Medical Intervention

Drug Classification Indication Action Dosage Nursing Implication

Ampicillin Antibiotics  Used for 48 hours after Destroys bacteria by 50 mg/kg IV  Watch for signs and
birth, until sepsis has inhibiting bacterial cell-wall over 30 symptoms of
been ruled out. synthesis during microbial minutes hypersensitivity reaction.
 Broad spectrum multiplication  Frequently measure the
antibiotic useful against patient’s temperature and
group B streptococcus, check for signs and
Listeria monocytogenes, symptoms of superinfection,
and susceptible E. coli especially oral or rectal
species candidiasis.
 Monitor for bleeding
tendency or hemorrhage.
Gentamicin Antibiotics  Antibiotics are often Destroys gram-negative 5 mg/kg IM  Watch for signs and
used for 48 hours after bacteria by irreversibly q24hr symptoms of
birth until sepsis has binding to 30S subunit of hypersensitivity reactions.
been ruled out. bacterial ribosomes and  Monitor CBC, BUN,
 Proven neonatal sepsis blocking protein synthesis, creatinine level, and
(pneumonia, resulting in a misreading of creatinine clearance.
septicaemia, etc), with genetic code and separation
bacteria known to be of ribosomes from
sensitive messenger RNA

Other Intervention

Procedure Indication Nursing Responsibility

Oxygen Therapy  Oxygen support may be required if pulse 1. Maintain the neonate’s clear airway and suction as
 Oxygen Hood oximetry or ABG suggest hypoxemia per protocol.
 Continuous Positive  Babies with respiratory problems may 2. Administer oxygen to maintain SpO2 as per standing
Airway Pressure need to breathe increased amounts of orders. Alarm limits are set accordingly.
(CPAP) oxygen to get normal levels of oxygen in

their blood. Oxygen therapy provides
babies with extra oxygen.
Regular analysis of ABG levels in neonates
with respiratory problems until signs of
respiratory distress have resolved.
Blood Test (ABG) (Arterial blood gases give an estimate of
oxygen and carbon dioxide content, which
can assist in determining the pH as well as
metabolic abnormalities.)
Larger preterm and sick term newborns in
Intravenous Nutrition whom it is anticipated that full enteral
feedings will be delayed longer than 3-5 days.
Enteral Feeding Newborn with a high respiratory rate for
3. Change SpO2 lead position every four hours.
4. Check oxygen level and document
(including the amount of supplemental oxygen and SpO2
levels):
 at nursing handover (beginning of each shift)
 hourly if the baby on CPAP or ventilated
 2 - 3 hourly if baby receiving LF O2 / incubator O2
5. Notify medical staff if a baby’s oxygen requirement
increases consistently by 10% or more.
6. Calibrate oxygen analyzer at the beginning of each
shift,
7. The oxygen analyzer is calibrated to:
 air if baby receiving <60% O2
 100% O2 if baby receiving >60% O2
8. Provide humidification appropriate to oxygen
delivery at all times
1. Define and describe the blood test to the mother
2. State the purpose and explain the procedure
3. Monitor patient’s vital signs
4. Assess the patient’s physical condition
5. Document and report the findings to the patient’s
doctor.
1. Initiate fluid therapy at 60-80 ml/kg/d with D10W
2. Observe the intravenous site closely for extravasation
(leakage).
3. Measure urine output.
4. Palpate and inspect the site for puffiness, redness,
blanching, and skin temperature.
5. Assess IV site hourly (at a minimum), and document.
1. Ensure the tube remains in the correct position.
 Check before first feed on each shift with pH strips.
2. Visually check the position of the tube before each
feed. If in doubt aspirate to check position.
3. Aspirate routinely 6 hourly or PRN as ordered or if
more than a few hours. uncertain of placement.
4. Observe for abdominal distension.
(This will help give the baby more nutrition
5. Ensure the infant has their tubes on free drainage
without the risk of breathing in food from the
mouth into the lungs.) with the free end of the tube draining into a
specimen pot.
6. Replace tubes every 2 weeks. (note if the gastric tube
is not to be removed)
7. Document date, time, and depth of insertion on
observation chart and care map.

References:

Transient Tachypnea of the Newborn. (n.d.). Retrieved September 29, 2020, from https://www.stanfordchildrens.org/en/topic/default?
id=transient-tachypnea-of-the-newborn-90-P02420

Oxygen Therapy- Nursing Responsibilities. (n.d.). Retrieved September 29, 2020, from
http://www.adhb.govt.nz/newborn/Guidelines/Respiratory/Oxygen/OxygenTherapyNursingResponsibilities.htm