Mindanao State University COLLEGE OF HEALTH SCIENCES Name of Student: Aisa Alyanna B. Habib Clinical Instructor: Ms.

Aisha B. Macabada,RN IMMEDIATE NEWBORN CARE

Purpose: To provide appropriate interventions and safety to the newborn after delivery and to help the newborn in adjusting to extrauterine life. Equipment: Infant crib with a drop light, Gloves, bulb syringe or suctioning machine, baby shampoo or baby oil, bath towel, cotton balls soaked with antiseptic solution, cotton balls soaked with alcohol, cord clamp, scissors, eye treatment, Vitamin K medication, Hepa B vaccine, syringe, tape measure, diaper, newborn clothings, identification bracelet

Score: _________ Date: August 20, 2010

PROCEDURE 1.) Assemble and prepare needed materials. Turn off aircon (if an air conditioned room). 2.) Do hand hygiene and don gloves. 3.) Receive baby from the doctor.

RATIONALE Organization and planning improve efficiency. Helps to minimize heat loss. Deters the spread of microorganism transmission. Newborn should be handled properly and gently since they tend to be slippery. Further drainage of secretions. Early detection of abnormal findings.

ASSESSMENT 4.) Put the baby on the infant crib with the head lower than the body and assess the physical condition of the neonate. 5.) Assess for APGAR scoring for first minute.

To establish gestational stage and to detect any observable condition such as difficulty in breathing, a congenital heart anomaly, meningocell, cleft lip or palate, hydrocephalus, a birthmark, imperforate anus, bowel obstruction After giving birth, rest is needed to regain the energy exerted during labor and overcome fatigue.

PLANNING 6.) It must take into account the newborns condition during this transmission period and the mothers need for adequate rest during the postpartal period.
Prepared and Compiled by: LGA Oanes, RN; C.E. Opalia RN; A. Macabada, RN

IMPLEMENTATION 7.) Suction the baby right away after delivery from mouth to nose and aspirate secretions with bulb syringe or suction tip attached to suction machine. 8.) Bath or clean the baby with lukewarm water (w/ baby shampoo or baby oil) per hospital protocol. Clean the babys eyes starting from the corner, near the nose bridge, and then gently towards outer corner of the eye. 9.) Dry and wrap the baby with a bath towel then keep warm by using drop light (gooseneck lamp) at least 12-24 inches away. 10.) Evaluate the newborns condition by doing again the post five minutes APGAR scoring. START CORD CARE 11.) Count the number of blood vessel.

Removes mucus and other secretions to present aspiration.

To prevent chilling. Bathing should proceed from the cleanest to the most soiled area.

To prevent chilling and minimize heat loss.

APGAR scoring is done every 5 minutes until a minimum score of 7 is reached. A normal cord contains 1 vein and 2 arteries. The absence of one is associated with congenital heart and kidney anomalies. Clean from the cleanest area to the most contaminated area.

12.) Disinfect the cord three times starting from the base going outward in a circular motion and from the base going up with cotton balls soaked with antiseptic betadine. 13.) Repeat disinfection of cord three times, now using cotton balls soaked with alcohol. 14.) Do milking of the cord. Then apply cord clamp 1-1.5 inches above the base after pulsation and cut the remaining cord immediately above the clamp. Hold the cord clamp with one hand then disinfect the clamp again. 15.) Put off gloves and administer (ophthalmiclenamycin ointment) prophylactic eye treatment against opthalmia neonatorum from inner canthus to outer canthus.
Prepared and Compiled by: LGA Oanes, RN; C.E. Opalia RN; A. Macabada, RN

Helps to prevent hurry drying and reduces development of infection.

Delaying the cutting until pulsation ceases helps ensure an adequate blood cell count in the newborn. Late clamping could cause overinfusion and the possibility of polycythemia and hyperbilirubinemia. Treatment against gonorrheal conjunctivitis that may have been acquired from the mother as infant passes through their birth canal.

16.) Administer a prophylactic injection of Vitamin K and IM on babys left outer middle third thigh (vastus lateralis) 0.5 mg. Inject hepatitis B vaccine on babys right outer middle third thigh (optional). 17.) Measure babys head circumference.

Newborns are at risk for bleeding disorder. Vitamin K adds in blood coagulation.

All newborns receive a first vaccination against Hepatitis B within 12 hours after birth. Usually 34-35 cm, circumference greater than 37 cm or less than 33 cm should be carefully assessed for neurologic involvement. Usually 32-33 cm. Usually 32-33 cm. Approximately 46-54 cm. Temperature is taken through the rectum to check if the infant has an imperforated anus. Minimizes heat loss. ID band is important to prevent the infant from getting handle to wrong parents, switched or kidnapped. Footprints are kept with the babys chart for permanent identification. Minimize heat loss. Establish parent-infant bonding. For frequent monitoring and light keeps the baby warm.

Measure chest circumference. Measure abdominal circumference. Measure length using tape measure. 18.) Check temperature per rectum. Take HR, RR and weigh the baby. 19.) Put on diaper. Clothe the baby. Restrain hands with cloth gloves and place identification bracelet. Fill in the babys name card. 20.) Get the babys foot prints and restrain on foot shoe cloth. 21.) Wrap the baby. Mummify. 22.) Show the baby to the mother. 23.) Transfer the newborn to the nursery unit then place in the crib in a trendelenburg position with drop light 12-24 inches away from the newborns baby depending on light wattage. EVALUATION AND AFTER CARE 24.) Do medical handwashing. Record HR,RR, temperature, final APGAR, antropometric measurements, medication administered, final documentation of the procedure.

Deters the spread of microorganism transmission. It serves as a baseline indicating whether the infant was well birth.

Prepared and Compiled by: LGA Oanes, RN; C.E. Opalia RN; A. Macabada, RN