ESSENTIAL NEWBORN CARE

Definition: It is the care rendered to the immediate newborn.

Purposes:
a. To evaluate newborn’s ability to adapt extrauterine life
b. To prevent hypothermia
c. To prevent newborn infection
d. To prevent bleeding from the umbilical cord
e. To establish maternal-child bonding
f. To establish breastfeeding
g. To prevent newborn complications

Legal basis:
DOH Unang Yakap Campaign RA 10028 ʹ Expanded Breastfeeding Act
EO 51 ʹ Milk code of the Philippines MDG 4

Equipment:

Sterile gloves Alcohol swab

Cord care set: 1 forceps, 1 scissors, 1 cord clamp Waste disposable
2 warm baby’s drapes (layette) Medication tray
Bonnet Tape measure
Terramycin eye ointment Rectal thermometer
Vitamin K Stethoscope
Hepatitis B Working gloves
2 disposable tuberculin syringes 1 disposable needle G23 (aspi ndl)

PROCEDURE RATIONALE

1. Wash hands using medical handwashing To deters the spread of microorganism

2. Prepare all needed equipment
3. Do double gloving
4. Call out time of birth after the delivery
5. On mother’s abdomen, immediately dry
the newborn using the first baby’s drape.
Wipe first the face.
6. Wipe dry the baby for at least 30 seconds
7. Do not wipe off vernix caseosa
8. Do not wash the baby for the first 6 hours
9. Carry out rapid newborn assessment
10. Remove wet drape/layette
11. Initiate skin to skin contact by placing
To save time and energy
To maintain aseptic technique
To determine the exact time of delivery
To prevent hypothermia. Wiping the face
clears the secretions on nose and mouth.
This will also stimulate the baby to cry
It provide natural protection of baby’s skin
Bathing causes hypothermia and infection.
To ensure wellbeing
To ensure that newborn is dry
Promote warm for the baby, maternal and
 the baby prone on mother’s abdomen or
between the breasts.
12. Place the bonnet on newborn’s head
13. Use the second drape/layette to cover
the baby’s back
14. Remove the first glove
15. Palpate the cord for pulsation, when
pulsation stops, apply the cord clamp 2
cms from the base.
16. From the cord clamp, milk the cord once
5cms towards the perenial area.
17. Apply forceps/clamp 4 cms from the first clamp.
18. Cut the cord in between clamps
19. Encourage the mother to nudge her
newborn into her breast.
20. Take the initial vital signs of the newborn;
cardiac rate, respiratory rate, and rectal
temperature. Repeat every 30 minutes
using axillary thermometer for the
succeeding monitoring.
21. Administers Terramycin eye ointment on
both eyes.
22. Administer Vitamin K 1mg intramuscularly
at left thigh.
23. Administer Hepatitis B vaccine 0.5cc
intramuscularly at right thigh.
24. Measure the anthropometrics of the newborn; head circumference, chest circumference
abdominal circumference, length, and weight.
25. Let the newborn stay mother’s abdomen
for at least 90 minutes.
newborn bonding, and stimulate uterine
contraction thus preventing postpartum
bleeding.
To keep the newborn warm
To avoid unnecessary exposure thus
preventing colds.
It is already considered unsterile
Pulsation delivers more blood from the
placenta to the newborn thus preventing
anemia prevent intraventricular `
hemorrhage.
Prevent spurt of blood upon cutting
Provide space for cutting
It allows maternal-newborn bond and
stimulate the release of oxytocin thus
promoting uterine contraction.
Determine fetal coping extrauterine.
Rectal temperature also checks anal patency
Prevent ophthalmia neonatorum
Promotes coagulation thus prevents
bleeding.
Promotes antibodies against Hepatis B virus
Maximizes maternal child bonding
26. Initiate breastfeeding Provides nourishment for newborn and
maternal involution.

ESSENTIAL INTRAPARTUM CARE

Definition: It is the care given to patients during the intrapartum stage of labor.

