using breathing exercises offers her a sense of well-
being.
1. Signs of labor
Signs of labor include strong and regular contractions,
pain in your belly and lower back, a bloody mucus
discharge and your water breaking. If you think you're in
labor, call your health care provider. Not all contractions
mean you're in true labor.
2. Preliminary signs of labor
Before labor, a woman often experiences subtle signs that
signal labor is imminent. It is important to review these with
women during the last trimester of pregnancy so they can
more easily recognize beginning signs.
 Lightening - descent of the fetal presenting part into
the pelvis, occurs approximately 10 to 14 days
before labor begins
o Lightening probably occurs early in
primiparas because of tight abdominal
muscles. In multiparas, it is not as dramatic
and usually occurs on the day of labor or
even after labor has begun.
A woman may experience shooting leg
pains from the increased pressure on her
sciatic nerve, increased amounts of vaginal
discharge, and urinary frequency from
pressure on her bladder.
 Increase in Level of Activity - A woman may awaken
on the morning of labor full of energy, in contrast to
the feeling of chronic fatigue she felt during the
previous month.
o This increase in activity is related to an
increase in epinephrine release initiated by
a decrease in progesterone produced by the
placenta. This additional epinephrine
prepares a woman’s body for the work of
labor ahead.
 Slight Loss of Weight - As progesterone level falls,
body fluid is more easily excreted from the body.
This increase in urine production can lead to a
weight loss between 1 and 3 pounds.
 Braxton Hicks Contractions - a woman usually
notices extremely strong Braxton Hicks contractions.
 Ripening of the Cervix - is an internal sign seen only
on pelvic examination. Throughout pregnancy, the
cervix feels softer than normal to palpation, similar
to the consistency of an earlobe (Goodell’s sign). At
term, the cervix becomes still softer (described as
“butter-soft”), and it tips forward. Cervical ripening
this way is an internal announcement that labor is
very close at hand.
3. Signs of true labor
Signs of true labor involve uterine and cervical changes. The
more a woman knows about these labor signs, the better she
will be able to recognize them. This is helpful both to prevent
preterm birth and for the woman to feel secure knowing
what will happen during labor.
 Uterine Contractions - The surest sign that labor has
begun is productive uterine contractions. Because
contractions are involuntary and come without
warning, their intensity can be frightening in early
labor. Helping a woman appreciate that she can
predict when her next one will occur and therefore
can control the degree of discomfort, she feels by
 Show - As the cervix softens and ripens, the mucus
plug that filled the cervical canal during pregnancy
(operculum) is expelled. The exposed cervical
capillaries seep blood as a result of pressure exerted
by the fetus. This blood, mixed with mucus, takes on
a pink tinge and is referred to as “show” or “bloody
show.” Women need to be aware of this event so
that they do not think they are bleeding abnormally.
 Rupture of the Membranes - Labor may begin with
rupture of the membranes, experienced either as a
sudden gush or as scanty, slow seeping of clear fluid
from the vagina. Some women may worry if their
labor begins with rupture of the membranes,
because they have heard that labor will then be
“dry” and that this will cause it to be difficult and
long. Actually, amniotic fluid continues to be
produced until delivery of the membranes after the
birth of a fetus, so no labor is ever “dry.” Early
rupture of the membranes can be advantageous as it
can cause the fetal head to settle snugly into the
pelvis, actually shortening labor.
o Two risks associated with ruptured
membranes are intrauterine infection and
prolapse of the umbilical cord, which could
cut off the oxygen supply to the fetus
4. Components of labor and its description
A successful labor depends on four integrated concepts:
1. A woman’s pelvis (the passage) is of adequate size and
contour.
2. The passenger (the fetus) is of appropriate size and in
an advantageous position and presentation.
3. The powers of labor (uterine factors) are adequate.
(The powers of labor are strongly influenced by the
woman’s position during labor.)
4. A woman’s psychological outlook (psyche)is preserved,
so that afterward labor can be viewed.
5.Types of fetal presentation
Cephalic- With this type of presentation, the fetal
head is the body part that will first contact the
cervix.
Breech - This means that either the buttocks or
the feet are the first body parts that will contact
the cervix.
Transverse- The fetus lies horizontally in
the pelvis so that the longest fetal axis is
perpendicular to that of the mother. The
presenting part is usually one of the
shoulders (acromion process), an iliac crest,
a hand, or an elbow
Types of Cephalic Presentation
Vertex- The head is sharply flexed, making the
parietal bones or the space between the
fontanelles (the vertex) the presenting part.
This is the most common presentation and
allows the suboccipitobregmatic diameter to
present to the cervix.

