How to do the proper procedure of newborn Unang Yakap

>Do the hand washing >Double gloving >Call out the time of birth >Put the baby at the mothers abdomen between the breast immediately. >Use blanket to dry the baby at least 30 seconds. : To stimulate the baby to breath. >Do not wipe off the vernix caseosa : to provide natural protective cover of the baby. >Do not wash the baby within 6 hours: to prevent hypothermia and infection. >Do a rapid assessment while drying the baby. >Remove the wet cloth. >Initiate skin to skin contact: put the baby at the abdomen or between the breast. >Cover the head of the baby by using bonnet. >Use second linen to covers the babys back: To keep the baby's warm. >Remove the first gloves: to prevent infection. >Do not cut the cord immediately: allow cord pulsations to stop without milking. >Clamp the cord at 2cm from the umbilicus base. >Apply 2nd clamp at 5cm from umbilicus. Benefits of proper cord Clamping A. Prevent anemia B. Lower the rate of intraventricular hemorrhage >Injects 10IU oxytocin to the mother arm: to prevent uterine atony. >Apply skin to skin contact: check the mothers condition then deliver the placenta. >Examine how heavy the bleeding is and examine the perineum. Benefits of Skin-to-Skin Contact A. B. C. D. Promotes bonding between mother and child Overall success of breast feeding/colostrums feeding Allows colonization with maternal skin flora Protects baby from hypoglycemia

>Encourage the crawling reflex After the babys breastfeed complete 1. Administer the erythromycin and Vitamin K Rationale: Eye care to prevent opthalmia neonaturum or prevent blindness. >Keep the child in the mothers arm. >Rooming in the mother and the newborn >The baby is wash after 6 hrs.

Goals of Department of Health (DOH) Unang Yakap

1. 2. 3. 4. 5. 6. 7. 8. Eradicate extreme poverty and hunger. Achieve universal primary education. Promote gender equality and empower women. Reduce child mortality. Improve maternal health Combat HIV/AIDS, Malaria and other diseases. Ensure environmental sustainability. Develop a Global partnership for development. Benefits of Skin-to-skin contact 1. 2. 3. 4. Promotes bonding between mother & child. Overall success of breast feeding/colostrums feeding. Allows colonization with maternal skin flora. Protect the baby from hypoglycemia.

Assessment of the patient prior and after delivery

Nursing Care in Labor/delivery
On

Admission need to be calm and reassuring. Mother may be stressed and tired. Collecting data: Need to know EDC, previous OB history, pre-natal care. Onset of laborcontractions, bloody show, condition of membranes. Vital signsmother and baby. Nursing Care During Labor
During Latent phase: Vital signs and interview on admission Encourage activity and ambulation (if ROM intact). Provide information regarding what to expect. Diet may be only clear liquids or NPO.

Nursing Care During Labor

During

Active phase: will be concentrating more on her labor. Assess her ability to cope and effectiveness of her support system. Never leave mother in active labor alone. Offer opportunity to void every two hours. Usually will be NPO with IV fluids to provide for hydration and medications as needed.
Mother

Nursing Care During Labor

Transitional phase: This is the last bit of stretching that must Most difficult part of the labor process. Prepare for delivery
At

be done before birth.

complete dilatation for primigravida At 7-8 cm for multipara

Nursing Care During Labor

Continue

to offer opportunity to void as needed. Vital signs for mother and baby more often. Signs you might observe are: Nausea/vomiting Involuntary shaking/tremors of the legs Mood change Desire to push Nursing Care During Labor
With

rupture of membranes: Assess fetal condition by noting FHTs Note amount and color of fluid: Meconium staining With PROM these additional problems may occur. Infection Prolapsed cord Preparation for Delivery
Provide for cleanliness throughout labor. Perineal cleansing Prepare sterile table and equipment. Provide emotional supportive care to patient Notify physician .

and family.

Evaluating the Fetal Condition

The fetal heart tones are the best indicator of fetal condition. Can be assessed with fetoscope, doppler, or monitor. Best to listen during or immediately following a contraction to

determine fetal distress.

The Fetal Heart Tones

The

location they are best heard can be an indicator of fetal position. the umbilicus may be a breech position. Below the umbilicus probably indicates a vertex presentation.
Above

The Fetal Heart Tones

The

location can also indicate fetal descent. be heard in the side at the level of umbilicus at first. As progress is made in descent will be closer to midline and lower. Just prior to birth may be in midline just over the pubic bone. The Fetal Heart Tones
May

Generally Average

will need to establish a baseline for each baby. range for normal FHTs is 120 to 160 beats per minute. Should have beat-to-beat variability of 6 10 per minute. Decelerations of Fetal Heart Tones
May

indicate fetal distress. be evaluated in relation to the contractions. Early decels are early in the contraction as it is beginning. Late decels occur late toward the end of the contraction.
Should

Variable

decels do not show any typical pattern in relation to the contractions.

Nursing Care During Stage Two

Continue Watch

to assess vital signs of mother and baby more often as labor progresses. for signs of impending birth: Bulging perineum Crowning Dilated anus Uncontrollable urge to push Perineal cleansing prep. Notify physician Danger Signals to Note
Abnormal

vaginal bleeding Cessation of contractions after labor established Elevated B/P, sever headaches, blurred vision Elevated temperature, pulse, respirations Rigid uterus after contraction Exhaustion Danger Signals
Irregular

fetal heart rate: tachycardia Persistent bradycardia Decelerations Meconium-stained amniotic fluid Hyperactivity of the fetus Prolapsed of the cord Assisted Deliveries
Persistent

Forceps may assist mother in delivery to shorten Mother may be exhausted and unable to push. Baby may be showing of fetal distress. Low outlet forceps may be used. Vacuum extraction is another method.

the 2nd stage of labor.

Care of the Infant

Airway clearance and establishment of independent Warmth is of immediate concern as well. Cord is clamped and cut. Bonding give baby to parents as soon as possible.

respirations are the first priority.

Assessment of Neonate Apgar Assessment Results

Rating Rating Rating

of 7 10 is a vigorous newborn. of 4 6 is a moderately depressed newborn who may require some intervention. of less than 3 is s severely depressed baby who will require intervention.

Prophylactic Care
Eye
To

treatment prevent opthalmic neonatorum Conjunctivitis from gonorrhea or clamydia Ilotycin, Tetracycline, Silver Nitrate

Aquamephyton
To

prevent bleeding problems in newborn. K is given as one time dose of 0.5-1 mg. Other Needs of the Newborn
Vitamin

Identification is very important. Triple band bracelets are commonly used. Babys footprints and mothers thumb prints Security is also an important concern. The OB area is a locked, secured

are used, as well as a photo.

unit. Nursing Care During Stage Three

Placenta is delivered following birth of the baby. Pitocin hastens delivery of the placenta and is usually Signs of placental separation are:
Globular

given at this point.

shape and firm uterus of the cord Gush of blood or increase in bloody flow. Stage Three
Lengthening

Mechanism

of placental delivery are: Schultze Mechanism--80% of the time the shiny fetal surface is seen first. Duncan Mechanism20% of the time the dull maternal surface escapes first. The placenta will be carefully inspected after delivery For abnormalities For completness Nursing Care During Stage Four
Early

Post-partum recoverythe first 1-2 hours after delivery. observation and assessment is of utmost importance and may be done every 15 minutes during the first hour. Check B/P, Pulse Fundal tone and location Lochial flow Perineal assessment Hemorrhage is the number 1 priority of concern at this time. Pitocin may be use to control P-P bleeding. Warmth is also a need during this period. May be hungry and thirsty. Allow for privacy with family for bonding.
Careful