Immediate Newborn Care I. Definition: Early management of the newborn in the delivery room or in the Nursery few minutes or soon after birth. II. Rationale: The newborn is a unique, fragile being who experiences the transition from a comfortable uterine environment to a threatening external environment. Each infant should be regarded as an individual and should not be looked upon as just another new baby and should receive the amount of care that his condition demand so as: 1. to establish and maintain respiration 2. to prevent infection to set in 3. to maintain records of observation of the infant’s condition 4. to prevent complication Procedure:
1. Prepare the needed equipments 2. Do medical hand washing
3. Don sterile gloves
To facilitate ac access to them, th therefore assuring an an organized work. To reduce the number of microorganisms present in the hand therefor thereforee control controllin ling g the spread of infection To protect the nurse’s hand from direct contact of blood and also to prevent cross contamination
4. Receive baby from the doctor 5. Put the baby on the infant crib with the head To facilitate drainage of secretions lower than the body 6. Suction the baby’s mouth and nose and do the Suctioning the mouth first will prevent aspiration first minute APGAR of the mucus. Suctioning helps clear the airway of mucus therefore entry of O2 is facilitated. 7. Bathe with lukewarm water or clean the baby Bathing cleanses dirty secretions as well as blood with baby oil which may become a source of infection 8. Dry the baby with a bath towel then keep warm by using drop light at least 12-24 inches away then do again the post five minutes APGAR 9. Weigh the baby 10. Restrain baby’s hand and feet with diaper 11. Remove used gloves then put on new sterile gloves Proceed to cord dressing: To prot protec ectt cord cord from from cont contam amin inat atio ion n ther thereb eby y 12. Disinfect cord 3x starting from the base going preventing septicemia out with cotton balls soaked in alcohol 13. Disinfect cord 3x from base going up with cotton balls soaked in alcohol 14. Apply cord clamp 1inch – 1.5inches above the base
15. Cut the cord immediately above the clamp 16. Hold cord clamp with one hand then disinfect 17. Measure baby’s head circumference, chest To provide necessary information which may circumference, abdominal circumference and birth indicate of either normalcy or abnormality: to length using tape measure. provide a basis for the future progress of the newborn. 18. Put on diaper then dress the baby To protect him from chilling since the newborn is sensitive to the sudden change of temperature outside the uterus. 19. Check temperature using rectal thermometer To check anal the patency of the anus 20. Inject vitamin K on baby’s left outer middle Vit.K is a blood coagulant therefore it protects the third thigh (vastus lateralis muscle) newborn from bleeding tendencies. (Vit. K is supposed to be synthesized by the normal bacterial flora of the GIT, but since the NB’s GIT is still sterile at birth, there is no bacterial flora yet to synthesize Vit. K, so it has to be provided from an external source. 21. Inject Hepatitis B vaccine on baby’s right outer middle third thigh (vastus lateralis muscle) 22. Get baby’s cardiac and respiratory rate To have a baseline data of the newborn’s cardiac and respiratory rate 23. Get the foot prints Foot printing serves as an identification 24. Apply bracelet To prevent mistakes in identifying the baby when given to the mother 25. Fill in baby’s name card 26. Wrap the baby/mummify This will help in developing maternal-child bonding 27. Apply terramycin ophthalmic ointment from It will prevent possible eye infection which maybe inner to outer canthus transmitted by maternal secretions as the newborn passed the birth canal. It is highly indicated for infants with mother known to have gonorrhea. The eye treatment will prevent ophthalmia neonatorum. 28. Show the baby to the mother This will help in developing maternal-child bonding 29. Transfer the newborn to the nursery unit then placed in the crib in a trendelenburg position with drop light on in 12-24 inches away from the newborn’s body depending light wattage 30. After care 31. Remove used gloves and do medical handwashing. 32. Record CR, RR, Temperature, final APGAR, anthropometric measurements, medications administeres, final documentation of the procedure (nurses notes)