Brow- Because the head is only moderately
flexed, the brow or sinciput becomes the
presenting part.
Face- The fetus has extended the head to
make the face the presenting part. From
this position, extreme edema and
distortion of the face may occur.
Mentum- The presenting diameter is so
wide that birth may be impossible. The
fetus has completely hyperextended the
head to present the chin. The widest
diameter (occipitomental) is presenting. As
a rule, a fetus cannot enter the pelvis in
this presentation.
6.Fetal Positions
LOA- Left occiput anterior (LOA) refers to the
position of your baby for labor and birth.
Specifically, LOA means your baby is entering
your pelvis head down, facing the area
between your spine and right hip.
LOP- If the baby is facing forward and slightly
to the left (looking toward the mother's right
thigh) it is in the left occiput posterior (LOP)
position. This presentation can lead to more
back pain (sometimes referred to as "back
labor") and slow progression of labor.
ROA- The right occiput anterior (ROA)
position means a baby enters the mother's
pelvis with his back towards the front right
side of her pelvis. Imagine the woman's pelvic
brim (seen from the top) as a clock. Her pubis
is at 12 o'clock and her spine is at 6 o'clock.
ROP - In the right occiput posterior position
(ROP), the baby is facing forward and slightly to
the right (looking toward the mother's left
thigh). This presentation may slow labor and
cause more pain.
7. Describe the ff:
A. Dilatation- refers to the enlargement or
widening of the cervical canal from an
opening a few millimeters wide to one
large enough (approximately 10 cm) to
permit the passage of a fetus.
B. Frequency- Is the time from the
beginning of one contraction to the
beginning of the next contraction.
C. Duration- The length of your
contractions; Measure the duration of
each contraction by timing when it begins
and when it stops. True contractions last
about 30 seconds at the onset and get
progressively longer up to 75 seconds and
stronger.
D. Interval- The time between contractions;
includes the length/duration of the
contraction and the minutes in between
the contractions. Mild contractions
generally begin 15 to 20 minutes apart
and last 60 to 90 seconds
E. Intensity- can be estimated by touching
the uterus. The relaxed or mildly
contracted uterus usually feels about as
firm as a cheek, a moderately contracted
uterus feels as firm as the end of the nose,
and a strongly contracted uterus is as firm
as the forehead.
F. Fetal Attitude- Describes the degree of
flexion a fetus assumes during labor or
the relation of the fetal parts to each other
G. Engagement- Refers to the settling of the
presenting part of a fetus far enough into
the pelvis to be at the level of the ischial
spines, a midpoint of the pelvis.
H. Station- Refers to the relationship of the
presenting part of a fetus to the level of
the ischial spines
I. Fetal Lie- Is the relationship between the
long (cephalocaudal) axis of the fetal
body and the long (cephalocaudal) axis of
a woman’s body; in other words, whether
the fetus is lying in a horizontal
(transverse) or a vertical (longitudinal)
position.
8. Purposes of Oxytocin Administration
 In labor - TO INITIATE CONTRACTIONS; oxytocin
stimulation works together with prostaglandin
 In CS - TO INCREASE UTERINE CONTRACTION &
REDUCE BLOOD LOSS post-op, oxytocin (Pitocin) is given
by the anesthesiologist as the child or the placenta is
delivered
 Post Delivery - TO INCREASE UTERINE CONTRACTION &
INVOLUTION or the return of the uterus to the
prepregnant state
 In Elective Termination of Pregnancy - TO INITATE
UTERINE CONTRACTIONS; a dilute IV solution of oxytocin
is used with misoprostol, prostaglandin F2 or E2 and a
20% saline injection into the uterus.
 In breastfeeding - TO AID IN SMOOTH MUSCLE  Lengthening of the Umbilical Cord
CONTRACTION of the mammary gland for milk letdown
9. Stages of Labor 12. Placental Expulsion

