EINC1 - SKILLS LAB
I. ESSENTIAL INTRAPARTUM NEWBORN CARE / UNANG YAKAP
PERFORMING IMMEDIATE NEWBORN CARE
(Department of Health Unang Yakap Essentials of Newborn Care)
I. DEFINITION
Immediate Newborn Care – early management of the newborn baby in the delivery
or nursery room after or within few minutes after birth.
II. RATIONALE
1. The newborn is unique, fragile being, who experiences the transition from
comfortable uterine environment to external environment.
2. Newborn should be regarded as individual and not just another new baby and
receive the amount of care that his condition demands so as to:
a. Establish and maintain respiration
b. Prevent aspiration
c. Maintain a stable temperature within normal range
d. Prevent infection
e. Establish an accurate identification
III. EQUIPMENT
First Tray (Sterile)
Sterile glove 2 pairs of forceps
Cord tie / cord clamp Betadine antiseptic
Sterile gauze Bulb syringe (optional)
NGT Fr. 5, 6, or 8 (optional) 1 pair of scissors
Second Tray (Nonsterile
Eye drops / eye ointment ID band
Stethoscope Thermometer (Axilla/Digital)
Tape measure Stamp pad (optional)
1 ampule Vitamin K(1 cc syringe with needle G-26)
1 vial/ampule Hepa B (1 cc syringe with needle G-26)
1 vial/ampule BCG (1 cc syringe with needle G-26)
Cotton ball with alcohol Suction apparatus (optional)
Weighing scale lined with towel Catheter Tube Fr. 8
Baby’s layette/diaper/close cap/mittens Drop light
Ambu bag (optional)
IV. PLANNING AND IMPLEMENTATION
Nursing considerations:
1. Wear a prescribed nursery gown, mask, and close cap.
2. Aseptic technique should be observed at all times.
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ACTION RATIONALE
TIME BOUND NURSING INTERVENTIONS:
1. Wash hands and wear double sterile To prevent the spread of infection.
gloves.
2. Deliver the baby using aseptic
technique.
First 30 minutes:
3. Dry the baby’s skin immediately. To prevent loss of heat by evaporation.
a. Wipe the baby’s mouth then the nose
with a sterile gauze.
b. Wipe the back by rubbing, and other To stimulate the baby to cry.
parts of the body. (Be careful not to
remove the vernix caseosa) and do
tactile stimulation of the soles of the
feet.
c. Perform assessment of the newborn To determine the general condition of the
using the Apgar scoring tool. newborn within the first minute of life.
1-3 minutes:
4. Promote skin to skin contact between To stabilize newborn’s temperature at birth
the mother and the newborn. (37.2⁰C).
a. Place the newborn directly in prone
position on mother’s chest or
abdomen.
b. Cover the newborn with a dry towel
or blanket and cover the head with a
close cap or bonnet.
c. Reassess the newborn 5 minutes To evaluate the condition of the newborn
after birth using the Apgar scoring within 5 minutes of life after birth.
tool and from head to toe
assessment.
5. Remove the soiled outer pair of gloves. To prevent contamination.
6. Allow at least 3 minutes after the To allow more blood from the placenta to
delivery to cut the cord or until the cord transfer to the baby.
stops pulsating.
a. Clamp the cord with a curved forceps
with latex band (or with umbilical
clamp) 2 cm. away from the base of
the cord.
b. Apply the straight forceps 3 cm.
away from the first clamp.
c. Cut the cord and slide the latex band
carefully and gently towards the base
of the cord (if cord clamp is not used)
and be careful not to overlap the
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latex band on the skin at the base of
the cord.
d. After clamping or tying the cord,
check the presence of the following:
- One umbilical vein
- Two umbilical arteries
- Bleeding near the base of the cord
15-90 minutes:
7. Promote early breastfeeding. Observe
for presence of rooting and sucking
reflex and initiate feeding.
a. Clean the nipple with a clean cloth or
gauze from inner to outer direction
b. Introduce the mouth of the baby to
mother’s nipple.
NON-TIME BOUND NURSING INTERVENTIONS
8. Administer the Crede’s Prophylaxis
a. Open the newborn’s one eye by
gently holding the upper lid upward
with the index finger and the lower lid
downward with the thumb.
b. Squeeze eye ointment gently and
deposit 1 cm. of medication on the
lower lid.
c. Apply the ointment from the inner to
the outer canthus of the eye. Do the
same to the other eye.
9. Place the ID band with the complete
name of the mother and the baby
preferably on the ankle of the newborn.
Perform the following procedures in the
newborn under droplight.
1. Line the table with a towel and place the To prevent heat loss from the newborn’s
newborn. body.
2. With the use of the tape measure, To determine if the intrauterine growth is
measure the length from the crown of within normal.
the head to the sole of the foot, head
and chest circumference.
3. Check the temperature. To assess the baseline temperature and to
determine further loss of body heat
4. Insert a small catheter tube into the To check the patency of the anus.
anus.
5. Line the weighing scale with a towel To prevent loss of heat from the newborn.
and check the weight.
6. Prepare and inject Vitamin K at the To prevent hemorrhage that may lead to
vastus lateralis muscle (prescribed anemia of the baby.
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according to the weight of the
newborn).
7. Perform after-care of materials and
equipment.
8. Provide gentle, minimal handling and
watchful eyes.
a. Promote rooming in and To promote mother and child bonding.
breastfeeding.
b. Bring the baby to the mother. Be
sure to check the baby’s
identification with the mother.
c. Give instructions to the mother To promote and support R.A. 7600,
regarding breastfeeding and care of Rooming in and Breastfeeding Act of 1992,
the baby. for Maternal and Child Health.
V. DOCUMENTATION AND EVALUATION
1. Record the assessment result of the APGAR score.
2. Absence of respiratory distress.
3. Free of infection and other complications.
4. The baby is identified correctly and with complete and correct data.
5. Recording of the dose, route, and time the Vitamin K and ophthalmic ointment is
administered.
6. Recording of V/S, anthropometric measurements, and unusualties.
EQUIPMENT AND INSTRUMENTATION
Basic Delivery Set (for multi gravida) (Additional instruments for Primi gravida)
- 2 clamps, one with Latex band - Additional gloves
- Scissors - Ovum forceps
- Rolled Gauze - Needle holder
- Kidney Basin - 5cc syringe with needle
- Sterile Gloves - Additional scissors
- Suction bulb - Additional gauze
- Straight Catheter - Tissue forceps
- Needle with suture
