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‡ After the birth of the infant
every effort should be
exerted to support him in
his first minutes, hours
and days of life. The
quality of the immediate
care given to the newborn
will determine his later
state of health or well
being.
°  
 
   
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‡ This is the top priority in
the immediate care of the
newborn.
‡ Right after the extension
of the newborn¶s head,
before the chest is
delivered, the mouth and
nose should right away
be cleared. This measure
is the best prevention to
meconium aspiration
which results to lung
infection: aspiration
pneumonia.
   
‡ Measures to promote patent air
passages are continued:

a. Position the baby :

þ slight trendelenburg
position as this can cause
abdominal contents to exert
pressure onto the diaphragm
causing more difficult breathing.
þ Avoid acute trendelenburg
positon
   
Position the baby:
‡ Keep the baby on its¶ back or side,
not on its¶ stomach
‡ Neither extend nor flex the head.
Either may obstruct the airway.
‡ Newborn babies normally make
this adjustment themselves. If
depressed, however, you may
need to position the head to get a
good airway.
   
Suction the Airway
‡ May need to help them clear mucous
and amniotic fluid from the airway
‡ Use a bulb syringe
‡ Use it gently
‡ If bulb syringe is not available, use
any suction device, including a small
hypodermic syringe without the
needle.
   
b. Suction the NB observing the ff:
1. Start with the mouth, then the
nose
2. Deflate the rubber ball of the bulb
syringe before its tip into the
mouth and nostril of the NB.
3. Suction shallowly- by using a bulb
syringe and not a long catheter.
£ Deep suctioning can cause
laryngospasm in the NB.
   
º. Suction briefly.
£ Suctioning does not only clear the
air passages of secretions, it also
aspirates much needed air or
oxygen if done continuously.
£ Observe correct and safe suctioning
period:
Preterm:< 5 sec./suctioning time
Fullterm: 5-10 sec./suctioning time
   
c. Oxygenation is not
routine in the immediate
NB care.
-Just ensure a patent airway
and a good supply of
atmospheric air and a
normal NB is likely to
breathe spontaneously.
- Injudicious use of oxygen
can result to damage to
the retina
- Causing neonatal
blindness known as
RETROLENTAL
FIBROPLASIA.
   m
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A. The newborn¶s
temperature at birth
(37.3) drops quickly
(35.5) owing to
mechanism of heat
loss:
-Evaporation
-Conduction
-Convection
-Radiation
 Mechanism of Heat Loss
‡ Evaporation - loss of
heat as liquid leaves the
newborn¶s body
‡ Conduction ± loss of
heat from warm body to
cool surface indirect
contact (e.g. weighing
scale, admitting table)
‡ Convection ± loss of
heat to cool air.
 Mechanism of Heat Loss
‡ Radiation ± loss of
heat to cool surface
not in contact (walls,
floor, ceiling)
‡ Most of newborn¶s
heat is loss by
evaporation.
   m
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B. Dry the newborn right
away afterbirth to
prevent heat loss by
evaporation.
C. Wrap the body and
promote flexion to
minimize the body
surfaces exposed to
cool air and cool
surfaces not in
contact thus
preventing heat loss
by convection and
radiation.
   m
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D. Never place newborn
on cold and unlined
surface to prevent
heat loss by
conduction
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E.The initial
temperature of the
newborn is taken per
rectum in order to
detect the most
common congenital
anomaly that is not
compatible with life:
Imperforate Anus
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‡ Succeeding temperature taking should
be per axilla this route can detect core
temperature of the newborn faster as
well as minimizes the potential risk of
traumatizing the rectum of the
newborn.
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F. During the entire
procedure to provide
immediate care to
the newborn, he is
under the floor lamp
(droplight) primarily
to keep him warm.
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÷. Subjecting the
newborn to cold
stress can result to:
brown fat metabolism
causing an increase
in fatty acids in
circulation thus
resulting to metabolic
acidosis.
   m
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‡ Increased metabolic
rate causing
increased utilization
of glucose and
oxygen thus
resulting to low
blood sugar
(hypoglycemia) and
respiratory distress.
  !m
‡ AP÷AR Scoring is the
initial evaluation of
the newborn during
the first and the five
minutes of life after
birth.
‡ The first scores
determines the
general condition of
the new and the need
for immediate
resuscitation
  !m
‡ The second score
measures how well
the infant in adjusting
to the extra uterine
life. It is a useful index
of the effectiveness of
resuscitation efforts
and thus determines
prognosis. This is
used to come up with
the nursing care plan
for the newborn.
  !m
The five adaptations:
A ± appearance; color
P - pulse; apical beat
for heart rate
÷ - grimace; reflex
irritability
A - activity; muscle
tone
R - respiratory effort;
cry
‡ Each of these are
given a score of 0, 1
or 2
  !m
‡ Heart rate is the most
important score. If is
absent, all the rest of
the adaptations are
absent. So a total
score of 0, means no
heart rate.
‡ The least important
AP÷AR score is
color. It is not
expected for the
newborn to be pink all
over it at first minutes
of life.
 Color

