MCN Rle - Einc Retdem

1.
HANDWASH
1. Lays out material in linear manner
2. Wears sterile gloves (double gloving)
3. Supports the perineum
- Clean the perineum with cotton + the straight forceps (from up slide down)--- usually done by other
nurse
> POSITION THE MOTHER in Lithotomy position
- When UTERUS is contracting “push mother”
- Put a towel at the top of the mother
- Put a folded OS or Gauz sa bottom ng hiwa ng vagina to support the baby and the other hand is nasa
top ng vagina --- (TO AVOID LACERATION)
--- Ps. Support also the side going to the neck when the baby’s head is out, and when the body is out
support the shoulder-neck and legs-back knees.
4. Calls out the time of birth and sex of the baby ---- LUMABAS NA SI BABY
- BABY BOY CALUMPIT, 10:30 AM
5. Dries thoroughly the baby for full 30 seconds using the 1st towel--- rationale: to stimulate breathing
of the baby and prevent hypothermia
- Wipe 5 sec eyes, 5 sec face, 5 sec head, 5 sec front and back, 5 sec arms and legs.
5.2. Wipes gently, do not wipe off the vernix (spread the vernix IF PRESENT)
--- vernix is use for thermo circulation
WHILE WIPING THE BABY, ASSESS ALREADY THE BREATHING (IN #6)
5.3. Removes the wet cloth
6. Performs a rapid assessment of the baby's breathing
- already done and observed while wiping the baby
7. Initiates immediate skin-skin contact.
- Remove/ pull up the gown of the mother
7.1. Position the newborn in PRONE POSITION on the mother's abdomen or chest
-- naka side dapat ulo ni baby, facing either right or left
7.2. Covers the newborn's back with a dry blanket
7.3. Covers the newborn's head with a bonnet

AFTER THAT INSTRUCT “MOTHE EMBRACE NOW YOUR BABY”
8. Removes the 1st set of gloves prior to cord clamping and cutting.
9. Clamps and cuts properly timed cord, between 1-3 minutes.
-- feel the palsation, if it stops you are now ready to clamp
-- measure form base and clamp 2-3 cm (two finger breadths)
>> cut the umbilical with straight forcep 5 cm from the base or 3 cm from the plastic clamp
-- cut the cord (using mayo scissor) close to the clamp
10. Injects Oxytocin 10 International Unit (IU) IM to the mother's deltoid.
-- before injecting, instruct the circulating nurse to check first the BP of the mother (sabihin ng
circulating nurse yung BP nang loud)
-- inject the oxytocin (sabihin din nang malakas)
11. Checks on the mother's condition and delivers the placenta.
-- hold the straight forcep then coil umbilical cord
-- wait the placenta to detach in the uterine wall of the mother
--- do up and down, and when there is lengthening of umbilical, coil again until it is out (while doing it
you can MASSAGE the LOWER FUNDUS of mother)
-- CATCH the PLACENTA and place it in KIDNEY BASIN
11.1. Checks how heavy her bleeding is and examine the perineum, vagina and vulva for tears.
-- check for laceration (abnormal)
-- check if the skin is still intact (normal)
>> CHECK FOR THE COMPLETENESS OF THE PLACENTA
-- count the cotilidon (square) 15-30 normal/complete
11.2. Cleans the mother and keep her comfortable
-- using gauze and curve forcep
11.3. Checks the perineum of the mother to assess for bleeding and tears
-- do it while cleaning the perineum
-- cover the legs of mother
12. Initiates breast feeding for the 1st 30-60 minutes.

-- check if there is breast milk “ma’am can I check if there’s already a milk”
12.1. Encourages the mother to move her baby towards her breast
12.2. Counsels on attachment and positioning.
WHILE BABY IS BREAST FEEDING LET THEM IN THAT OSITION FOR 20-30 mins
GET THE BABY FOR ANTHROPOMETRIC MEASUREMENT
13. Administers the:
1. Eye ointment – open the eye of baby and put the ointment from inner cantus to outer cantus
2. BCG – 0.05 ml
-- inject at the right arm (intradermal/deltoid)
-- 15 degrees only!!
3. Vitamin K – 0.1 ml
-- inject at the left upper thigh (press the thigh before injecting)
-- 90 degrees
4. Hepatitis B – 0.5 ml
-- inject at the left upper thigh
-- 90 degrees
14. Performs anthropometric measurements.
14.1 Head circumference: 33-35 cm.
-- on the eyebrow
14.2 Chest circumference: 30-33 cm
-- on the nipple line
14.3 Abdomen: 27-30cm
-- above the umbilical
14.4 Arm: 10-12 cm
-- place mid upper arm
14.5 Thigh: 13-16 cm
-- upper thigh
14.6 Length: 47-50 cm

-- from toe to head
14.7 Weight: 2,500-4,000 grams
-- remove all the cloths (2.2-3.3 kg) normal
DRESSING THE BABY
1. Place the baby sa may blanket na may damit sa ibabaw

2. Diaper (do not cover umbilicus)
3. Knittens (pang kamay)
4. Socks
5. Bonet
6. COVER THE BABY

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1.

1. Lays out material in linear manner

2. Wears sterile gloves (double gloving)

3. Supports the perineum

> POSITION THE MOTHER in Lithotomy position

- When UTERUS is contracting “push mother”

- Put a towel at the top of the mother

- BABY BOY CALUMPIT, 10:30 AM

--- vernix is use for thermo circulation

5.3. Removes the wet cloth

6. Performs a rapid assessment of the baby's breathing

- already done and observed while wiping the baby

7. Initiates immediate skin-skin contact.

- Remove/ pull up the gown of the mother

-- naka side dapat ulo ni baby, facing either right or left

7.2. Covers the newborn's back with a dry blanket

7.3. Covers the newborn's head with a bonnet

9. Clamps and cuts properly timed cord, between 1-3 minutes.

-- feel the palsation, if it stops you are now ready to clamp

-- measure form base and clamp 2-3 cm (two finger breadths)

-- cut the cord (using mayo scissor) close to the clamp

10. Injects Oxytocin 10 International Unit (IU) IM to the mother's deltoid.

-- inject the oxytocin (sabihin din nang malakas)

11. Checks on the mother's condition and delivers the placenta.

-- hold the straight forcep then coil umbilical cord

-- wait the placenta to detach in the uterine wall of the mother

-- CATCH the PLACENTA and place it in KIDNEY BASIN

-- check for laceration (abnormal)

-- check if the skin is still intact (normal)

>> CHECK FOR THE COMPLETENESS OF THE PLACENTA

-- count the cotilidon (square) 15-30 normal/complete

11.2. Cleans the mother and keep her comfortable

-- using gauze and curve forcep

-- do it while cleaning the perineum

-- cover the legs of mother

12. Initiates breast feeding for the 1st 30-60 minutes.

12.2. Counsels on attachment and positioning.

GET THE BABY FOR ANTHROPOMETRIC MEASUREMENT

13. Administers the:

-- inject at the right arm (intradermal/deltoid)

-- inject at the left upper thigh

14. Performs anthropometric measurements.

14.1 Head circumference: 33-35 cm.

14.2 Chest circumference: 30-33 cm

-- on the nipple line

14.3 Abdomen: 27-30cm

-- above the umbilical

14.4 Arm: 10-12 cm

-- place mid upper arm

14.5 Thigh: 13-16 cm

14.6 Length: 47-50 cm

14.7 Weight: 2,500-4,000 grams

-- remove all the cloths (2.2-3.3 kg) normal

DRESSING THE BABY

1. Place the baby sa may blanket na may damit sa ibabaw

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