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    Immediate Care of The Newborn

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    Bianca Camille
    1. Immediate care of the newborn focuses on establishing respiration, maintaining warmth to prevent hypothermia, ensuring safety to prevent injury and infection, and identifying any problems requiring attention. 2. The most important step is clearing the airway to allow breathing, as the placenta is no longer functioning. Newborns are obligatory nose-breathers so the nose must be cleared of secretions. 3. Other key steps include stimulating crying if weak or absent, placing the newborn in a position to drain secretions, giving eye prophylaxis and vitamin K injection, and monitoring breathing and heart rate using the APGAR scoring system.

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    Immediate Care of The Newborn

    Uploaded by

    Bianca Camille
    256 views3 pages
    1. Immediate care of the newborn focuses on establishing respiration, maintaining warmth to prevent hypothermia, ensuring safety to prevent injury and infection, and identifying any problems requiring attention. 2. The most important step is clearing the airway to allow breathing, as the placenta is no longer functioning. Newborns are obligatory nose-breathers so the nose must be cleared of secretions. 3. Other key steps include stimulating crying if weak or absent, placing the newborn in a position to drain secretions, giving eye prophylaxis and vitamin K injection, and monitoring breathing and heart rate using the APGAR scoring system.

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    Immediate Care of the Newborn

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    1. Immediate care of the newborn focuses on establishing respiration, maintaining warmth to prevent hypothermia, ensuring safety to prevent injury and infection, and identifying any problems requiring attention. 2. The most important step is clearing the airway to allow breathing, as the placenta is no longer functioning. Newborns are obligatory nose-breathers so the nose must be cleared of secretions. 3. Other key steps include stimulating crying if weak or absent, placing the newborn in a position to drain secretions, giving eye prophylaxis and vitamin K injection, and monitoring breathing and heart rate using the APGAR scoring system.

    Copyright:

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    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    256 views3 pages

    Immediate Care of The Newborn

    Uploaded by

    Bianca Camille
    1. Immediate care of the newborn focuses on establishing respiration, maintaining warmth to prevent hypothermia, ensuring safety to prevent injury and infection, and identifying any problems requiring attention. 2. The most important step is clearing the airway to allow breathing, as the placenta is no longer functioning. Newborns are obligatory nose-breathers so the nose must be cleared of secretions. 3. Other key steps include stimulating crying if weak or absent, placing the newborn in a position to drain secretions, giving eye prophylaxis and vitamin K injection, and monitoring breathing and heart rate using the APGAR scoring system.

    Copyright:

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    Download as DOC, PDF, TXT or read online from Scribd
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    of 3

    Immediate Care of the Newborn

    Goals:

    • To establish, maintain and support respirations.


    • To provide warmth and prevent hypothermia.
    • To ensure safety, prevent injury and infection.
    • To identify actual or potential problems that may
    require immediate attention.

    Establish respiration and maintain clear airway

    The most important need for the newborn immediately after birth is a clear airway to enable the
    newborn to breathe effectively since the placenta has ceased to function as an organ of gas
    exchange. It is in the maintenance of adequate oxygen supply through effective respiration that
    the survival of the newborn greatly depends.

    Newborns are obligatory nose breathers. The reflex response to nasal obstruction, opening the
    mouth to maintain airway, is not present in most newborns until 3 weeks after birth.

    To establish and maintain respirations:

    1. Wipe mouth and nose of secretions after delivery of the head.

    2. Suction secretions from mouth and nose.

    • Compress bulb syringe before inserting


    • Suction mouth first, then, the nose
    • Insert bulb syringe in one side of the mouth

    3. A crying infant is a breathing infant. Stimulate the baby to cry if baby does not cry
    spontaneously, or if the cry is weak.

    • slap the buttocks rather rub the soles of the feet.


    Do not
    • Stimulate to cry after secretions are removed.
    • The normal infant cry is loud and husky. Observe for the following abnormal cry:
    o High, pitched cry – indicates hypoglycemia, increased intracranial pressure.
    o Weak cry – prematurity
    o Hoarse cry – laryngeal stridor

    4. Oral mucous may cause the newborn, to choke, cough or gag during the first 12 to 18 hours of
    life. Place the infant in a position that would promote drainage of secretions.

    • Trendelenburg position – head lower than the body


    • Side lying position – If trendelenburg position is contraindicated, place infant in side
    lying position to permit drainage of mucus from the mouth. Place a small pillow or rolled
    towel at the back to prevent newborn from rolling back to supine position.