Placental expulsion occurs when the placenta comes

out of the birth canal after childbirth.
The period from just after the baby is expelled until just
after the placenta is expelled is called the third stage of
labor.
 After separation, the placenta is delivered either by
the natural bearing-down effort of the mother or by
gentle pressure on the contracted uterine fundus by
a physician or nursemidwife (Credé’s maneuver).
Crede’s Manuever – This is
10. Mechanisms (Cardinal Movement) of Labor
executed by exerting manual
pressure on the post-partum
mother’s abdomen at the location
of the bladder, just below the
navel or umbilicus.
The fundus of the uterus is “pinch” upward and backward by
the midwife’s non-dominant thumb and forefingers, while the
dominant hand pulls the cord downward.
 Pressure must never be applied to a uterus in a
noncontracted state, because doing so may
cause the uterus to evert and hemorrhage.

NURSING INTERVENTIONS:
1. ENGAGEMENT,  Observe Lochia for color and amount
DESCENT, AND FLEXION  Offer fluids as indicated
- occur simultaneously  Palpate fundus immediately after delivery of
 the head engages below the plane of the pelvic inlet placenta; massage gently if not firm
 the presenting part begins to descendinto the birth  Palpate fundus at least every 15 minutes for first 1-2
canal hours
 the chin of the fetus moves towards itschest  Inspect Perineum
2. INTERNAL ROTATION  Assist with maternal Hygiene as needed.
- the fetal head rotates by 90° (two 45° steps)in the midpelvis, a. clean gown
from a transverse to anterior-posterior position b. warm blanket
3. RESTITUTION c. clean perineal pads
- The fetal head rotates 45° in the opposite  Promote beginning relationship with baby and
direction as it passes through the pelvic outlet parents through touch and privacy
4. EXTENSION Administer medications as ordered/needed methergine
- the fetal head, lying behind the sumphysis (Pitocin added to IV if present)
pubis bone and the pelvic floor, acts
upwards and forwards 13. Differentiate a Schultze and Duncan Placenta
5. EXTERNAL ROTATION
- the anterior shoulder rotates 45° anteriorly The placenta is in the uterus. One side is attached to the
as it meets the maternal pelvic floor. This uterus and the other faces the baby. These are sometimes
action is transmitted to the head which also referred to as “Dirty Duncan” and Shiny Schultz.
rotates 45°, placing the head in its original Schultz Placenta
transverse position
● The separation of the
6. EXPULSION
placenta from the uterine
- Delivery of the head, anterior shoulder
wall during labor; begins at
followed by the posterior shoulder, and the
the placental center and
body
leads to an expulsion of the placenta after delivery of the
NURSING INTERVENTION:
baby. 
 Prepare the Patient for Delivery
● Appearing shiny and glistening from the fetal membranes
 Assist in the Physician in episiotomy and
episiorrhapy
Duncan Placenta
 Assist Patient in breathing techniques
 Bring a multiparous patient to the DR at 7-8 cm ● The expulsion of the placenta
with the presentation of the
11. Signs of placental separation (A.S.U.L) maternal rough side first, rather
than the usual fetal side of the
 Appearance of the Placenta
placenta. 
at the Vaginal Opening
 Sudden gush of Bleeding ● It looks raw, red, and irregular, with the ridges or
 Uterus becomes firm and cotyledons that separate blood collection spaces showing,
globular
 Uterus rises in the
abdomen

