restriction are all examples of physiological risk factors in neonates. Treat any infection or hypoxia. Hypothermia is most likely to occur in babies born before 28 weeks of. The nurse should have the appropriate medication and equipment available, and be knowledgeable about the protocol to follow during malignant hyperthermia. Certain individuals, such as the elderly, infants and young children, the obese, outdoor workers, and those with chronic medical conditions, are at increased risk for developing a heat-related illness. What is the pathophysiology of asphyxia neonatorum. Assist in performing iced lavage. Through thorough observation of the newborn, a healthcare provider can identify the necessity for intervention, and the efficacy of treatment. Both axillary and tympanic routes measure temperatures lower than true core body temperature. 0-3 months: Axillary Route Provide cooling measures such as placing them in a tub of cool water or sponging with cool water. To bring the body temperature down quickly as possible. The complete protocol in managing a malignant hyperthermia crisis can be found here. She received her RN license in 1997. 6. (2008). Remove and clean thermometer with alcohol. Then, within the first six months of life, the newborn must gain 2 pounds per month. A set of interconnected operations that should be undertaken before birth, as well as in the hours and days after birth, to reduce heat loss in all babies mandated by WHO. Each criterion has a maximum score of 2 and a minimum value of 0. Nursing Diagnosis: Risk for Impaired Parent/Infant Attachment related to newborns current health status and hospitalization. WHO recommends that neonatal temperatures be taken at the axilla and that rectal temperatures be taken only if there is a diagnosis of neonatal hypothermia. Consider forced air warming (Bair Hugger) for patients undergoing extensive surgery. Measurement of body temperature. Ensure temperature is taken on admission to PACU. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented. Physiological. In a study, 18cc/kg of cold saline infusion decreased core temperature by ~1.0C in children with acute brain injury who were treated for fever (Fink et al., 2012). Surface cooling by placing ice packs in the groin area, axillae, neck, and torso is an effective way of cooling the core temperature. Comparison of temporal artery to mercury and digital temperature measurement in pediatrics. Some people believe that wrapping a blanket over a baby is done for warmth, while others believe it is done for comfort. As a result, assessment is required for constant monitoring. This practice guideline will assist the obstetrical, post-partum, and neonatal nurses as well as other health care providers in providing appropriate thermal support/regulation in a variety of settings. Woolen caps should be worn by most infants in incubators. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Always remember to dry the babys head. Mortality from malignant hyperthermia can be as high as 70%, however, prompt recognition of symptoms and rapid treatment can decrease mortality to 10% (Isaak & Stiegler, 2016). Heat-related illness occurs when the bodys thermoregulatory system fails. Sessler, D. I., Lee, K. A., & McGuire, J. 50 Flemington Road Parkville Victoria 3052 Australia, Site Map | Copyright | Terms and Conditions, A great children's hospital, leading the way, SEPSIS- assessment and management, RCH CPG, https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Nursing_assessment/, https://www.rch.org.au/clinicalguide/guideline_index/febrile_child/, https://www.rch.org.au/clinicalguide/guideline_index/SEPSIS_assessment_and_management/, https://www.rch.org.au/clinicalguide/guideline_index/Fever_and_suspected_or_confirmed_neutropenia/, https://www.rch.org.au/kidsinfo/fact_sheets/fever_in_children/, Heat loss occurring during conversion of liquid to vapour, Transfer of heat from the body surface to the surrounding air via air current, Relocate patient away from draughts, close door, Transfer of heat from one solid object to another solid object in direct contact, Cover cold surfaces with pre-warmed towel or blanket, Transfer of heat to cooler solid objects not in direct contact with the body. Using the most current evidence-based research, the practice guideline will provide . Monitor the patients oxygen saturation and pulse rate with pulse oximetry. Stress the need to report persistent elevated temperature, especially among the elderly as they may not present with fever when there is an infection. Patient maintains BP and HR within normal limits. Closely monitor the vital signs of the newborn. Assess the patient for symptoms of poor tissue perfusion. Use this guide to help you formulate nursing interventions for a hyperthermia nursing care plan and nursing diagnosis. Promotes comfort and helps prevent chilling since diaphoresis occurs during defervescence. Journal of Emergency Nursing, 38(6), 523-530. Manage Settings 7-10 points: The newborn is deemed to be healthy and in good condition. Using a heated incubator set to 1 to 1.5 degrees Celsius which a temperature that is higher than the body temperature and should be adjusted with the temperature of the baby. Journal of Pediatric Nursing, 23(3), 234-236. doi: 10.1016/j.pedn.2008.03.005, Barbi, E., Marzuillo, P., Neri, E., Naviglio, S., & Krauss, B. S. (2017). All-in-One Nursing Care Planning Resource E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental HealthIncludes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Telethermometer. Continuous administration of dantrolene is necessary until the patient responds with a decrease in ETCO2, decreased muscle rigidity, and decreased heart rate. Thermoregulation is a regulatory process that helps newborns keep their body temperature at a normal level. It says "Hypoglycemia". Hypothermia, especially moderate to severe hypothermia, raises the risk of. Such elevations range from mild to extreme; body temperatures above 40 C (104 F) can be life-threatening. Buy on Amazon, Gulanick, M., & Myers, J. L. (2022). Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client CareIdentify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Digital thermometer. Paediatrics and Child Health, 22(4), 127-130. doi:10.1016/j.paed.2011.09.002, Hay, A. D., Costelloe, C., Redmond, N. M, Montgomery, A. If the client is alert enough to swallow, provide cool liquids to help lower the body temperature. The filter may become saturated after one hour; therefore, a replacement set of filters should be substituted after each hour of use (Malignant Hyperthermia Association of the United States). Gently insert probe into ear canal until the canal is entirely sealed off, ensuring the tip is facing the eardrum. Market analysis is furnished for the worldwide . The Journal of Perioperative Nursing in Australia, 30(3), 23-29. doi:10.26550/303/23-29. Recognize and reward caring and protective parenting practices with positive reinforcement. Fink, E. L., Kochanek, P. M., Clark, R. S., & Bell, M. J. St. Louis, MO: Elsevier. momof2littlemen 1 Post Desired Outcome: The patient will be able to demonstrate signs of improved comfort. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. Pflgers Archiv: European Journal of Physiology, 435(3), Emergency Nurses Association. Fever control and application of hypothermia using intravenous cold saline. Introduction. The height and weight of a newborn are part of the physical examination. Brown fats breaks down into fatty acids Nursing 1 Drying the infant immediately after bath and removing the wet towels Nursing 2 Placing the infant skin-to skin-to with the mother asap Nursing 3 Cover head with hat asap Nursing 4 Avoiding uncovering or exposing the infant's entire body for procedures Nursing 5 Warm the patient immediately after birth, allow skin-to-skin contact with the mother and keep covered and provide a cap on the babys head and cover the body with a second towel. Buy on Amazon, Gulanick, M., & Myers, J. L. (2017). Learn how your comment data is processed. Common causes of hyperthermia result from the combined effects of activity and salt and water deprivation in a hot environment, such as when athletes perform in scorching weather or when older adults avoid using air conditioning because of expense. Because there is no universally accepted normal temperature, many authors accept a range of temperatures as normal, with neonatal norms ranging from 36 to 37.7C, depending on the studys geographical location and environmental/seasonal factors. This will be the baseline data to determine the appropriate intervention. To determine what factors lead to a fluid volume deficit of a newborn that can be treated immediately. Acrocyanosis and skin that is cold, mottled, or pale, Tachypnea, agitation, and shallow, irregular breathing, Apnea, hypoxia, metabolic acidosis, respiratory distress, Low birth weight and premature birth. Enhances digestion while reinforcing that feeding time is enjoyable. (1991). 7. One of the tasks that a healthcare provider does with a newborn is taking their vital signs. Adults should never choose the temperature of the delivery room according to their personal preferences. Monitor the patient for any indicators of swelling or purulent discharge. Proper education will raise the understanding of the risks and sticking to the guidelines. The significantly dehydrated patient is no longer able to sweat, which is necessary for evaporative cooling. Limit the quantity of the patients visitors and advise the mother to avoid people who are sick from visiting the patient. *Significant variation of suggested temperature values and ranges exists within current literature. All nutritional deficiencies of the patient will be corrected. The acceptable vital signs measurements of a newborn are listed below. Reifel Saltzberg, J. M. (2013). 4-6 points: The newborns status is delicate, and he or she may require more extensive airway clearance and supplemental oxygen. Neonatal hypothermia is linked to a variety of risk factors that are divided into four categories: Skin temperature can be determined using the following methods: 2. Hypothermic infants should be rewarmed, and any underlying condition must be diagnosed and treated. Uncontrolled body temperature can lead to hypothermia or hyperthermia, so it is important to provide newborn babies with appropriate nursing care to help them regulate their temperature. The development of this nursing guideline was coordinated by Elizabeth Cooke, RN, ED, and approved by the Nursing Clinical Effectiveness Committee. Note that the difference in temperatures between core temperature measurement and other non-invasive methods is considered to be 0.5C (Barnason et al., 2012; Sessler et al., 1991; Tayafeh et al., 1998). Acknowledging and minimising environmental influences on thermoregulation is important for all paediatric patients, especially the neonatal and at risk patient populations. Observe the contributing reasons to the fluid volume deficit. Heat exhaustion is characterized by elevated body core temperature (37C to 39.4C) associated with orthostatic hypotension, tachycardia, diaphoresis, tachypnea, weakness, syncope, muscle aches, headache, and flushed skin. Provide hypothermia blankets or cooling blankets when necessary. Temperature monitoring and control in the newborn baby. Everyone is also concerned about the newborns health, so learning about the newborns typical profile and activities is a decent idea. Babies in closed incubators are frequently clothed. Metabolic acidosis. This brief and its companion on early and exclusive breastfeeding address key elements of "essential newborn care," important routine care practices regardless of place of birth. Rapid warming can induce ventricular fibrillation. 