    5. Keep the nares patent. Remove mucus and other particles that may be cause obstruction.
    Newborns are obligatory nose breathers until they are about 3 weeks old.

    Care of the Eyes

    It is part of the routine care of the newborn to give prophylactic eye treatment against gonorrhea
    conjunctivitis or opthalmia neonatorum. Neisseria gonorrhea, the causative agent, may be passed
    on the fetus from the vaginal canal during delivery. This practice was introduced by Crede, a
    German gynecologist in1884. Silver nitrate, erythromycin and tetracycline ophthalmic ointments
    are the drugs used for this purpose.

    Erythromycin or tetracycline Opthalmic Ointment:


    1. These ointments are the ones commonly used now a days for eye prophylaxis because
    they do not cause eye irritation and are more effective against Chlamydial conjunctivitis.
    2. Apply over lower lids of both eyes, then, manipulate eyelids to spread medication over
    the eyes.

    Vitamin K or Aquamephyton

    The newborn has a sterile intestine at birth, hence, the newborn does not possess the intestinal
    bacteria that manufactures vitamin K which is necessary for the formation of clotting factors.
    This makes the newborn prone to bleeding. As a preventive measure, .5 (preterm) and 1 mg (full
    term) Vitamin K or aquamephyton is injected IM in the newborn’s vastus lateralis (lateral
    anterior thigh) muscle.

    Care of the cord

    The cord is clamped and cut approximately within 30


    seconds after birth. In the delivery room, the cord is clamped
    twice about 8 inches from the abdomen and cut in between.
    When the newborn is brought to the nursery, another clamp is
    applied ½ to 1 inch from the abdomen and the cord is cut at
    second time. The cord and the area around it are cleansed
    with antiseptic solution. The manner of cord care depends on
    hospital protocol. What is important is that the principles are
    followed. Cord clamp maybe removed after 48 hours when the cord has dried. The cord stump
    usually dries and fall within 7 to 10 days leaving a granulating area that heals on the next 7 to 10
    days.

    Instruction to the mother on cord care:

    1. No tub bathing until cord falls off. Do not sponge bath to clean the baby. See to it that
    cord does not get wet by water or urine.
    2. Do not apply anything on the cord such as baby powder or antibiotic, except the
    prescribed antiseptic solution which is 70% alcohol.
    3. Avoid wetting the cord. Fold diaper below so that it does not cover the cord and does not
    get wet when the diaper soaks with urine.
    4. Leave cord exposed to air. Do not apply dressing or abdominal binder over it. The cord
    dries and separates more rapidly if it is exposed to air.
    5. If you notice the cord to be bleeding, apply firm pressure and check cord clamp if loose
    and fasten.
    6. Report any unusual signs and symptoms which indicates infection.
    • Foul odor in the cord
    • Presence of discharge
    • Redness around the cord
    • The cord remains wet and does not fall off within 7 to 10 days
    • Newborn fever
    THE APGAR SCORING SYSTEM

    The APGAR Scoring System was developed by Dr.


    Virginia Apgar as a method of assessing the newborn’s
    adjustment to extrauterine life. It is taken at one minute and
    five minutes after birth. With depressed infants, repeat the
    scoring every five minutes as needed. The one minute score
    indicates the necessity for resuscitation. The five minute
    score is more reliable in predicting mortality and
    neurologic deficits. The most important is the heart rate,
    then the respiratory rate, the muscle tone, reflex irritability
    and color follows in decreasing order. A heart rate below
    100 signifies an asphyxiated baby and a heart rate above
    160 signifies distress.

    ASSESS 0 1 2
    HEART RATE Absent Below 100 Above 100
    RESPIRATION Absent Slow Good crying
    MUCLE TONE Flaccid Some flexion Active motion
    REFLEX IRRITABILITY No response Grimace Vigorous cry
    COLOR Blue all over Body pink, Pink all over

    Extremities blue

    Score:

    • 7 – 10 Good adjustment, vigorous


    • Moderately depressed infant, needs airway clearance
    • Severely depressed infant, in need of resuscitation.

    ASSESSING THE AVERAGE NEWBORN

    Head Circumference 34 – 35 cm
    Temperature 97.6 – 98.6 F axillary
    Chest Circumference 32 – 33 cm
    Heart Rate 120 – 140 bpm
    Respirations 30 – 60 bpm
    Weight 2.5 to 3.4 kg
    Length 46 to 54 cm

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