CORD DRESSING RD NOTES

*performed inside NICU - infant radiant warmer

system?
*small table for eqpt
*closed cap + mask
IMMEDIATE NEWBORN CARE

7 cm dilated - Dr order trans of mom from

labor>delivery room = prepare crib: disinfectin prep
of the delivery

1. Disinfects and prepares crib before the delivery of

the newborn.
a) In & out, incl frame, new linen
2. Prepares two (2) droplights.
3. Assembles all equipments.
a) Equipment on right side, working area on
left side
b) Layette over infant warmer, dress, diaper,
bonnet, mittens, boots, 2nd layetter
c) Arrange in order of use (top to bottom:
dress, diaper, bonnet, boots and mittens,
second layette + binder (not necessary but
used to restrain NB knees when applying
medication))
d) Prep hypotray: inside portion is sterile. +
tuberculin syringe, medication needed later, 4. Performs medical handwashing then disinfects
another med for crede’s proph, tape hand using hand
measure, add thermometers, ample swab sanitizer.
e) Kidney basin for waste receptacle, comb to 5. Opens sterile kidney basin pack.
clean bb’s head 6. Gets 4 sterile cotton balls and places it on the
f) Steth - pediatric steth if available - use kidney basin. Pours alcohol on the cotton balls.
smaller diaphragm 7.Opens sterile clothing pack and places the contents
g) Working gloves, CBs, sharps container, on top of the sterile
alcohol field.
h) Prepare jotdown notebook 8. Prepares the hypotray.
9. Opens the sterile instrument pack and places the
2 sterile forceps under
the hypotowel correctly.
9. Prepares the Vitamin K injection correctly.
a) Prep medication: should not be done very
early to maintain the patency of the drug.
b) Vit K is amber colored ampoule to prev
exposure of sunlight - prep when bb is
about to be delivered

c)
d) on the tray - no need to prep medx
ticket because it is a UNIVERSAL ORDER
for babies to receive Vit K and Crede’s
prophylaxis - to prevent infection and
bleeding

