IMMEDIATE NEWBORN CARE  Observe for the following abnormal cry:

1. High pitch cry – indicates hypoglycemia,

Introduction increased intracranial pressure
Newborn undergo profound physiological changes 2. Weak cry – prematurity
at the moment of birth as they are released from 3. Hoarse cry – laryngeal stridor
warm, snug, dark, liquid-filled environment that  Keep the nares open. Newborn are obligatory nose
has met all of their basic needs, into a chilly breathers until they are about 3 weeks.
unbounded, brightly lit gravity-based outside Receiving a Newborn
world.
What are the steps?
 Within minutes after being plunged into the strange
environment, a newborn’s body must initiate Prepare the things needed:
reparations and accommodate a circulatory system
o 2 sterile gloves
to extrauterine oxygenation. Within 24 hours,
neurologic, renal, endocrine, gastrointestinal, and o Droplight2 clean cloth
metabolic functions must be operating completely o Tape measure
to sustain life o Weighing scale
 How well a newborn makes these major o 70% isopropyl alcohol
adjustments depends on his/her genetic o Sterile cord clamp
composition, the competency of the recent o Sterile blade
intrauterine environment, the care received during o Erythromycin ophthalmic ointment
labor and birth period, and the care received for the o Vitamin K
new born or neonatal period (from birth to the 28 o Tuberculin syringe
days of life). NURSES CAN PLAY A MAJOR o Diaper
ROLE IN ACHIEVING THIS GOAL. o Isolette / bassinette
GOALS OF THE IMMEDIATE NEWBORN CARE: o Sterile cotton balls
o Anthropometric Measurements:
1. To establish, maintain and support respiration.  Weight: 5.5 to 7.5 lbs
2. To provide warmth and prevent hypothermia.  Height/length: 46 – 54 cm
3. To ensure safety and prevent injury and infection.  Head circumference: 34 – 35 cm
4. To identify actual or potential problems that may
 Chest circumference: 32 – 33 cm
require immediate attention
 Abdominal circumference: 32 – 33 cm
Provide Warmth and Prevent Hypothermia
CHANGE sterile GLOVES
 Newborn suffers large losses of heat because he is
o Cord care:
wet at birth
 They loss 2 to 3 degree centigrade of heat at birth  Use 70% isopropyl alcohol and sterile cotton
because the external environment is much cooler balls
than the temperature inside the mother’s womb.  Apply in a circular manner from the sterile part
to the clean part
Nursing responsibilities:  Clamp the cord ½ - 1 inch above the abdomen
and cut it
 Dry the baby from head to foot using soft cloth
 Place the newborn under droplight Cord Care:
 Delay initial bathe until temperature has stabilized
 Maintain ambient temperature of the nursery  Use a sterile blade in cutting the cord
 Inspect for the presence of 2 arteries and 1
vein (AVA)
Maintain and Establishing effective Respiration:  Clamp is removed after 48 hors when the
cord is dried (the cord stump usually dries
 The newborn’s position should be the one which and falls off within 7-10 days)
promotes drainage of secretions o Eye Care
 It should be Trendelenburg position or head should  Crede’s prophylaxis: tetracycline or
be lower than the rest of the body erythromycin ophthalmic ointment or 1%
silver nitrate, OU
Full term: fr. 8 suction catheter
 Commonly used because the do not cause eye
Preterm: fr. 5 suction catheter irritation and more effective against gonorrheal
and chlamydial infection which may be passed
Suction gently and quickly on to the fetus from the vaginal canal during
 Mouth first befire the nose to prevent air from delivery
forcing mucus back into the bronchi and alveoli
 A crying infant is a breathing infant
  Apply over the lower eyelids of both eyes from
inner to outer canthus
o Vitamin K
 Or aquamephyton / phytomenadione
 The newborn does not posses the intestinal
bacteria that manufuctures vitamin k which is
necessary for the formation of clotting factors.
This makes the newborn prone to bleeding.

Dose:

 Preterm: 0.05 ml
 Full term: 0.10 ml

MANNER:

 Inject-aspirate-push

Route:

 Intramuscular (VASTUS LATERALIS)

For Babies Delivered via NSD:

o Diaper the baby

o Dress the baby
o Wrap the baby with thick cloth in a “swaddle”
manner
o Place the baby in a bassinette
o Render droplight

For Babies Delivered via C.S

o Diaper the baby

o Place in an isolette for 6 hours (SOP) after
delivery

DON’T FORGET:

 Clean your area (CLAYGO)

 Baseline Vital Signs after 30 minutes
 Temp: 35.5 – 37.5 C
 CR: 120 – 160 bpm
 CR when crying: up to 180 bpm
 CR when asleep: as low as 100 bpm
 RR: 30 – 60 cpm
 Watch out for any signs of distress
 Document necessary data
 Newborns I.D band