14. Delivery Room Instruments
Mayo Table – where all instruments are
placed
Mayo Scissor – used to cut umbilical cord
Kelly Clamp- Kelly Curve- used to
clamp the cord towards the baby. Kelly
Straight- used to clamp the cord towards
the placenta.
Metz Scissor – used to suture during
episiorraphy
Needle holder- used to hold the needle
Tissue forceps- used to grasp tissue
Handle with Ten blades (inside knife)
-used to cut superficial tissue
Handle with 20 blades (skin knife)
-used to cut skin
MAJOR SET
Kocher-Ochsner- used to grasp heave tissue
and can be also used as a clamp.
its jaw can be straight and curved.
Babcock Forceps - used to grasp delicate
tissue such as intestine, fallopian tube,
ovary, and appendix, also available in long
sizes.
Allis Forceps- used to grasp tissue and is
available also in long size
Round Nose (Kelly curve) - used to clamp
larger tissues or vessels.
Hemostat- used to clamp blood vessels or tag
sutures.it may be straight or curve
Backhaus towel clips-- used to hold drapes,
most especially towels in place.
Thumb forceps- used by compression
between your thumb and forefinger and are
used for grasping, holding, or manipulating
body tissue
Army Navy Retractor (also called
right-angle retractor/US Army
retractor
Used to retract shallow or superficial incisions. From small
wounds to abdominal operations.
Blade #4- Used for skin incisions in both
cardiac and thoracic surgery and to cut the
bronchus in lung resection surgery.
Mayo Scissors - used to cut
heavy tissues such as fascia,
muscle, uterus, breast).
Metzebaum – used to cut delicate
tissues
MINOR SET
Straight Mayo Scissors- used to cut
suture and supplies.
Also known as suture scissors
Metzenbaum – used to cut delicate
tissues
Adison Forceps- used to clamp deep
blood vessels
Mosquito - used to clamp small
blood vessels (may be straight or
curved).
Dilation (dilatation) and curettage (D&C)
Is a brief surgical procedure referring to the dilations (opening
of the cervix and the surgical removal of the contents of the
uterus.
Purpose
● Remove tissue in the uterus during or after a miscarriage
or abortion or remove small pieces of placenta after childbirth.
This helps prevent infection or heavy bleeding.
● Diagnose or treat abnormal uterine bleeding. Diagnosing
or treating growths such as fibroids, polyps or endometriosis,
hormonal imbalances, or uterine cancer. A sample of uterine
tissue is viewed under a microscope to check for abnormal
cells.

