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Goals:
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.
4. Oral mucous may cause the newborn, to choke, cough or gag during
the first 12 to 18 hours of life. Place the infant in a position that would
promote drainage of secretions.
5. Keep the nares patent. Remove mucus and other particles that may
be cause obstruction. Newborns are obligatory nose breathers until
they are about 3 weeks old.
Vitamin K or Aquamephyton
The newborn has a sterile intestine at birth, hence, the newborn does
not possess the intestinal bacteria that manufactures vitamin K which
is necessary for the formation of clotting factors. This makes the
newborn prone to bleeding. As a preventive measure, .5 (preterm) and
1 mg (full term) Vitamin K or aquamephyton is injected IM in the
newborn’s vastus lateralis (lateral anterior thigh) muscle.
the abdomen and the cord is cut at second time. The cord and the area
around it are cleansed with antiseptic solution. The manner of cord
care depends on hospital protocol. What is important is that the
principles are followed. Cord clamp maybe removed after 48 hours
when the cord has dried. 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.
1. No tub bathing until cord falls off. Do not sponge bath to clean
the baby. See to it that cord does not get wet by water or urine.
2. Do not apply anything on the cord such as baby powder or
antibiotic, except the prescribed antiseptic solution which is 70%
alcohol.
3. Avoid wetting the cord. Fold diaper below so that it does not
cover the cord and does not get wet when the diaper soaks with
urine.
4. Leave cord exposed to air. Do not apply dressing or abdominal
binder over it. The cord dries and separates more rapidly if it is
exposed to air.
5. If you notice the cord to be bleeding, apply firm pressure and
check cord clamp if loose and fasten.
6. Report any unusual signs and symptoms which indicates
infection.
• 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
ASSESS 0 1 2
HEART RATE Absent Below 100 Above 100
RESPIRATION Absent Slow Good crying
MUCLE TONE Flaccid Some flexion Active motion
REFLEX IRRITABILITY No response Grimace Vigorous cry
COLOR Blue all over Body pink, Pink all over
Extremities blue
Score:
Head 34 – 35 cm
Circumference
Temperature 97.6 – 98.6 F axillary
Chest Circumference 32 – 33 cm
Heart Rate 120 – 140 bpm
Respirations 30 – 60 bpm
Weight 2.5 to 3.4 kg
Length 46 to 54 cm