IMMEDIATE NEWBORN CARE Goals:  To establish, maintain and support respirations.  To provide warmth and prevent hypothermia.

 To ensure safety, prevent injury and infection.  To identify actual or potential problems that may require immediate attention Establish respiration and maintain clear airway The most important need for the newborn immediately after birth is a clear airway to enable the newborn to breathe effectively since the placenta has ceased to function as an organ of gas exchange. It is in the maintenance of adequate oxygen supply through effective respiration that the survival of the newborn greatly depends. Newborns are obligatory nose breathers. The reflex response to nasal obstruction, opening the mouth to maintain airway, is not present in most newborns until 3 weeks after birth. To establish and maintain respirations: 1. Wipe mouth and nose of secretions after delivery of the head. 2. Suction secretions from mouth and nose.  Compress bulb syringe before inserting  Suction mouth first, then, the nose  Insert bulb syringe in one side of the mouth 3. A crying infant is a breathing infant. Stimulate the baby to cry if baby does not cry spontaneously, or if the cry is weak.  Do not slap the buttocks rather rub the soles of the feet.  Stimulate to cry after secretions are removed.  The normal infant cry is loud and husky. Observe for the following abnormal cry:  High, pitched cry – indicates hypoglycemia, increased intracranial pressure.  Weak cry – prematurity  Hoarse cry – laryngeal stridor

to choke. Silver nitrate. place infant in side lying position to permit drainage of mucus from the mouth. may be passed on the fetus from the vaginal canal during delivery. cough or gag during the first 12 to 18 hours of life. . As a preventive measure. erythromycin and tetracycline ophthalmic ointments are the drugs used for this purpose.4. Erythromycin or tetracycline Opthalmic Ointment: 1. Apply over lower lids of both eyes. hence. Place a small pillow or rolled towel at the back to prevent newborn from rolling back to supine position. Keep the nares patent. manipulate eyelids to spread medication over the eyes. This practice was introduced by Crede. Oral mucous may cause the newborn. 5.  Trendelenburg position – head lower than the body  Side lying position – If trendelenburg position is contraindicated. Vitamin K or Aquamephyton The newborn has a sterile intestine at birth. 2. Care of the Eyes It is part of the routine care of the newborn to give prophylactic eye treatment against gonorrhea conjunctivitis or opthalmia neonatorum. This makes the newborn prone to bleeding. a German gynecologist in1884.5 (preterm) and 1 mg (full term) Vitamin K or aquamephyton is injected IM in the newborn’s vastus lateralis (lateral anterior thigh) muscle. Care of the cord . the newborn does not possess the intestinal bacteria that manufactures vitamin K which is necessary for the formation of clotting factors. the causative agent. Newborns are obligatory nose breathers until they are about 3 weeks old. Remove mucus and other particles that may be cause obstruction. Place the infant in a position that would promote drainage of secretions. Neisseria gonorrhea. then. These ointments are the ones commonly used now a days for eye prophylaxis because they do not cause eye irritation and are more effective against Chlamydial conjunctivitis.

Instruction to the mother on cord care: 1. The cord stump usually dries and fall within 7 to 10 days leaving a granulating area that heals on the next 7 to 10 days.  Foul odor in the cord  Presence of discharge  Redness around the cord  The cord remains wet and does not fall off within 7 to 10 days  Newborn fever THE APGAR SCORING SYSTEM The APGAR Scoring System was developed by Dr. With depressed infants. Fold diaper below so that it does not cover the cord and does not get wet when the diaper soaks with urine. 5. another clamp is applied ½ to 1 inch from the abdomen and the cord is cut at second time. reflex irritability and color follows in decreasing order. apply firm pressure and check cord clamp if loose and fasten. What is important is that the principles are followed. No tub bathing until cord falls off. Report any unusual signs and symptoms which indicates infection. except the prescribed antiseptic solution which is 70% alcohol. the muscle tone. The most important is the heart rate. The five minute score is more reliable in predicting mortality and neurologic deficits. Avoid wetting the cord. then the respiratory rate. 2. The cord and the area around it are cleansed with antiseptic solution. Cord clamp maybe removed after 48 hours when the cord has dried. Do not sponge bath to clean the baby. 4. In the delivery room. 3. A heart . the cord is clamped twice about 8 inches from the abdomen and cut in between. See to it that cord does not get wet by water or urine. Do not apply dressing or abdominal binder over it.The cord is clamped and cut approximately within 30 seconds after birth. If you notice the cord to be bleeding. The cord dries and separates more rapidly if it is exposed to air. The one minute score indicates the necessity for resuscitation. When the newborn is brought to the nursery. The manner of cord care depends on hospital protocol. It is taken at one minute and five minutes after birth. repeat the scoring every five minutes as needed. Leave cord exposed to air. Virginia Apgar as a method of assessing the newborn’s adjustment to extrauterine life. 6. Do not apply anything on the cord such as baby powder or antibiotic.

in need of resuscitation. vigorous  Moderately depressed infant.6 F axillary Chest Circumference 32 – 33 cm Heart Rate 120 – 140 bpm Respirations 30 – 60 bpm Weight 2. Extremities blue 2 Above 100 Good crying Active motion Vigorous cry Pink all over Score: 7 – 10 Good adjustment. needs airway clearance  Severely depressed infant. ASSESSING THE AVERAGE NEWBORN Head Circumference 34 – 35 cm Temperature 97.4 kg Length 46 to 54 cm  . ASSESS HEART RATE RESPIRATION MUCLE TONE REFLEX IRRITABILITY COLOR 0 Absent Absent Flaccid No response Blue all over 1 Below 100 Slow Some flexion Grimace Body pink.rate below 100 signifies an asphyxiated baby and a heart rate above 160 signifies distress.6 – 98.5 to 3.

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