ð
 ‡ Most newborns have

acrocyanosis (body is
centrally pink, but hands
and feet are blue

 ‡ Cyanosis requires
treatment:
± Oxygen
± Airway


 ± Ventilation
 "
 m 
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A. Identification is done
as soon as possible
after birth before the
newborn is separated
from the mother.
‡ In cases of birth of
a high risk
newborn, proper
identification must
first be done before
transporting him to
the nearest
hospital.
 "
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# 
B. The best way to identify
newborn is by means of
taking his footprints.

C.Proper identification of
the newborn is legal and
moral responsibility of
every nurse.
 "$ !%
 
A. The immediate soap
and water bath is given
to normal and full term
newborns. This is
primarily to cleanse the
skin of the mucus,
blood, at times
meconium, in order to
prevent infection.
B. Oil bath is given to the
pre terms and other
high-risk newborns.
 "$ !%
 
C. Never give the
newborn marine
bath. This is the bath
someone gives as he
holds the newborn
directly under the
cold, running water
of the faucet and
briskly bathes him.
This bath subjects
the newborn to cold
stress.
 " $   &# '
‡ Õredes Prophylaxis
± Dr. Õrede
‡ -prevent ophthalmia
neonatorum or gonorrheal
conjunctivitis
‡ how transmitted ± mom
with gonorrhea
‡ drug: Erythromycin,
Terramycin,
Oxytetracyclyne
ophthalmic ointment
 "  
(
A. Cord Dressing must
be performed under
strict aseptic
techniques to
prevent
Tetanus Neonatorum.
 "  
(
B.The Cord should be
examined carefully for
the presence of three
vessels: Umbilical vein
(left), and 2 smaller
Umbilical arteries (right
and left)
 "  
(

C. Leave about1inch of
the cord from the base.
±Omphalitis
 "  
(
D. In the first 2º hours, the
cord should be
inspected for bleeding.
(omphalangia)
 "
) *" 

A. Prophylactic Vitamin K
is injected to prevent
bleeding or hemorrhagic
disease in the NB.
B. The NB ÷IT is initially
sterile ± no E. coli to
synthesize vitamin K.
C. The best site of IM
injections in the NB,
infants and young
children is the thigh
muscle, specifically the
vastus lateralis.
 + m 
 !,  m!

A. Weight ± 3000 grams to 3,º00 grams

with the lowest limit normal of 2, 500 grams.
- A pre-term newborn weighs less than 2,500 grams.
 + m 
 !,  m!
B. Height ± the newborn height ranges from 19-21 inches
or an average of 50 cm.

- The heel-to-crown measurement is to be taken.

 + m 
 !,  m!
C. Head cirmcumference
± the head, the biggest
part is about ¼ of the
body length. It
- measures 33 to 35 cm
( 13-1º in)
-measurement: 31-33 cm
(12-13 in)
 + m 
 !,  m!
D.Chest/Abdominal
circumference ±
the chest is
almost equal to
the abdomen in
measurement: 31-
33 cm (12-13 in)
+$ 
 -
 

(

 *.  
 ROOMIN÷-IN AND
BREASTFEEDIN÷
‡ Rooming-in ±is a hospital policy whereby
the mother has her new infant by her bedside, can
take care of him or her as she desires and as her
condition permits

‡ Check the baby¶s chart if there¶s an order for

rooming-in.
 ROOMIN÷-IN AND
BREASTFEEDIN÷
‡ Bring baby to mother.
Be sure to check the
baby¶s identification
with the mother.

‡ ÷ive instructions to
the mother regarding
breastfeeding and
care of the baby.
ROOMIN÷-IN AND
BREASTFEEDIN÷

R.A. 7600
Rooming-in
and
Breastfeeding Act
of 1992
Essentials of Immediate
NB Care
1. Establish Airway
2. Keep The NB Warm
3.Do APGAR Scoring
4. Identify The Newborn Properly
5. Provide Skin Õare
6.Give Õrede¶s Prophylaxis
7. Perform Õord Dressing
8. Inject Vit. K IM
9. Take Anthropometric Measurements
10. Provide Gentle, Minimal Handling
and Watchful Eyes
11. Rooming-In and Breastfeeding
 THANKYOU!

D