Immediate Newborn Care

I. Definition:
Early management of the newborn in the delivery room or in the Nursery few minutes or soon
after birth.

II. Rationale:
The newborn is a unique, fragile being who experiences the transition from a comfortable
uterine environment to a threatening external environment.
Each infant should be regarded as an individual and should not be looked upon as just another
new baby and should receive the amount of care that his condition demand so as:
1. to establish and maintain respiration
2. to prevent infection to set in
3. to maintain records of observation of the infant’s condition
4. to prevent complication

Procedure:
1. Prepare the needed equipments To facilitate access to them, therefore assuring an
organized work.
2. Do medical hand washing To reduce the number of microorganisms present
in the hand therefore controlling the spread of
infection
3. Don sterile gloves To protect the nurse’s hand from direct contact of
blood and also to prevent cross contamination
4. Receive baby from the doctor
5. Put the baby on the infant crib with the head To facilitate drainage of secretions
lower than the body
6. Suction the baby’s mouth and nose and do the Suctioning the mouth first will prevent aspiration
first minute APGAR of the mucus. Suctioning helps clear the airway of
mucus therefore entry of O2 is facilitated.
7. Bathe with lukewarm water or clean the baby Bathing cleanses dirty secretions as well as blood
with baby oil which may become a source of infection
8. Dry the baby with a bath towel then keep warm
by using drop light at least 12-24 inches away then
do again the post five minutes APGAR
9. Weigh the baby
10. Restrain baby’s hand and feet with diaper
11. Remove used gloves then put on new sterile
gloves
Proceed to cord dressing: To protect cord from contamination thereby
12. Disinfect cord 3x starting from the base going preventing septicemia
out with cotton balls soaked in alcohol
13. Disinfect cord 3x from base going up with
cotton balls soaked in alcohol
14. Apply cord clamp 1inch – 1.5inches above the
base
15. Cut the cord immediately above the clamp
16. Hold cord clamp with one hand then disinfect
17. Measure baby’s head circumference, chest To provide necessary information which may
circumference, abdominal circumference and birth indicate of either normalcy or abnormality: to
length using tape measure. provide a basis for the future progress of the
newborn.
18. Put on diaper then dress the baby To protect him from chilling since the newborn is
sensitive to the sudden change of temperature
outside the uterus.
19. Check temperature using rectal thermometer To check anal the patency of the anus
20. Inject vitamin K on baby’s left outer middle Vit.K is a blood coagulant therefore it protects the
third thigh (vastus lateralis muscle) newborn from bleeding tendencies. (Vit. K is
supposed to be synthesized by the normal bacterial
flora of the GIT, but since the NB’s GIT is still
sterile at birth, there is no bacterial flora yet to
synthesize Vit. K, so it has to be provided from an
external source.
21. Inject Hepatitis B vaccine on baby’s right outer
middle third thigh (vastus lateralis muscle)
22. Get baby’s cardiac and respiratory rate To have a baseline data of the newborn’s cardiac
and respiratory rate
23. Get the foot prints Foot printing serves as an identification
24. Apply bracelet To prevent mistakes in identifying the baby when
given to the mother
25. Fill in baby’s name card
26. Wrap the baby/mummify This will help in developing maternal-child
bonding
27. Apply terramycin ophthalmic ointment from It will prevent possible eye infection which maybe
inner to outer canthus transmitted by maternal secretions as the newborn
passed the birth canal. It is highly indicated for
infants with mother known to have gonorrhea. The
eye treatment will prevent ophthalmia
neonatorum.
28. Show the baby to the mother This will help in developing maternal-child
bonding
29. Transfer the newborn to the nursery unit then
placed in the crib in a trendelenburg position with
drop light on in 12-24 inches away from the
newborn’s body depending light wattage
30. After care
31. Remove used gloves and do medical
handwashing.
32. Record CR, RR, Temperature, final APGAR,
anthropometric measurements, medications
administeres, final documentation of the procedure
(nurses notes)