Handout Checklist For Student Newborn Care

CHECKLIST FOR STUDENT
NEWBORN CARE
Prepared By: Analisa L. Pepito RN, MN

1.Call out time of birth, sex of the newborn and attach
identification band.
Rationale:
Newborn identification is an important nursing

responsibility. Nurses must be certain the infant has an
identification band in place, so medicine administration
or performing procedures can be done safely. (Two
identifiers) A number that corresponds to the mother’s
hospital number, mother’s name; sex, date and time of
infant’s birth are printed on the band. Two bands should
be used and attached to the infant’s arms or legs because
bands can slide off easily.
2.Deliver onto mother’s abdomen or into her arms
while assessing the infant’s APGAR score at 1
min, 5 minutes ( and 10 min if response is poor)
after birth.
Rationale:
Rapid cardiopulmonary adaptation. If APGAR
score is 8 or higher, no intervention is needed. If
an infant is obviously in distress interventions to
correct the problem are instituted immediately
rather than waiting for the 1-minute Apgar score.
The 1-minute score determines how well the baby

tolerated the birthing process.
The 5-minute score tells the health care provider
how well the baby is doing outside the mother’s
womb.
3.Immediate thorough drying (with a dry warm
cloth then remove all wet linen).
Rationale: Apart from protection from cold stress

and hypothermia, drying stimulates breathing. It
should be the immediate action for all newborns
regardless of gestational age or birth weight.
The head should be dried well because substantial
heat loss can occur from the head, which is about
one fourth of the neonate’s body surface area.
4. Early Skin to skin contact.
Rationale: Generally perceived to be an

intervention for provision of warmth and bonding.
Less well appreciated are its contribution to
immunoprotection of the newborn and protection
from hypoglycemia.
5.Properly timed cord clamping and cutting once pulsation stops
(within 1-3 mins) (16 pts A-D)
Rationale: Delayed cord clamping increases the infant’s blood volume and
iron reserves, and reduces the incidence of iron-deficiency anemia in
infancy.
A. No milking of umbilical cord towards the infant.

Rationale: When umbilical cord is forced into the baby’s abdomen, the pressure can
cause tiny blood vessels in the brain to rupture increasing the risk of severe
intraventricular hemorrhage or bleeding into the brain’s fluid-filled cavities.
B. Clamp cord 2 cm with sterile cord clamp and at 5 cm from the base then cut
close to the first clamp.
Rationale: It is recommended that clamping of the umbilical cord is done at least 5

centimiters from the abdominal wall. If the umbilical cord is a broad based it is also
recommended to clamp at a safe distance from the basis. Premature infants should be
clamp longer than the recommended distance for possibility of umbilical
catheterization.
C. Do not apply anything onto the cord stump (e.g. alcohol, providone-iodine)
Rationale: Keeping the cord stump dry is the best way to promote healthy healing and
a natural break off. Alcohol (ethanol and isopropyl alcohol) should be avoided. The
antibacterial effect of alcohol is brief and can be harmful to the baby. It can also delay
the usual 7-14 days of cord drying and separation by a day or two.
D. Examine the number of blood vessels in the umbilical cord.

Rationale: AVA= two arteries one vein. A single umbilical artery requires search for
congenital malformations. In some reports, a significant number of these infants have
congenital anomalies particularly renal and gastrointestinal malformations.
6. Non-separation of newborn
from the mother for initiation
of breastfeeding.
Rationale:
The benefits of breastfeeding for
the health and well-being of the
mother and baby are well
documented . WHO recommends
initiation of BF within an hour after
delivery. This may reduce neonatal
mortality by decreasing the
ingestion of infectious pathogens.
7. AFTER COMPLETION OF THE FIRST
BREASTFEEDING: (28 pts)
A. Perform first complete Physical examination.
Rationale: Immediately after birth the nurse

performs assessments that are most immediately
crucial to determining the neonate’s health status.
This include cardiorespiratory status,
thermoregulation, and the presence of anomalies.
The nurse determines whether resuscitation or
other immediate interventions are necessary. When
the infant is stable and oxygenating well, a more
thorough assessment can be performed. This is
also done to evaluate a newborn for maturity
and general well-being.
B. Take anthropometrics measurements

(Weight, Height, Head Circumference, Chest
circumference, Abdominal Circumference)
Rationale: Vital statistics of the newborns are

important determinants used to confirm if the
newborn is healthy.
7. AFTER COMPLETION OF
THE FIRST BREASTFEEDING:
C. Perform eye care with

