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1. RESPIRATORY ADAPTATION
FETUS - pressure in the Right Atrium is more than in the left, Blood flow through foramen ovale
High pressure in the lungs routes blood through Foramen Ovale and Ductus Arteriosus away from the
lungs
NEWBORN- pressure in the Left Atrium is more causing foramen ovale to close
DEOXYGENATED BLOOD that enters the heart directs blood to the lungs for gas exchange
Nutrient rich blood from gut circulates through the NB's liver, ductus venosus closes
3. THERMOREGULATORY ADAPTATION
-process by which the body balances heat production with heat loss
CONDUCTION-§transfer of body heat to a cooler solid object in contact with the baby
Intervention:covering surfaces with a warmed blanket or towel helps minimize conduction heat loss
*RADIATION - the transfer of heat to a cooler object not in contact with the baby
Intervention: cold window surface or aircon: moving as far as from the cold surface, reduces heat loss
4. METABOLIC ADAPTATION
Any conditon that puts physiologic stress on the NB depletes glycogen stores
Stresses affects: Prolonged labor, maternal infection, respi distress, cold stress
-Early signs: jitteriness, poor feeding, irritability, low temperature, weak/high pitched cry
5. HEPATIC ADAPTATION
*HYPERBILIRUBINEMIA (sakit)
- high levels of bilirubin in the bloodstream - Jaundice. Serum level of 4-6 mg/dL or greater: head, face,
trunk, extremities
*JAUNDICE
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NB is a social organism capable of communicating trhough behavior and controlling his/her responses to
environment
3. Drowsy- eyes open and close; eyelids look heavy; with body activity, with intermittent fussiness
4. Quiet Alert - quiet state with little body movement but eyes are open, attentive to people or things
close to him
5. Active Alert- eyes are open, active body movements, responds to stimuli with activity
APGAR SCORE
*Taken at first minute and first five minutes of the newborns life
Goals
ABNORMAL CRY
FACILITATE DRAINAGE
*SIDE LYING POSITION - place infant in side lying position to permit drainage of mucus from the mouth
PROVIDE WARMTH
*DRY THE BABY- immediately adter delivery, the baby should be dried
MILKING- (away from the body) towards the placenta para di mag burst out yung blood pag nacut
CORD CARE
*CLAMPING THE CORD - stimulates the first breath, hence, establishment of independent respirations
*Clean with sterile cottonballs and antiseptic solutions (betadine or 70% isoprophyl alcohol from base
up)
WATCH OUT!
*If you notice the cord be bleeding, apply firm pressure and check cord clamp if loose and fasten
-the cord remains wet and does not fall off within 7 to 10 days
-newborn fever
Note: (bleeding at the umbilical cord mismo, bc of wrong cutting) (nasagad yung cut)
*AGA (appropriate gestational age) - when newborns weight falls between 10th and 90th percentiles
expected for gestational age
CREDE'S PROPHYLAXIS
*EYE PROPHYLAXIS
VITAMIN K - (left thigh) a single injection of 0.5 to 1.0 mg of natural vitamin K can help prevent HDN
(Hemorrhagic Disease of Newborn)
1 ampule - 1 mg
10mg - 1ml
Proper IDENTIFICATION
-placement of wristlet (plastic bracelet pink/blue) blue-male, left foot pink-female, right foot
Has the potential to avert approximately 70% of newborn deaths that are due preventable
-DOH released an AO 2009-0025 mandating the application of a new protocol (ENC-P) on delivering
babies that could bring a sharp decrease in the childhood death rate in the country
-PHILIPPINES is one of the 42 countries accounting for 90% of all global under-five mortality
Filipino children die an estimate of 82,000 annually before their 5th birthday
-NEONATAL DEATHS
Highest number occurs in the first two days of life : Birth apshyxia, Complications of prematurity, sepsis
Millennium Development Goal 4 - aims to reduce under five mortality by 2/3 by 2015
ENC PROTOCOL
-is a series of time bound, chronologically-ordered, standard procedures that a baby receives at birth
-includes preventive measures which are needed to ensure the survival of the newborn
-there is growing evidence for simple interventions that can improve newborn survival
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1. immediate and thorough drying
@Wipe the face, eyes, head, front, back, arms and legs
Note:
Do not Do footprinting
No Slapping
No Squeezing of chest
Note:
-clamp the cord using a sterile plastic clamp or tie at 2 cms from the umbilical base. Then clamp again at
5cms from the base.
Note:
-after the first clamp, you may "strip" the cord of blood before applying the second clamp
-Cut the cordclose to the plastic clamps so that there is no need for 2nd trim
Point this out to the mother and encourage her to nudge the newborn towards the breast
Counsel on positioning
-Weighing, bathing, eye care, examinations, injections (hepatitis B, BCG) should be done after the first
full breastfeed is complete