8. Heatstroke occurs when the bodys thermoregulation fails and is defined as elevated core body temperature (above 39.4C) and central nervous system involvement. Handwashing is an efficient method of preventing infection spread. Lavage of the stomach and rectum with cold fluids will dramatically lower body temperature. The babys body temperature can swiftly decrease if born in a cold environment. (2) Make certain that eyelids are closed prior to applying eye patches. But it can also occur during warm weather or locations with extreme temperatures. Ask the mother about the patients feeding status, the frequency and amount of feeding, whether breastfed or formula, and the behavior while feeding. As a result, the energy reserves get exhausted, leading to hypoglycemia. HO 3 Essential Newborn Care 06May2013. (2011). During the first few days of life, the newborn loses about 5-10% of its birth weight. Although newborns may appear to be identical, they each have their distinct physical characteristics and personality. Gastric lavage is an invasive cooling technique that can achieve a reduction of about 0.15C per minute. NOC Outcomes The following are some NOC outcomes that may be appropriate for patients with Ineffective Thermoregulation: Hyperthermia, tachypnea, unexplained rise in end-tidal carbon dioxide that does not respond to ventilation, tachypnea, and sustained skeletal muscle contractions are the manifestations common to persons who suffer from malignant hyperthermia. . (2014). 4. Assess the patients height and weight, and medical history and determine the results of diagnostic tests as advised. 21. The defining aspects of ineffective tissue perfusion are evaluated to give a baseline for future comparison. Monitor the patients intake by the number of feeding and urine output. Her experience spans almost 30 years in nursing, starting as an LVN in 1993. Nursing Diagnosis: Risk for Infection related to immunosuppression secondary to preterm birth. Anesthesiology, 75(6), 985-989. Low levels limit oxygen uptake and delivery to the tissues at the alveolar-capillary barrier. Look for signs of dehydration, including thirst, furrowed tongue, dry lips, dry oral membranes, poor skin turgor, decreased urine output, increased concentration of urine, and weak, fast pulse. She received her RN license in 1997. A pink complexion upon birth is the healthiest color. Patient maintains body temperature below 39 C (102.2 F). It is important to ascertain an individuals baseline in order to identify abnormal body temperature deviations, and to evaluate these in the context of other vital signs and overall patient presentation. Download & View 3987978 Nursing Care Plan Ineffective Thermoregulation as PDF for free. Moderate hypothermia (34.9C body temperature). 3. 6. Loosen or remove excess clothing and covers. Nursing Care Plans Related to Newborn Assessment and Care Risk for Impaired Gas Exchange Care Plan Risk for impaired gas exchange can be caused by delayed or poor adaptation to life outside the uterus. Using a white noise machine, reduced environmental stimulation and adjusted room temperature will make it suitable for the babys temperature regulation and will help comfort the baby. Please note, any febrile child who appears seriously unwell should have a thorough assessment and their treating medical team notified, irrespective of the degree of fever. This is especially significant in infants who have minimal brown and white fat at birth. These lab results are linked to the patients nutritional state and immune system performance. Having a reddish complexion upon birth is also a common occurrence. These are some of the typical symptoms of infection. Address parental views by educating parents about t. Appropriate parental education aids in the clarification of reasonable expectations. Identify the triggering factors for hyperthermia and review the clients history, diagnosis, or procedures. Nursing Care Plan for Newborn Baby 1 Risk for hyperthermia Nursing Diagnosis: Risk for Hyperthermia related to developing thermoregulation Desired Outcome: The patient will maintain normal body temperature as evidenced by an acceptable range of vital signs and normal white blood cells (WBC) count. Isoflurane anesthesia and circadian temperature cycles in humans. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Assessment Assess the newborn's temperature according to agency policy. Wet or dirty diapers will make the baby uncomfortable and feel cold. Assist in performing peritoneal lavage. Prevents germs from spreading to the patient through equipment used with another patient. Printz, V., Hobbs, A. M., Teuten, P., & Paul, S. P. (2016). The World Health Organization (WHO) recommendations are used to characterize the normal ranges of infant normothermia and hypothermia in the absence of agreement among researchers. The geographical place in which the infant is born, as well as the time of year or seasons and room temperature at the moment of birth are all environmental risk factors. 5. Nursing care plans: Diagnoses, interventions, & outcomes. Monitor the patients body temperature, Keep track of the patients heart rate, and cardiac rhythm. The APGAR score is determined by evaluating the following parameters: Activity, Pulse, Grimace, Appearance, and Respiration of newborns. Thermoregulation Today's newborn often is born amid an impressive array of fetal monitors and concerned perinatal personnel.
