Unciano Colleges Inc. Sta. Mesa Manila

Unciano Colleges Inc.
Sta. Mesa Manila
In
Partial fulfillment
Of the
Requirement
In
OR/DR Pag-asa Hospital
Title:
“Unang yakap”
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 mother’s 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 cover’s the baby’s 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 mother’s condition then deliver the placenta.
>Examine how heavy the bleeding is and examine the perineum.
“Benefits of Skin-to-Skin Contact”
A. Promotes bonding between mother and child
B. Overall success of breast feeding/colostrums feeding
C. Allows colonization with maternal skin flora
D. Protects baby from hypoglycemia
>Encourage the crawling reflex
“After the baby’s breastfeed complete
1. Administer the erythromycin and Vitamin K
Rationale: Eye care to prevent opthalmia neonaturum or prevent blindness.
>Keep the child in the mother’s arm.
>Rooming in the mother and the newborn
>The baby is wash after 6 hrs.

Planning
Place: at Mr. Aniceto house
Time Started: 12:30pm
 We researched a video about “Unang yakap” and we watched several times as we are
watching, we familiarized and write the procedure on how to do proper care of new born
as well as the mother.
Time Ended: 2:00pm
 2:20pm
 Assigning role to our members for the role play that we will perform.
Members:
Jefferson – OB/doctor
Lilibeth - Pediatrician
Janine – Mother/Patient
Jesus – Handle/assist
Props:
1. Gloves 3pairs
2. Blanket 2pcs.
3. Bonnet 1pc.
4. Cord Care set
5. Erythromycin
6. Vitamin K
7. Hepatitis B
 We prepare some props that we will use for our practice.
 2:40pm
- Start practicing the role play.
 3:30
-We made a documentation of the process on the new program of the DOH “Unang
Yakap”.
Goals of Department of Health (DOH)
“Unang Yakap”
1. Eradicate extreme poverty and hunger.
2. Achieve universal primary education.
3. Promote gender equality and empower women.
4. Reduce child mortality.
5. Improve maternal health
6. Combat HIV/AIDS, Malaria and other diseases.
7. Ensure environmental sustainability.
8. Develop a Global partnership for development.
Benefits of Skin-to-skin contact
1. Promotes bonding between mother & child.
2. Overall success of breast feeding/colostrums feeding.
3. Allows colonization with maternal skin flora.
4. 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 labor—contractions, bloody show, condition of membranes.
 Vital signs—mother 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.
 During Active phase:
 Mother 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.
 Transitional phase:
 This is the last bit of stretching that must be done before birth.
 Most difficult part of the labor process.
 Prepare for delivery
 At complete dilatation for primigravida
 At 7-8 cm for multipara
 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
 With rupture of membranes:

 Assess fetal condition by noting FHT’s
 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 and family.
 Notify physician .
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.
 Above the umbilicus may be a breech position.
 Below the umbilicus probably indicates a vertex presentation.

 The location can also indicate fetal descent.
 May 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.
 Generally will need to establish a baseline for each baby.
 Average range for normal FHT’s 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.
 Should 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.
 Variable decels do not show any typical pattern in relation to the contractions.
Nursing Care During Stage Two
 Continue to assess vital signs of mother and baby more often as labor progresses.
 Watch 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:
 Persistent tachycardia
 Persistent bradycardia
 Decelerations
 Meconium-stained amniotic fluid
 Hyperactivity of the fetus
 Prolapsed of the cord
Assisted Deliveries
 Forceps may assist mother in delivery to shorten the 2nd stage of labor.
 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.
Care of the Infant
 Airway clearance and establishment of independent respirations are the first priority.
 Warmth is of immediate concern as well.
 Cord is clamped and cut.
 Bonding –give baby to parents as soon as possible.
Assessment of Neonate
Apgar Assessment Results
 Rating of 7 – 10 is a vigorous newborn.
 Rating of 4 – 6 is a moderately depressed newborn who may require some intervention.
 Rating of less than 3 is s severely depressed baby who will require intervention.
Prophylactic Care
 Eye treatment
 To prevent ‘opthalmic neonatorum’
 Conjunctivitis from gonorrhea or clamydia
 Ilotycin, Tetracycline, Silver Nitrate
 Aquamephyton
 To prevent bleeding problems in newborn.
 Vitamin K is given as one time dose of 0.5-1 mg.
Other Needs of the Newborn
 Identification is very important.
 Triple band bracelets are commonly used.
 Baby’s footprints and mother’s thumb prints are used, as well as a photo.
 Security is also an important concern.
 The OB area is a locked, secured
unit.
Nursing Care During Stage Three
 Placenta is delivered following birth of the baby.
 Pitocin hastens delivery of the placenta and is usually given at this point.
 Signs of placental separation are:
 Globular shape and firm uterus
 Lengthening of the cord
 Gush of blood or increase in bloody flow.
Stage Three
 Mechanism of placental delivery are:
 Schultze Mechanism--80% of the time the shiny fetal surface is seen first.
 Duncan Mechanism—20% 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 recovery—the first 1-2 hours after delivery.
 Careful 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.

Unciano Colleges Inc. Sta. Mesa Manila

Uploaded by

Copyright:

Available Formats

Unciano Colleges Inc. Sta. Mesa Manila

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Unciano Colleges Inc. Sta. Mesa Manila

Uploaded by

Copyright:

Available Formats

Unciano Colleges Inc.

Sta. Mesa Manila

OR/DR Pag-asa Hospital

>Call out the time of birth

>Do a rapid assessment while drying the baby.

>Remove the wet cloth.

>Cover the head of the baby by using bonnet.

>Remove the first gloves: to prevent infection.

>Clamp the cord at 2cm from the umbilicus base.

>Apply 2nd clamp at 5cm from umbilicus.

“Benefits of proper cord Clamping”

B. Lower the rate of intraventricular hemorrhage

>Injects 10IU oxytocin to the mother arm: to prevent uterine atony.

>Examine how heavy the bleeding is and examine the perineum.

“Benefits of Skin-to-Skin Contact”

A. Promotes bonding between mother and child

B. Overall success of breast feeding/colostrums feeding

C. Allows colonization with maternal skin flora

D. Protects baby from hypoglycemia

>Encourage the crawling reflex

“After the baby’s breastfeed complete

1. Administer the erythromycin and Vitamin K

Rationale: Eye care to prevent opthalmia neonaturum or prevent blindness.

>Keep the child in the mother’s arm.

>Rooming in the mother and the newborn

>The baby is wash after 6 hrs.

Place: at Mr. Aniceto house

Time Started: 12:30pm

as well as the mother.

Time Ended: 2:00pm

 We prepare some props that we will use for our practice.

- Start practicing the role play.

1. Eradicate extreme poverty and hunger.

2. Achieve universal primary education.

3. Promote gender equality and empower women.

4. Reduce child mortality.

5. Improve maternal health

6. Combat HIV/AIDS, Malaria and other diseases.

7. Ensure environmental sustainability.

8. Develop a Global partnership for development.

Benefits of Skin-to-skin contact

1. Promotes bonding between mother & child.

2. Overall success of breast feeding/colostrums feeding.

3. Allows colonization with maternal skin flora.

4. Protect the baby from hypoglycemia.

Nursing Care in Labor/delivery

 On Admission need to be calm and reassuring.

 Mother may be stressed and tired.

 Need to know EDC, previous OB history, pre-natal care.

 Onset of labor—contractions, bloody show, condition of membranes.

 Vital signs—mother 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: