Care of the Normal Newborn

Question 1

Newborn Protocols

Answer 1

Vitamin K:
Erythromycin
Hepatitis B Vaccine:

Question 2

Vitamin K:

Answer 2

• 0.5 to 1mg is given IM within 1 hour of birth in vastus lateralis
• Dose determined by kg
• Rationale: sterile gut, no bacteria to synthesize Vit K.
• Vitamin K Prothrombin levels decrease for 5 to 8 days
• Vitamin K promotes liver formation of clotting factors 2, 7, 9, & 10
• The newborn is routinely, given prophylactic vitamin K to prevent possible Hemorrhagic disease of the newborn
• Given IM in lateral aspect of the thigh

Question 3

Erythromycin

Answer 3

• antibacterial eye ointment
• Given for eye prophylaxis to protect against gonorrhea (and other bacteria infections) to prevent blindness w/infection
• Legally required on all newborns
• Educate mom that: It may cause eyes to appear swollen and slightly red (normal- does not indicate infection), and which disappears in 1-2 days

Question 4

Hepatitis B Vaccine:

Answer 4

• 0.5ml within 12 hours of birth IM in Vastus Lateralis
• Only vaccine given at birth

Question 5

Newborn Screening Exams

Answer 5

Newborn Screening Exams
Critical Congenital Heart Defect (CCHD) exam
Hearing Screen Exam:

Question 6

Newborn Screening Blood exam :

Answer 6

• Screens for more than 20 disorders by doing a heel stick
• Including PKU(phenylketonuria) and hypothyroidism, sickle cell anemia, thalassemia.
• Done first 24-48 hours

Question 7

Critical Congenital Heart Defect (CCHD) exam

Answer 7

• pulse ox on right hand and either foot.
• If 95% or less or 3% or more difference between upper and lower extremities= more tests to be ordered(ECHO)
• Done first 24 hours.

Question 8

Hearing Screen Exam:

Answer 8

otoacoustic emissions and acoustic brainstem test before discharge.

Question 9

TEACHING

Answer 9

Bulb Syringe:
- How to use it on the mouth and nose
Cord Care:
- Keep Dry
- Fold diaper away from cord
- Remove clamp in 24 hours until cord drys out

Question 10

Circumcision assessment/ tx

Answer 10

Assess for:
- Bleeding and infection
Treatment:
- Loose diaper, petroleum to prevent sticking to diaper unless plastibell was used
- Tylenol/ glucose= pain
- Topical anesthetic