Erythromycin ophthalmic ointment on
both eyes ( from inner to outer
canthus. Apply one cm ribbon to both
eyes.
Rationale: Helps to prevent
ophthalmia neonatorum in infants of
mothers infected with gonorrhea and
conjunctivitis.
D. Inject Vitamin K 1 mg IM on
vastus lateralis. (even in preterms) left
anterolateral thigh (Vastus lateralis
area)
Rationale: This is to prevent and treat
hemorrhagic disease in newborns.
7. AFTER COMPLETION OF THE FIRST BREASTFEEDING:
E. Inject Hepatitis B vaccine 10 mcg (0.5ml) IM on

right anterolateral thigh (Vastus lateralis area).
Rationale: For immunization against infection

caused by all known subtypes of Hepatitis B virus.
F. Inject BCG vaccine 0.05ml ID (left deltoid) or left

upper arm.
Rationale: To prevent severe TB in infants because

the neonatal immune system is still immature. This
protects the newborns from serious forms of
tuberculosis(TB) such as TB meningitis9an infection
of the brain) and Miliary TB(widespread infection).
G. Take the newborns initial vital signs. (TPR)

Rationale: To obtain an accurate baseline
measurement. Vital signs measurements begin
to change from those present in intrauterine life
at the moment of birth.
8. Room-In with the mother.
Rationale:
Rooming-in allows the mother to
develop confidence in caring for her
baby. It also allows the mother to
read the baby’s cues to know if the
infant is sleepy or hungry. This is a
huge help when the mother leaves
the hospital.
9. Explain all above measures
(Newborn therapeutics such
as admininstering Vit K, Hep
B, BCG and Erythromycin
ophthalmic ointment) to the
mother.
Rationale:
Explanation lessens anxiety
thus promoting cooperation.
10. Keep with mother in skin to skin contact and
cover with warm blanket and bonnet hat.
Rationale: This enables colonization of the

newborn to maternal flora(vs hospital flora) to
protect against infection and promotes
breastfeeding. This prevents hypothermia, and
stimulates hormones to support breastfeeding and
mothering.
11. Keep newborn’s temperature between 36.5

to 37.5 0C.
Rationale:
Temperature will fall almost immediately to below

normal because of heat loss, the temperature of the
birthing homes and the infant’s immature
temperature-regulating mechanisms if the baby is
not protected from heat loss at birth and in the
moments afterwards.
Hypothermia raises the infant’s metabolic rate

and oxygen consumption, worsening any
respiratory problems.
12. Postpone bathing until
after 24th hour of life or no
earlier than 6 hours of life.
Rationale:
Bathing the newborn
immediately after birth
predisposes him/her to
developing hypothermia.
When hypothermia sets in,
there is an increased risk of
infection, coagulation defects,
acidosis, delayed fetal-to-
newborn circulatory
adjustment, hyaline membrane
disease and intracranial
hemorrhage.
Bathing also washes away the
vernix caseosa, which has
been shown in several studies
to have antimicrobial
properties similar to that of
amniotic fluid and breastmilk.
13. Minimize handling of the
newborn.
Rationale:
Healthcare workers and family
members caring for the
newborns should thoroughly
wash their hands and arms to
the elbows with an antiseptic
soap before handling infants.
This prevents/reduces
transmission of infection.
14. Watch out for difficulty of breathing, early
jaundice , feeding difficulties.
Rationale: Any abnormal observations should

be referred to the primary care
provider(attending physician) for immediate care
and management of the newborn.
15. Record all assessments, Newborn

therapeutics given, and other measures done in
the patient’s chart.
Rationale:
The infant’s chart is also a vital piece of

documentation because it serves as a baseline for
the infant’s health status. It provides information
of all measures done to the newborn. It should
also contain birth record documentation.

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CHECKLIST FOR STUDENT

Prepared By: Analisa L. Pepito RN, MN

Newborn identification is an important nursing

The 1-minute score determines how well the baby

Rationale: Apart from protection from cold stress

4. Early Skin to skin contact.

Rationale: Generally perceived to be an

A. No milking of umbilical cord towards the infant.

Rationale: It is recommended that clamping of the umbilical cord is done at least 5

D. Examine the number of blood vessels in the umbilical cord.

A. Perform first complete Physical examination.

Rationale: Immediately after birth the nurse

B. Take anthropometrics measurements

Rationale: Vital statistics of the newborns are

C. Perform eye care with

E. Inject Hepatitis B vaccine 10 mcg (0.5ml) IM on

Rationale: For immunization against infection

F. Inject BCG vaccine 0.05ml ID (left deltoid) or left

Rationale: To prevent severe TB in infants because

G. Take the newborns initial vital signs. (TPR)

Rationale: This enables colonization of the

11. Keep newborn’s temperature between 36.5

Temperature will fall almost immediately to below

Hypothermia raises the infant’s metabolic rate

Rationale: Any abnormal observations should

15. Record all assessments, Newborn

The infant’s chart is also a vital piece of

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