 Vitamin K (Aqaumephyton/ Phytomenadione)

o Brown ampule
o Rationale: to prevent bleeding, prevent hemorrhagic disease
of the newborn (HDN) d/t hypoprothrombinemia (low clotting
factors)
 The baby’s liver is immature (manufactures clotting
factors)
 The gut is sterile
o Normal flora manufactures vitamin K
o To stimulate the synthesis of vitamin K dependent clotting
factors II, VII, IX, and X
o Another dose of vitamin K could be given in case of bleeding
o Dose: 0.1 ml/cc (full-term)
 Pre-term: 0.05
o Route: IM
o Site: vastus lateralis
 BCG
o Rationale: to prevent primary Koch’s infection/complex &
leprosy
 Robert Koch
o Dose: 0.05 ml/cc
o Site: right upper arm/deltoid area
 Left upper arm: school entrance (PD 996); dose: 0.1
o Route: Intradermal
o Must produce wheal/ vesicle/ bleb/ blister
 (-) wheal can lead to ulceration (malpractice-wrong
route)
 BCG should only be under the skin
 Hepatitis B
o Rationale: to prevent hepatitis B
o Dose: 0.5 ml/cc
o Site: vastus lateralis
o Route: IM
 Oil Bath
o To spread vernix caseosa (heat insulation)
 Anthropomorphic measurement
o Head circumference: 33-35 cm
 HC > CC: 1-2 cm only; >3 cm: hydrocephalus
 HC = CC: 6 months
 HC < CC: 12 months
o Chest circumference: 31-33 cm
o Abdominal circumference: 31-33 cm
o Birth length: 46-54 cm
 ↑ 50%: 12 months
o Birth weight: 2.5-3.5 kg (2500-3500 g)
<2.5 kg
 Pre-term (<37 weeks)
 Low birth weight (full-term but inadequate nutrition)
 Small gestational age (<10% of body weight among all
babies)
 <2000 g: very low birth weight
 <1500 g: extreme very low birth weight
>4 kg
 Macrosomia (gestational diabetes)
 BW x 2: 6 months
 BW x 3: 12 months
 Initial temperature
o Rectal: to check the patency of the anus
o To r/o imperforate anus
  (+) imperforate anus: No meconium >24 hours

Case Scenario
 3.2 kg – bodyweight for 6 months: 6.4
12 months: 9.6
 46 cm – length at 12 months: 69 cm
 MS: vitamin K is also given to liver cirrhosis

PHYSICAL ASSESSMENT
 Cephalocaudal

HEAD
 Microcephaly: <30 cm HC; viral infection: rubella

 Anencephaly: absence of the skull/brain

 Live up to 9 months d/t the presence of the brain stem
 Encephalocele: protrusion of the brain; occiput common site

 Craniotabes: localized softening d/t decreased maternal calcium

intake

 Molding: overlapping/overriding of the suture d/t prolonged labor