#novembernle 2021
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TOPIC:MCN part1
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APGAR SCORING
priority: C,A,B= circulation (heart): AP, (brain/spinal cord: GA
airway:R
breathing (lungs): R
-appearance,pulse(HR), grimace, activity, respiratory effort (RR)
>>SCORING
1. appearance (color)
-blue all over=0
-acrocyanosis(bluish hands and feet) =1
-pink all over=2
2. pulse (HR)
-pulseless=0
-<100=1
->100=2
**120-160bpm=normal
**170-180=crying
**90-110bpm=sleeping
3. grimace (reflex irritability)
-(-) response=0
-some grimace=1
-vigorous cry=2
4. activity (muscle tone)
-flaccid=0
-some flexion=1
-active motion=2
5.repiratory effort (RR)
-breathless=0
-irregular (down)=1
-vigorous cry
**nasal breathers
INTERPRETATION:
7-10=adjusting well
4-6=needs clearing/)O2
**suction=HINDI NA GINAGAWA
0-3=needs rescucitation
**BACK RUB HINDI NA BINABALIGTAD BABY to stimulate cry
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EINC (ESSENTIAL INTRAPARTAL NEWBORN CARE)
1. IMMEDIATE DRYING
**pwede mag-oil to spread vernix casiosa
vernix casiosa-helps sa heat ng baby
>>thermoregulator
**delay bath 6-8hrs
2. SSC (skin-to-skin contact) KANGAROO CARE
-TYPES
a. evaporation=kaya immediate drying for 30 sec
b. conduction= heat ng mommy to neonate
c. radiation= cover head with bonnet
head pinakamalaki
d. convection= turn on electric fan or AC para hindi lumabas heat ng
baby because of air current
NO METAL NEAR BABY! (stethoscope, metal chart,etc)
**prevent cold stress (burns fast, nahihirapan huminga)
3. PROPERLY TIMED CORD CLAMPING
**1-3MINS, natural blood transfusion
**30-80mL-nasa cord
**wait for pulsation to stop before cutting
TOTAL BLOOD=300-500ml/min>>PILITERI
**2CM above, 5 cm below>>>cord
**profuse bleeding >>ophalagia>>hemophilia>>lalaki
von willebrand>>common sa babae
XXXXXXXXXXXXX NO MILKING OF CORD=destroys RBC=hemolysis
XXXXXXXXXXXXX DO NOT COVER CORD SA DIAPER (mababasa ng ihi)
**cord falls off 7days or 1wk
**spongebath
4. EXCLUSIVE BF
**first 6 months to second year of life highly recommended UNICEF
**empty breast, 10-15 minutes
**nipple and areola
**use finger to break suction
GOOD ATTACHMENT
a. chin touches the breast
b. mouth wide open
c. lower lip turned outward
d. more areola visible above than below
>>>>>>>>>>MILK BANKING: 3 days or 73 hrs=body of refrigerator
3 months=freezer
***Marmett/Hoffman technique=express milk using breast pump
***inverted=pindutin like doorbell hanggang mamaga
***SIGNS NA GUTOM NA BATA: tossing, turning, wiggling, eyemovement closed
eyelids, mouthing, licking, tonguing movements, alertness, movements of
arms and legs, crying (late sign)
**engrossment=bonding
**anti-strep/staph/e.coli=breastmilk (antibiotic ng baby, 3-6 mos)
**linoleic acid-para gumanda skin, bf
**breast milk=conjunctivitis
**DANGER SIGNS (CUVA mnemonics)
C-convulsions
U-unable to drink/feed
V-projectile vomiting
A-abnormally sleepy or difficult to awaken
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CORD CARE
1. open air
2.sponge bath, wag ilubog kc mababasa cord
3. diaper fold below cord
4. hayaan matanggal ang cord
XXXXXXXXXXXwag hilain
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ophthalmia neonatorum-pus in eyes
retinopathy of prematurity- retrolental fibroplasia
tetanus neotorum-irritable, arching or back, no TT si mother
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BLS
1.prevention
2. EMS activation
3. high-quality CPR
**back rub-sa baby para malaman kung conscious
**apical pulse-sa baby
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16 wks-quickening:multi
18-20 wks-quickening:para
**after work, after dinner=fetal kicks
1kick for 10 mins, 5kicks for 30 mins, 10 kicks for 1hr
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ANTROPROMETRICS
1. HC (head circumference)
=34-35cm/ 13"-14"
**head pinakamalaki
2. CC/AC (chest circumference/abdominal circumference)
=32-33 cm/ 12"-13"
3. BW (birth weight)
>decrease 10% after 1wk
>2x (6mos)
>3x (12 mos)
>4x (2yrs)
**2.5-5.0 kg (5.5-8.8 lbs)
4. BL (birth length)
> increase 1"/month (1-6 mos)
> 1/2" per month (7-12 mos)
> 50% (ave. ht increase in 1st yr)
> 1/2"adult height @ 2 yo
**45-53cm (18"-21")
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STILLBORN=dead baby
-<24 wks gestation
-parang abortion
STILLBIRTH=
**preterm o term
Nrsg Action
1. encourage holding the child
2. bathe baby like NBC
3. warm baby para mahawakan baby
4. pwede kumuha fingerprints and footprint for legal docs
pwede rin mag;cut buhok for momentos
5. name the child kung pwedesa culture o spiritual rules
6. organ donor (kung meron pa viable. doctor) trained HCP
XXXXXXXX Philippines
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CCF (care of the childbearing Family)
A. ANTEPARTUM
1. organogenesis
2. high G&D
3. minerals, macronutrients, Ab
B. INTRAPARTUM
C. POSTPARTUM
** Intra & post same
**post=like an old man, difficult to awaken (danger)
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OB Estimates
1.naegel: LMP
(Jan-Mar) +9+7+0
(Apr-Dec) -3+7+1
total: EDC
2. bartholomew: SP (3mos),, U(5mos),, XP (9mos)
3. Hasse:
4. Morrison:
5. McDonald: FH x 8/7 or FH x 2/7 = AOG (jmos)
6. Johnson:
