NCMA217 RLE (EINC) Flashcards
An evidence based standards for safe quality
care of birthing mothers and their newborns
within 48 hours of intrapartum period and a
week of life for the newborn
ESSENTIAL INTRAPARTAL NEWBORN CARE
EINC
Administrative Order
2009 – 0025 – December
2009
EINC
Unang Yakap
EINC PRACTICES
Continuous maternal support
by a companion of her choice,
during labor and delivery
EINC PRACTICES
the mother is still mobile, within reason,
during this stage
Mobility during labor
EINC PRACTICES
Position of choice during
labor and delivery
EINC PRACTICES
before offering labor anesthesia
Non-drug pain relief
EINC PRACTICES
Spontaneous pushing in a
semi-upright position
EINC PRACTICES
Episiotomy will not be done, unless
necessary
EINC PRACTICES
Active management of
third stage of labor
EINC PRACTICES
Monitoring the progress of labor with the use of
partograph
EINC PURPOSES
as he or she
transitions from intrauterine life to extrauterine life.
Assess and evaluate the newborn
EINC PURPOSES
system-by
system for normal versus abnormal functioning,
providing maintenance of normal and potential
treatment of abnormal findings.
Evaluate and monitor the newborn
EINC PURPOSES
between infant and parent/s
Foster bonding
EINC PURPOSES
Provide a
safe environment at all times
4 CORE STEPS OF EINC
90 MINS
1.Immediate and thorough
drying
2.Early skin to skin contact
3. Properly timed cord clamping
4. Non-separation of newborn from
mother for early breastfeeding
Immediate and thorough drying
30 SECONDS
Call the time of birth
Using a clean dry cloth, dry the
newborn thoroughly for at least 30
seconds
Wipe the eyes, face, head, front and
back, arms and legs
Remove wet cloth
Do a quick check of breathing while
drying
APGAR SCORING
A
Appearance
(Blue/Pale
all over
the body)
0
APGAR SCORING
A
Appearance
(Accrocyanosis
Circumural
Cyanosis )
1
APGAR SCORING
A
Appearance
(PINK
ALL OVER)
2
APGAR SCORING
P
Pulse
(0 )
0
APGAR SCORING
P
Pulse
(<100 bpm )
1
APGAR SCORING
P
Pulse
(>100 bpm )
2
APGAR SCORING
G
Grimace
(NO
REACTION to
stimulation )
0
APGAR SCORING
G
Grimace
(No cry to stimulation
Weak Cry / Grimace )
1
APGAR SCORING
G
Grimace
(Strong Cry )
2
APGAR SCORING
A
Activity
(None,
Flaccid)
0
APGAR SCORING
A
Activity
(Some flexion of
arms & legs )
1
APGAR SCORING
A
Activity
(Well flexed
Arms & legs )
2
APGAR SCORING
R
Respiration
(0 )
0
APGAR SCORING
R
Respiration
(<30
Wear, irregular cry)
1
APGAR SCORING
R
Respiration
(>30
Strong vigorous
cry)
2
APGAR
APPEARANCE
PULSE
GRIMACE
ACTIVITY
RESPIRATION
APGAR SCORING
0-3
INTEPRETATION
Severely
Depressed
APGAR SCORING
0-3
NURSING
INTERVENTION
Immediate
Resuscitation
APGAR SCORING
4-6
INTEPRETATION
Guarded
APGAR SCORING
4-6
NURSING
INTERVENTION
Suctioning
APGAR SCORING
7-10
INTEPRETATION
Good Prognosis
APGAR SCORING
7-10
NURSING
INTERVENTION
Proceed to
Routine
Newborn Care
Early skin to skin contact
Position the newborn prone on the
mother’s abdomen or chest
Cover the newborn’s back with dry
blanket
Cover the newborn’s head with bonnet
Place identification band on ankle
If newborn is crying and breathing
normally avoid any manipulation
Properly timed cord clamping
Remove the first sets of gloves
Hold the cord and feel the pulsation.
Wait 1-3minutes until the pulsation
stop then put the sterile clamp or tie
2cm above the base, and get the Kelly
clamp 5cm above the base
Cut the cord close to the plastic
clamp
Non separation of mother from her newborn
Observe the newborn and
feeding cues (crawling,
licking, rooting, sucking)
Counsel on positioning and
attachment
Initiate breastfeeding
Anthropometric Measurement
HEAD
HC: 33-35 cm (1 finger breath
from the eyebrow)
Anthropometric Measurement
CHEST
CC: 31-33cm (nipple line)
Anthropometric Measurement
ABDOMEN
AC: 31-33 cm (umbilical level)
Anthropometric Measurement
LENGTH
BL: 47-54 cm (posterior fontanel
up to the heel of the foot following
contour of newborn’s body
Anthropometric Measurement
WEIGHT
WT: 2.5-4 kg. or 5.5 -8.8lbs. or
2500-4000 grams
MEDICATIONS
EYE
CREDE’S PROPHYLAXIS
ERYTHROMYCIN
OPHTHALMIC
OINTMENT
TERRAMYCIN
MEDICATION (EYE)
To prevent OPTHALMIA
NEONATORUM
TERRAMYCIN
MEDICATION (EYE)
applied from inner to
outer canthus of the
eyes
TERRAMYCIN
MEDICATIONS
BCG (BACILLUS CALMETTE
GUERINE)
Dosage & Route:
0.05 ml, ID Deltoid (R)
MEDICATION
To prevent lung TB infection, TB
Meningitis, Miliary TB
BCG (BACILLUS CALMETTE
GUERINE)
MEDICATION
HEPA - B
Dosage & Route:
Site:
Dosage & Route:
0.5ml , IM
Site: Vastus Lateralis
MEDICATIONS
Promote blood clotting
Prevent bleeding
Prevent Hypofibrinogenemia
VITAMIN K
MEDICATIONS
VITAMIN K
DRUG OF CHOICE
PHYTOMENADIONE,
AQUAMEPHYTON
MEDICATIONS
VITAMIN K
ROUTE
Intramuscular
MEDICATIONS
VITAMIN K
SITE
Left-Vastus lateralis (common)
Rectus Femoris (alternative site)
MEDICATIONS
VITAMIN K
DOSAGE
PRE TERM - 0.05 CC
FULLTERM - 0.1 CC
POST TERM – 0.1 CC