Hysterometer- A graduated sounding
instrument for measuring the depth of the
uterine cavity
Tenaculum- For cervical traction.
Unique design grasps the cervix in a
single “snap close” movement,
minimizing pain.
Curretes sharp #2,3,4,5 - a surgical
instrument shaped like a scoop or spoon
used to remove tissue or growths from a
body cavity.
Ovum Forceps- are commonly used to
remove placental fragments inside the
uterus.
It is also used as a hemostat or a clamping
instrument.
Uterine Forceps- specially designed
forceps to help grasp or hold the uterine
the parts of the body when the uterus is
being operated.
15. Perineal Care
Pattern for cleaning perineum before birth. Cleaning from the
birth canal outward moves bacteria away from, not into, the
vagina. Numbers refer to steps of the procedure.
16. Positioning Mother in the DR Table
● If a physician prefers a lithotomy position for birth,
position the woman into the bed stirrups. Raise both of
the woman’s legs at the same time to prevent strain on
her back and lower abdominal muscles.
● The strap holding the leg in the stirrups should be secured
snugly but not so tightly that it causes constriction.
● Pad the stirrups with abdominal pads if a woman has
ankle edema.
● To prevent thrombophlebitis, be certain that there is no
pressure on her calves.
● Because pushing becomes less effective in a lithotomy
position, the top portion of the table should be raised to a
30- to 60-degree angle, so that the woman can continue
to push effectively.
● Lying for longer than 1 hour in a lithotomy position leads
to intense pelvic congestion, because blood flow to the
lower extremities is impeded. Pelvic congestion may lead
to an increase in thrombophlebitis in the postpartal
period. It may also contribute to excessive blood loss with
birth and placental loosening. For these reasons, place the
woman’s legs in a lithotomy position only at the last
moment.
● Once a woman is in a lithotomy position, the bed’s lower
half is folded downward so the physician can be in close
proximity to the birth outlet.
● Make sure there is always someone at the foot of a broken
birthing bed so that, if birth should occur precipitously, the
infant will not fall and be injured.
● Alternative birth positions include the lateral or Sims’
position, the dorsal recumbent position, semi-sitting, and
squatting.
17. Draping during Delivery
● After anesthetic administration, a woman is positioned
with a towel under her right hip to move abdominal
contents away from the surgical field and to lift her uterus
off the vena cava.
● A screen may be placed at her shoulder level and covered
with a sterile drape to block the flow of bacteria from her
respiratory tract to the incision site.
● This also helps block the woman’s and support person’s
lines of vision, preventing additional anxiety caused by the
sight of the incision.
● Be sure the support person is positioned at the woman’s
head to provide support.
18. Actual Handling of Delivery
● As soon as the head of a fetus is prominent (approximately
8 cm across) at the vaginal opening, the physician or
nurse-midwife may place a sterile towel over the rectum
and press forward on the fetal chin while the other hand is
pressed downward on the occiput.
● This helps a fetus achieve extension, so that the head is
born with the smallest diameter presenting. This also
controls the rate at which the head is born.
● Pressure should never be applied to the fundus of the
uterus to effect birth, because uterine rupture could occur.
● A woman is asked to continue pushing until the occiput of
the fetal head is firmly at the pubic arch. Then the head is
born between contractions. This helps to prevent the head
from being expelled too rapidly.
● The woman may be asked to pant deliberately, so that she
does not push during a contraction.
● She may be asked to push again without a contraction
present to deliver the shoulders.
● Instructions should be repeated as necessary, because
often a woman is so involved with the coming birth that
she does not hear.
● Immediately after birth of the baby’s head, the physician
or nurse-midwife suctions the infant’s mouth with a bulb
syringe and then passes his or her fingers along the occiput
to the newborn’s neck, to determine whether a loop of
umbilical cord is encircling the neck.
● After expulsion of the fetal head, external rotation occurs.
Gentle pressure is exerted downward on the side of the
infant’s head, and the anterior shoulder is born.
● Slight upward pressure on the side of the head allows the
anterior shoulder to nestle against the symphysis as the
posterior shoulder is born.
● The remainder of the body then slides free without any
further difficulty.
● A child is considered born when the whole body is born.
This is the time that should be noted and recorded as the
time of birth.
● With the birth of the infant, the second stage of labor is
complete
19. Ritgen’s Maneuver
● Used to control delivery
of the fetal head.
● It involves applying
upward pressure from
the coccygeal region to
extend the head during actual delivery, thereby protecting
the musculature of the perineum.
● The physician or nurse-midwife may place a sterile towel
over the rectum and press forward on the fetal chin while
the other hand is pressed downward on the occiput.
20. Episiotomy

-An episiotomy is an incision made
in the perineum the tissue between
the vaginal opening and the anus
during childbirth.
 Midline (median) incision. A midline incision is
done vertically. A midline incision is easier to repair,
but it has a higher risk of extending into the anal area.
 Mediolateral incision. A mediolateral incision is
done at an angle. A mediolateral incision offers the
best protection from an extended tear affecting the
anal area, but it is often more painful and is more
difficult to repair.
21. Cord clamping and cutting
-Umbilical
the newborn from mother. Umbilical
cord clumping consists in the binding
of the umbilical cord by nipper to
interrupt blood flow from placenta to foetus.  prevent sore and cracked nipples so it's important to get it
 Ductus venosus
-Continuation og umbilical cord- a shunt to bypass liver
 Foramen ovale
-shunts blood from RA to LA
 Ductus arteriosus
-Connects aorta and pulmonary artery
infant. This compasses interventions such as ensuring
warmth, breastfeeding, love and safety and infection
control. This protocol is now practiced in birthing centers and
hospitals. Placing babies in immediate skin-to-skin contact
with their mothers keeps babies warm, prevents exposure to
surfaces in health facilities that may carry diseases, and helps
establish breastfeeding. Babies who drink only their mother’s
breastmilk receive antibodies from their mothers, protecting
them from potentially deadly infections like pneumonia,
diarrhea and sepsis. In fact, Unang Yakap and exclusive
breastfeeding are vital to Infection Prevention and Control
(IPC) measures. With proper IPC, protection from infection
becomes stronger, especially in challenging circumstances
and in emergencies. 
24. Latch-on
Latching on is how your baby attaches
to your breast to feed. Lots of people
assume that this comes naturally, but
in reality it's more of a skill that the
mother and the baby need to learn
together. Good attachment also helps
right. 
The LATCH assessment is an assessment tool that can
provide measures to help evaluate a newborn’s
breastfeeding effectiveness.