Purposes:
a. To prevent intrapartum and postpartum complications
b. To establish breastfeeding and early latching on.
c. To prevent neonatal complications
d. To promote maternal and child bonding
e. To promote involution

Legal basis:

DOH Unang Yakap campaign

R.A. 10028 or the Expanded Breastfeeding Act
MDG 5

Equipment:

Sterile OB pack containing: Sterile cord clamp

Basin Sterile bonnet
2 big drapes (layette) Surgical blade
3 small drapes (hypo towels) Disposable syringe 5cc
1 pair of leggings Suture- chromic 2-0 double armed
Sterile flushing bowl/kidney basin with CB
soaked in betadine solution OS.
Sterile Instrument set containing: Local anesthesia
Blade holder, Tissue forceps Oxytocic drugs
Mayo scissor, Placental curette Sterile gloves
Bandage scissors, 2 ovum forceps
3 clamps, Needle holder

PROCEDURE RATIONALE

1. Determine when to open the OB pack To limit the exposure of the sterile
equipment.
2. Do medical hand washing To deter the spread of microorganism
3. Obtain the pack and check its sterility To ensure sterility
and expiration.
4. Open the OB pack aseptically To prevent contamination
5. Open the instrument set and cautiously drop the contents on the sterile field.
6. Place all sterile supplies on the sterile field: To ensure completeness of equipment
Flushing bowl, cotton balls
 Suture, disposable syringe
Surgical blade, OS
Cord clamp, Bonnet
3 pairs of surgical gloves
7. Using pick up forceps, arrange all equipment For easy accessibility of the equipment
according to its use.
8. Perform surgical hand scrubbing To ensure aseptic technique
9. Don sterile gloves
10. With assistance, aspirate 5 cc of local anesthesia. To be used during episiotomy and
episiorrhaphy.
11. Prepare the suture; cut the suture 1/3 for the Cutting needle is used to suture the skin,
cutting, 2/3 for the round needle. while the round needle is for the soft
tissues.

12. Mount the round needle to the needle holder
and secure the cutting needle.
13. Mount the surgical blade into the blade holder.
14. Drape the client’s legs aseptically.
15. Place 1 hypo towel under patient’s buttocks.
16. Coach the patient the proper breathing and
pushing technique.
17. Do Ritgen’s maneuver in external rotation
18. Assist the baby’s head in external rotation
19. Anchor the baby’s neck, pull the head
the
downwards and upward.
20. Slide your hands on baby’s back and
grasps both legs.
21. Immediately place the baby on the
mother’s abdomen for essential newborn care.
22. After cutting the cord, do Brandt Andrew’s
maneuver.
23. Place 1 hypo towel on the hypogastric
area of the mother.
Round needle is used first.
This is used for the episiotomy
To maintain sterility
To promote effective pushing technique
To prevent perineal laceration
To align the baby’s head and its shoulder
To deliver the anterior shoulder first then
posterior shoulder.
To deliver the entire body of the baby
To promote maternal and child bonding
To easily pull the placenta
To maintain sterility
24. Massage the uterus
endometrium.
25. Observe for the signs of placental separation.
placenta
26. Perform Crede’s maneuver (counter traction)
while applying traction of the cord to pull out
the placenta.
27. Replace another hypo towel under the
buttocks.
28. Assist in the episiorrhaphy or repair of
laceration.
29. Do perineal cleaning
30. Remove all drapes from the patient
31. Apply contoured brief/adult diaper
32. Straighten the legs of the patient
To promote uterine contraction causing the
separation of placenta from the
To prevent premature pulling of the
To prevent uterine prolapse or uterine
inversion.
To maintain sterility during suturing
To promote easy and time healing of
episiotomy or laceration.
To prevent infection
For the presence of vaginal secretions
and lochia.
Promote comfort

33. Change patient’s gown and make patient comfortable.

34. Dispose the placenta appropriately Promote proper waste disposal

35. Remove all sharps and dispose properly

36. Wash the instrument according to hospital protocol

37. Place all soiled linens into the hamper

38. Clean the area

39. Remove gloves

40. Document the procedure