HA

• Neonatal period


  From birth to 28 days of life
• Intrauterine


  Inside the mother's womb
• Extrauterine


  Outside the mother's womb
• Transition


  Between 6 to 8hrs
• Essential Intrapartal Newborn care (EINC)

  1. Immediate and thorough drying within 30 secs

  2. Early skin to skin contact

  3. Proper time cord clamping (1-3 mins)

  4. Non separation of the baby from the mother for breastfeeding
• Immediate and thorough drying within 30 secs

  • Massage the baby, to stimulate them to cry so they can use their lungs
  • Provide warmth to the baby
  • Do your APGAR scoring
  • After 30 secs, you need to remove the wet cloth
• Early skin to skin contact

  It can provide warm and bonding between the mother and her baby
• Proper time cord clamping

  • Wait 1-3 mins until pulsation stop
  • Put the cord clamp 2cm above the base and 5cm above the base
  • Cut below the cord clamp
  • Purpose: To prevent anemia on the side of the baby
• Non separation of the baby from the mother for breastfeeding


  • Nilalagay si baby sa may chest part ng mother. So magkakaroon na si baby ng routine reflex
  • 1st milk from the mother – colostrum
• Identification of newborn


  1. Put an identification bracelet

  2. Blue – boy; pink – girl

  3. Footprint newborn and fingerprint mother on identification sheet per agency policies and procedures

  4. Place matching identification bracelets on mother and newborn

  5. ID bracelet in wrist or ankle
• Dressing of Umbilical Cord

  1. Strict asepsis to prevent tetanus

  2. Betadine or alcohol may be applied, as per doctor's preference and institutional protocols, on the cord and surrounding skin

  3. Minimize microorganism and promote drying

  4. Cord turns black on 3rd day and fall 7-10 days

  5. Clamped for at least the first 24 hrs. after birth

  6. Can be removed when the cord is dried and occluded
• AVA


  2 arteries (deoxy) and 1 vein (oxy) inside the umbilical cord
• Wartons gelly


  Gelatinous substance that support and protect AVA
• APGAR Scoring


  • Developed by Virginia Apgar
  • Permits a rapid assessment of the need for resuscitation based in five signs that indicate the physiologic needs of the neonate
  • Assessment of the infant's ability to adapt to extrauterine life
  • Assign at 1 minute and at 5 minutes after delivery
  • 1st minute – determines general condition of the baby
  • Next 5 minutes – determines the capability of the baby to adjust extrauterine
  • Next 10 minutes – optional –depends on results of the 5 mins Apgar score
• 5 Vital Indicators of APGAR Score

  • Appearance / Skin Color
  • Pulse / Heart Rate
  • Grimace / Reflex Irritability
  • Activity / Muscle Tone
  • Respiratory Rate
• Acrocyanosis


  Bluish color of the hand and feet
• Circumoral cyanosis


  Bluish color of mouth
• APGAR Score 0 - 3


  Severely Depressed
• APGAR Score 4 - 6

  Guarded
• APGAR Score 7 - 10

  Good Prognosis
• Nursing Intervention for APGAR Score

  1. Immediate Resuscitation for 0 - 3

  2. Suctioning for 4 - 6

  3. Proceed to Routine Newborn care for 7 - 10
• Suctioning


  • To remove secretions
  • To stimulate your baby to cry
  • Dependent function of a nurse (with doctor's order)
  • If no doctor, place the baby in a side lying position for secretion to drain
• Silverman- Andersen Retraction Score (SAs)


  • Used to assess severity of respiratory distress in newborn and preterm infants without respiratory support
  • The score comprises 4 inspiratory categories of movements and 1 expiratory category (grunting)
• Retractions


  It stretches muscles pulling the skin around the bones
• Grunting


  Noisy breathing sound
• Apnea


  Pauses breathing 15-20 secs
• Cyanosis


  Bluish skin color (oxygen level in the blood is too low) problem in the lung and heart
• Jaundice


  Yellow skin color (high level of bilirubin) more than 24 hours can cause brain damage
• Silverman-Andersen Retraction Score 0 - 3

  Mild Respiratory Distress
• Silverman-Andersen Retraction Score 4 - 6


  Moderate Respiratory Distress
• Silverman-Andersen Retraction Score > 6


  Impending Respiratory failure
• Silverman-Andersen Retraction Score 10

  Severe Respiratory Distress
• Ballard Scoring


  A commonly used technique to check and assessed the neuromuscularity and physical maturity of the new born

  
• Head Circumference


  • Circumference is 33-35 cm
  • Measure head circumference (HC) or occipital frontal circumference (OFC)
  • Point of measurement 1 finger above eyebrows
  • Less than 33 and more than 35 cm may indicate: Microcephaly, Improper brain growth, Premature closing of the sutures, Intrauterine infection, Chromosomal defect
• Chest Circumference


  • Circumference is 31 – 35 cm
  • Less than 29 and more than 34 cm may indicate abnormal findings
  • Place tape measure at nipple line and wrap around infant
  • Point of measurement above nipple line
• Abdominal Circumference


  • Circumference 31 – 35cm
  • Same size of the chest measure just above the umbilicus
  • Measured above the level of umbilicus
  • Not routinely measured unless there is a suspicion of abdominal distention due to obstruction in the GIT
• Body length


  • 47 – 54 cm
  • From the heel to posterior fontanel
• Body weight


  • 2.5– 4 kgs / 2,500 – 4,000 gms / 5.5 – 8.8 lbs
  • Using newborn scale
  • Unclothed
  • Weight less than 2.5 kgs and more than 4 kgs are an abnormal finding
• Axillary/ Rectal Temp.


  36.4 – 37.2 C/ 97.5 – 99F
• Lungs sounds


  Normal findings show breathing is easy and non – labored, lungs are clear bilaterally