22.
Cord

Vessels and its

function Steps to a Good Latch

-The umbilical cord is mostly Teach mothers to:

made up of connective tissue
known as Wharton's Jelly and 1. Tickle the baby's lips with their nipple.
has relatively few cells. The This will help the baby open their mouth
cord has one large umbilical wide.
vein and two umbilical
arteries. These vessels
transport blood to and from
the placenta, where exchange
between the mother and fetus 2. Aim the nipple just above the baby's
takes place. The umbilical cord top lip. Make sure the baby's chin isn't
should be assessed for length, tucked into their chest.
insertion, number of vessels,
thromboses, knots, and the presence of Wharton's jelly.
After childbirth, doctors clamp and cut the cord. A small
stump will be left on the child’s belly. It can be anywhere
from a half-inch to an inch long. At first, the stump might look
shiny and yellow. But as it dries out, it may turn brown or
gray or even purplish or blue. It’ll shrivel and turn black
before it falls off on its own. Usually, it comes off between 10
and 14 days after your baby is born, but can take as long as
21 days.

23. Unang Yakap 
- is a simple and evidence-based
intervention that may help in ensuring
the survival of all newborns and young
3. Aim the baby's lower lip away from the base of their
nipple. Baby's lips should be turned outward like a fish.
The baby should lead into the breast chin first and then
latch onto the mother’s breast. The baby's tongue
should be extended, and the breast breast should fill
your baby's mouth.

25. APGAR Scoring
Apgar scoring is done at one and five minutes after
birth. The newborn is considered to be “vigorous” if the initial
scores are 7 and above. If the five-minute score is less than 7,
scoring is done every five minutes thereafter until the score
reaches 7.
26. (Newborn) Normal Range of the following:
a. Height/Length
 The
average birth length (50th
percentile) of a mature female
newborn is 49 cm (19.2 in).
 For mature males, the average
birth length is 50 cm (19.6 in).
 The lower limit of expected birth
length is arbitrarily set at 46 cm (18
in).
 Although rare, babies with lengths
as great as 57.5 cm (24 in) have
been reported.
b. Weight
 The average birth weight (50th percentile) for a
mature female newborn is 3.4 kg (7.5 lb).
 For a mature male newborn is 3.5 kg (7.7 lb).
 Newborn weights vary according to ethnicity and
background.
 The arbitrary lower limit of expected birth weight for
all newborns is 2.5 kg (5.5 lb).
 Birth weight exceeding 4.7 kg (10 lb) is unusual, but
weights as high as 7.7 kg (17 lb) have been
documented.
 If a term newborn weighs more than 4.7 kg, the baby
is said to be macrosomic, a condition that usually
occurs in conjunction with a maternal illness, such as
diabetes mellitus.
 Second-born children
usually weight more
than first-born ones.
 Birth weight continues to increase with each
succeeding child in a family.
c. Head circumference
 In a mature newborn, the head circumference is
usually 34 to 35 cm (13.5 to 14 in).
 A mature newborn with a head circumference
greater than 37 cm (14.8 in) or less than 33 cm (13.2
in) should be carefully assessed for neurologic
involvement, although some well newborns have
these measurements.
d. Chest circumference
 Chest circumference is measured at the level of the
nipples. If a large amount of breast tissue or edema
of breasts is present, this measurement will not be
accurate until the edema has subsided.
 The chest circumference in a term newborn is about
2 cm (0.75 to 1 in) less than the head circumference.
e. Vital signs
Temperature
 The temperature of newborns is about 99° F (37.2°
C) at birth because they have been confined in their
mother’s womb and supportive uterus.
 Temperature will fall almost immediately to below
normal because of heat loss, temperature of birthing
rooms, approximately 68° to 72° F (21° to 22° C), can
add to this loss of heat, and infant’s immature
temperature-regulating mechanisms if the baby is
not protected from heat loss at birth and in the
moments afterward.
Pulse rate
 The heart rate of a fetus in utero averages 110 to
160 beats per minute (bpm). Immediately after birth,
as the newborn struggles to initiate respirations, the
heart rate may be as rapid as 180 bpm.
 Within 1 hour after birth, as the newborn settles
down to sleep, the heart rate stabilizes to an average
of 120 to 140 bpm.
 During crying, the rate may rise again to 180 bpm. In
addition, heart rate can decrease during sleep,
ranging from 90 to 110 bpm.
Respiratory rate
 The respiratory rate of a newborn in the first few
minutes of life may be as high as 90 breaths per
minute.
 As respiratory activity is established and maintained
over the next hours, this rate will settle to an
average of 30 to 60 breaths per minute.
27. Crede’s Prophylaxis
● It is an installation of prophylactic agent in the eyes
of all neonates that serves as precautionary measure
against opthalmic neonatorum, which is the
 inflammation/infection of the eyes resulting from
gonorrheal or chlamydial infection contracted by the
newborn during passage through the mother's birth LABOR AND DELIVERY POCKET GUIDE
canal it occurs within the first 30 days of life.