11. Washes hands then dons a clean pair of gloves.

(medical handwashing + disinfect using alcohol) -
working gloves to protect nurse from the newborn
because newborn has come in contact with the
discharges of the mother
12. Upon receiving the newborn, checks the ID band;
weighs the baby, provides warmth; checks for
bruises and deformities. ( no injuries, complete
e) appendages, gender pair w id band, spinal
f) alignment)
- baby is already wrapped when endorsed to you
- before endorsing to you, the pediatrician will
Weigh the baby (remove the cover so layette
will not be included)
- take note of wt in jotdown notebook
- when the baby is endorsed to you - remove the
cover because we have the layetter - turn bb to
sides when removing
- IDENTIFY BB - id band at foot part and check
g) - do quick head to toe assessment
13. Takes Vital Signs for 1 full minute, (rectal temp;
CR; RR)
a) Beyond / less than range - RECHECK
b) Core TEMP: initially check rectally to check
for patency of anus - hole or none
c) Both feet w fingers, elevate and slightly fold
so anus is exposed, insert only the tip in
circular motion - slowly - ensuring not to
injure the mucosa lining - beep: read and
record - place it on waste receptacle
h) Prep of vit K: tuberculin syringe d) CR: disinfect stet, warm, count one full
i. 1 ampoule = ten administrations minute, record
ii. Hospital: 1 bb=1ampoule e) RR: place over the chest/abdomen & feel for
iii. Scored ampoule rise and fall- observe for retractions (ribs)
iv. Disinfect neck before breaking - CB f) CHEST AND ABDOMEN SHOULD RISE AND
WITH ALCOHOL, discard FALL SIMULTANEOUSLY, it should NOT be in
v. Get another CB, wrap it around the a seesaw manner
neck and make sure the dot (score) is g) No wristwatch because we do not want to
facing AWAY from you injure baby in case they come in contact
vi. Make sure medication is at the bottom with the watch
of ampoule, then break 14. Restrain the upper mid lower extremities.
vii. Place on tray, then discard the sharps a) lock bb arm, tuck layette under buttocks
viii. Aspirate content of vit K - prep b) Binder not used bc cord should be left open
aspirating needle - lock, remove cover - used to restrain knees - place on top of
using one hand, drop cover knees, crisscross @ the back, bring forward -
ix. Withdraw 0.1 cc then square knot - not too tight/loose
15. Applies Crede’s Prophylaxis properly from inner
to outer canthus.
- double check again
- discard first drop - expose lower lid of bb - pull
cheeck downward - tip should not come in contact w
bb’s eye
x. - make sure bb is not crying
xi. Pull plunger down to remove excess air, - check again
then push until u see single drop on top 15. Gets 1 sterile cotton ball with alcohol and
of it. disinfects the site for intramuscular injection.
xii. Put back cover using Fish hook, making
sure to not contaminate the tip, place it
 a) Locate site first: - between anterior and - use comb to remove excess blood - support neck
lateral upper thigh and remove blood poolling on the head - do it gently
- divide into 3 parts: upper, mid, and lower esp with dried blood - do not force - when done
third - CHOOSE THE MIDDLE THIRD - vastus place to waste receptacle
lateralis 25. Puts on the newborn’s diaper and clothing.
- IM : 90 degrees -use sterile baby’s dress - follow how it
b) Circular motion - inner to outer - then is worn, in hospital we use baby’s gown - arms first-
discard make sure bb is in the fist position so finger will not
i. Get another CB(can be dry - heel of beinjured - turn to side then insert excess - get the
palm over knee to lock knee of baby - excess then do the same to other side - tie cord
LIGHTLY - then do CUSHION FASHION to (inside and outside)
grab most of the muscle a) - put on bonnet to prev hypothermia-
ii. W other hand, grab needle, remove support head
cover, drop b) Fold the dress for aesthetic reasons -for bb
iii. Inject 90 degrees, hold the hub, to be presentable for the family
aspirate to check if you hit a blood c) Sterile dress because cord comes in contact
vessel, if none then slowly introduce VIT with the dress
K d) Cord on top
iv. Remove, then press until no blood e) Male bb - diaper should no be placed on top
comes out - no need to rub - RUBBING of bb’s cord
ENHANCES ABSORPTION f) Lift buttocks supporting both feet - insert at
v. Lock cover of needle, then discard the back - diaper lower than cord so when
needle full w urine, it doesnt contaminate the cord
vi. Once done, remove CB and remov the g) Put on mittens - put it from the back (?) -
restraints - kneee and layette but check the inside first for excess thread -
17. Injects the Vit K correctly into the vastus lateralis. remove excess
18. With the use of the sterile forceps, gets 1 CB with
alcohol and
disinfects the stump of the cord with one stroke.
19. using 1 CB with alcohol, disinfects the cord going
from the edge of the stump of the cord with one h)
stroke. i) Placing it straight and not from back has the
20. Uses the last cotton ball to disinfect the base of tendency to let it flip backwards - insert
the cord. then lock - tie - not too tight or too loose -
21. Releases the restraints from the upper and lower apply to other hand
extremities. j) Put on booties - the id band is at the top
22.Takes the anthropometric measurements k) Change layette - carry bb and support well -
accurately and records it. remove layette - spread new layette
* TAKE MEASUREMENTS-tape measure cm l) Diamond shape - fold head portion -
- head: lower border of tape measure - in line w bb spreadv - gently lower bb - layette is in line
eyebrow and tip of the ears - support bb head - with the neck - insert arms sa fold - then
position TM inches facing u, slowly lower head, make bring across - tuck excess at the back - lower
sure lower border is in line with tip of the ear and portion bring to the top - stretch excess -
the eyebrows - MEASURE AND READ - IF IT FALLS SA arms under fold - wrap bb - tuck exccess
NUMBER THEN IT IS 0.5 m) Put bb to crib - head elevated - to prev inc in
-CHEST : on top in line w nipple - slowly turn bb to intracranial pressure - buttocks first, then
sides then slowly lower the tape measure to lvl of lower bb head - prepare the labels and so
nipple - stretch so not folded -place in line - READ on
-abdominal - slowly lower - position right next to n) RECHECK VITAL SIGNS - temp @ axillary --
umbilical cord (above) - read lift arm and position thermometer every 30
-remove TM mins
-length - tip in line with the heel - turn bb to side 26. Wraps tire newborn in a blanket and prepares for
- try to extend extremeties a little - back of leg - footprint taking.
stretch heel to vertex of the head - position thumb 27. Does the aftercare. Soaks instruments for 30
sa measurement - then while mt hold on TM, slowly minutes in a disinfectant solution then rinses and
return bb to supine - then read the measurement dries the instruments.
without removing finger - place to waste receptacle - begin with the sharps - drop to sharps
container
23.Takes the vital signs except the temperature. - disinfect thermometer - stem to bulb
24. Cleanses the newborn using a towel and comb. twisting motion - placed next to bb
- *WASHING DONE 6 HRS AFTER BIRTH - we only - return equipment
remove excess blood - commonly found at the - remove gloves then do handwashing
vertex - since bb is vertex position 28. Document accurately.
 a)

b)

c)

d) Make sure heading is complete

e)

f) Follow shift color

29. Monitors the vital signs every 30 minutes for 2

hours then every hour
for 2 hours.

II. PERSONAL ATTRIBUTES

1. Performed procedure with ease and confidence.

2. Showed inter in his/her work.

3. Attentive while doing the procedure.

4. Analyzed the importance or personal hygiene and

good grooming.
5. Accepted constructive criticism and suggestions
with a positive attitude
6. Performed procedure with honesty.
7. Handled the newborn with tender loving care.