What are the key steps you need to take after a baby is born? That initial physical exam, the importance of providing heat, which measurements you need to take? In this first video of a long series, we cover the basics you need to know in the nursery and to pass your NCLEX!
We are following the curriculum of this NCLEX book. The Amazon link is below. If you use the link to buy the product we may earn a commission! Thanks! NCLEX -RN Examination: https://amzn.to/3QQPMml --------------------------------------------------------------------- Please be sure to give us a like, comment about future topics, and subscribe to this channel to stay up to date on all things NICU! Also, click the notification bell after you subscribe to gain your weekly NICU knowledge as soon as it's loaded! --------------------------------------------------------------------- Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist. ---------------------------------------------------------------------------- *Disclaimer*: This video is intended for educational purposes only and while we strive to give the most accurate information, errors may occur. Subsequently, this video should not be a replacement for medical advice.
As soon as the baby is born, you'll be expected to help with the initial assessment and management.
You can learn so much by just that first glance of the baby.
Does the baby have any dysmorphic features?
Does the baby look like it may have Down syndrome?
Is the baby missing a leg?
Does the baby look like it is term, which means that it's born after 37 weeks?
Or does the baby have really thin skin, it's on the smaller side,
and it really appears scrawny, so it's more likely to be preterm?
But the first thing you care about after a baby is born is, is the baby breathing?
And the way that a healthy baby shows you that it's breathing well is normally
it's crying with a good cry right after delivery.
Obviously, if the baby is not crying, you have to do something about it.
Part of the initial routine resuscitation of babies is drying the baby,
as well as stimulating the baby.
And very often the stimulation is enough to make the baby cry.
So you can stimulate by rubbing the back or by tapping on the feet.
Just the drying itself is normally enough of a stimulation.
Even if the baby is crying, watch to see how easily the baby is crying
and look for any abnormal signs.
For example, the baby could have nasal flaring,
where the nostrils flap in and out.
Or the baby could have grunting, where it's kind of making this noise.
Or the baby could have retractions,
where you see the skin get sucked underneath the bones,
behind the ribs or over the sternum.
These are all signs of respiratory distress,
and it could mean that the baby needs either more oxygen
or just more support, CPAP or even intubation.
Also, as part of your assessment, check to see if the baby is blue or cyanotic.
Is the baby blue all over, including the mouth?
Or are just the hands and feet blue with a pink mouth?
If the baby's blue all over, this is called cyanosis, central cyanosis.
If just the hands and feet are blue, then it's called acrocyanosis,
and this can be very normal in a newborn baby.
Part of your initial assessment also involves
taking vital signs and recording APGARS,
and we'll talk about these in another video.
A very important part of taking care of a brand new baby
is making sure that that baby stays warm.
In a term baby, we can do this by drying the baby,
by wrapping them in warm blankets and putting a cap on their head.
This is all done under a radiant warmer,
which are like those beds that give the heat from above.
Another good way of keeping the babies warm
is by directly placing them onto mommy's chest
for skin to skin immediately after delivery.
Another role that you have to play, which is really important,
is making sure that the baby is correctly identified.
So normally on the identification sheet,
this involves getting a footprint of the baby
and sometimes a fingerprint of the parent.
Every hospital has like a different protocol.
And then generally you're putting matching bracelets
on both the baby as well as the parents
with the baby's name as well as medical record number.
You can imagine why this is so important.
Right now, go watch the video on APGARS.
