Normal Newborn: immediate/early care

chapter 22, wk 5

Vitamin K (Phytonadione)

Fat-soluble vitamin given IM (0.5–1 mg) within 1 hour of birth to promote clotting factor synthesis and prevent bleeding.

• must be given to male babies if getting circumcised

• drug must be protected from light, can affect potency

Erythromycin Ophthalmic Ointment

Antibiotic applied (1-cm ribbon to lower conjunctival sac) within 1hr after birth to prevent ophthalmia neonatorum from gonorrhoeae.

• dont wipe away, allow time for it to absorb

• may cause blurry vision but bby vision is already blurred

Delayed Cord Clamping

Delaying clamping for 30 to 60 seconds after birth to increase newborn iron stores.

Umbilical Cord Blood Vessels

Two arteries and one vein.

Umbilical Cord Healing Time

Turns brownish-black in 2–3 days and falls off in 10 to 14 days.

• purulent drainage, redness, or edema indicates infection

ABCs of Safe Sleep

Alone, on their Back, in a Crib.

• sleeping on their back has the lowest associated rate for sids

Care for Uncircumcised Penis

Wash daily with water; never forcibly retract the foreskin as it may not separate from glans for 3 to 6 years.

• May occasionally gently pull back to assess separation

• could be painful;

• may cause bleeding or infection

Care for Circumcision Site

Apply petroleum jelly with diaper changes for 4–7 days (unless PlastiBell is used), squeeze warm water over penis, do not rub off yellow crust (normal, will fall in 7-14 days)

• call provider if there are more than a few drops of blood during the first day post-procedure

• should fully heal in 10 days

Hepatitis B Vaccine

3-dose series; first dose given IM within 12–24 hours of life.

HBIG (Hepatitis B Immune Globulin)

Administered within 12 hours of birth along with the Hep B vaccine if the mother is Hepatitis B positive.

Metabolic Screening (PKU Test)

Newborn heel-stick screening testing for 48 invisible genetic/metabolic conditions.

• test for conditions we cannot see with physical assessments - helps with early interventions

CCHD Screening Criteria (critical congenital heart disease)

Performed after 24 hours of life via pulse oximetry on right hand and either foot; pass if >95% in both hand and foot with <3% difference in numbers

CCHD Screening Failure

Automatic failure if <90% in either hand or foot. or if less than 95% in either hand or foot or greater than 3% difference in numbers

• can be repeated an hour after first test. If the second test fails, must be sent for an echocardiogram