Professional Documents
Culture Documents
1. Lay baby to his side in the bassinet positioning him/her in slight trendelenberg
(10-15 degrees angle).
2. Suctions the newborn observing the following considerations.
a. Starts with the mouth, then with the nose.
b. Uses a bulb syringe, deflates the ball of the bulb syringe before
inserting it to the mouth or nostril of the newborn as soon as the head is out of
the vaginal vault. Then release bulb compression to suction secretions.
c. When using mechanical suction machine, control the pressure by
pinching the catheter (French #8 or #10) as it is withdrawn from the nose or
mouth.
d. Suctions secretions first on the mouth before the nose by rotating it
in a gentle manner.
e. Withdraws the catheter taking precautions not to traumatize the
membrane.
f. Suction briefly and observes correct and safe suctioning period
•Preterm – less than 5-10 seconds per suctioning time.
•Full term – 5-10 per suctioning time.
g. rinses the catheter with sterile water.
h. Take notes or secretions obtained as to color and consistency.
KEEPING THE NEWBORN WARM
1. Dries the newborn right after birth to prevent heat loss by
evaporation.
2. Wraps the body and promotes flexion preventing heat loss by
convection and radiation.
3. Avoids pacing the newborn on cold and unlined surfaces
preventing heat loss by conduction.
APGAR SCORING
The Apgar score was devised in 1952 by Dr. Virginia Apgar as a
simple and repeatable method to quickly and summarily assess the
health of newborn children immediately after childbirth. Apgar was
an anesthesiologist who developed the score in order to ascertain
the effects of obstetric anesthesia on babies.
The Apgar score is determined by evaluating the newborn baby on
five simple criteria on a scale from zero to two, then summing up
the five values thus obtained. The resulting Apgar score ranges
from zero to 10. The five criteria (Appearance, Pulse, Grimace,
Activity, Respiration) are used as a mnemonic learning aid.
The five criteria of the Apgar score:
Muscle tone none some flexion flexed arms and legs Activity
that resist extension
EYES: start from the inner to outer canthi using the wash cloth, using the different portion of
the wash cloth.
NOSE AND CHEEKS: using the same wet wash cloth clean from the nose to the cheeks in
one direction, repeat on the other side. No attempt should be made to cleanse the nose
internally.
EARS: gently wipe external ear and behind the ear, never probe the ear canal.
HEAD: gently lather the hair using a mild soap or a baby shampoo, a soft brush maybe used.
NECK: hyperextend the neck, then wipe with a soapy washcloth.
CHEST AND ABDOMEN (TRUNK): clean the trunk including the periumbilical area using the
soapy washcloth moved in long gentle motion, making sure that the cord is not soaked.
ARMS AND HANDS: washcloth in long gentle motions, wash the armpits and the interdigital
area.
BACK: in a side lying position wash the back including the buttocks using a long gentle
strokes.
LEGS AND FEET: wash in long gentle motions; include the webs between the toes.
GENETALIA
FEMALE: wash from the front to back unidirectional using a clean wet cotton ball
for each stroke.
MALE: gently retract the foreskin then clean the glands penis using clean wet
cotton balls. If the foreskin cannot be retracted, it must not be forced.
3. Using the same sequence, rinse quickly and thoroughly then dry the baby from head to toe.
Special attention to skin folds.
CORD DRESSING
After birth, the umbilical cord falls off between 2-3 weeks.
1. Positions the newborn on his back with ankles held in one hand then
raised or flexed toward the abdomen while the dominant hand inserts the
thermometer and maintains it in place.
2. Checks the mercury level to 35°C.
3. Lubricates the bulb of the rectal thermometer with cotton ball with small
amount of petroleum or oil.
4. Introduces slowly into the rectum of the newborn no more than the length
of the bulb or a maximum of 2.5 cm. (1 inch).
5. Keeps the rectal thermometer in place for one whole minute.
6. Removes the thermometer, wipes it with cotton and reads it at eye level.
7. Records the obtained temperature on the chart.
•Blink Reflex. A blink reflex in a newborn serves the same purpose as it does in
an adult – to protect the eye from any object coming near it by rapid eyelid closure.
•Rooting Reflex. If the cheek is brushed or stroked near the corner of the mouth,
a newborn infant will turn the head in that direction. Disappears at about the sixth
week of life.
•Sucking Reflex. When a newborn’s lips are touched, the baby makes a sucking
motion. The sucking reflex begins to diminish at about 6 months of age. It
disappears immediately if it is never stimulated.
•Palmar Grasp Reflex. Newborns grasp an object placed in their finger on it. This
reflex disappears at about 6 weeks to 3 months of age.
•Plantar Grasp Reflex. When an object touches the sole of a newborn’s
foot at the base of the toes, the toes grasp in the same manner as the
fingers do. This reflex disappears at about 8 to 9 months of age in the
preparation for walking.
•Tonic Neck Reflex. When newborns lie on their backs, their heads
usually turn to one side or the other. The arm and the leg on the side
toward which the head turns extend, and the opposite arm and leg
contract. This is also called fencing reflex.
Babinski Reflex. When the side of the sole of the foot is stroked in an
inverted “J” curve from the heel upward, a newborn fans the toes
(positive babinski sign). It remains positive (toes fan) until at least 3
months of age.