● The agent used for prophylaxis varies according to Submitted by:

the hospital protocols but usually include forms of
erythromycin or tetracycline. MARIE ASHLEY CASIA

NEONATAL DOSAGE: Apply 1 to 2

cm ribbon of ointment to the
lower conjuctival sac of eye; also
may be used in drop form
.
Procedures:
1.Prepare materials
2.Wash hands
3.Apply gloves
4.Place the infant in supine position
5.Wipe eyelid of the newborn with a sterile cotton ball
saturated with sterile normal saline solution, from the inner
canthus to the outer canthus of the eye.
6.Retract the lower eyelid with your thumb ( to reveal the
conjunctiva, because the 7.ointment is supposed to be placed
on the conjuctiva sac and not on the eyeball.)
8.Instill a liberal amount of the doctor ordered ophthalmic
ointment in the lower conjuctival sac starting from the inner
to the outer canthus of the eye. The tip of the tube should
not touch the eye or eyelid ( to prevent injury).
9.Wipe off excess medication with a sterile gauze ( as this
may irritate the skin near the eyes) Repeat procedure with
the other eye.
10. Observe eyes for irritation.

28. Purpose of Vitamin K administration

● Newborns are at risk

for vitamin K deficiency
bleeding (VKDB)
caused by inadequate
prenatal storage and
deficiency of vitamin K
in breast milk.
Systematic review of evidence to date suggests that
a single intramuscular (IM) injection of vitamin K at
birth effectively prevents VKDB. Current scientific
data suggest that single or repeated doses of oral
(PO) vitamin K are less effective than IM vitamin K in
preventing VKDB.

● The Physicians of Canada recommend routine IM

administration of a single dose of vitamin K at 0.5 mg
to 1.0 mg to all newborns. Administering PO vitamin
K (2.0 mg at birth, repeated at 2 to 4 and 6 to 8
weeks of age), should be confined to newborns
whose parents decline IM vitamin K. Babies who
don't get vitamin K at birth are at risk for a
potentially fatal bleeding disorder called vitamin K
deficient bleeding (VKDB). VKDB can cause bruising
or bleeding in nearly every organ of the body.
Almost half of VKDB cases involve bleeding in the
brain and brain damage.

UNIVERSITY OF SOUTHERN
PHILIPPINES FUNDATION

COLLEGE OF HEALTH SCIENCES

NURSING DEPARTMENT
S.Y 2021-2022
2ND SEMESTER