NEWBORN ADMISSION

Dx: NEWBORN

Date:
Time:

INDICATION FOR SEPTIC WORK-UP

1.
Ruptured BOW >24hr
2.
Thickly meconium stained
3.
Non-institutionalized delivery
4.
Hypothermia
5.
(+) Jaundice (pathologic after 24hr)
6.
Mother with history of the ff 2wks prior to delivery
a.
Fever
b.
Hep B
c.
Anti TB Tx
d.
UTI
e.
Candidiasis
f.
Cough and colds
g.
TORCH dse

Maternal Hx:
( ) Prenatal Check up (where/when)
( ) MVP/FeSO4/TTd
( ) Maternal Illness
Trimeser:_____ Meds:______
( ) smoker ( ) alcoholic bev drinker
( ) exposure to radiation, viral illness
PE
( ) awake ( ) alert ( ) NIRCD
( ) warm, moist skin ( ) jaundice
( ) normocephalic ( )occiput
( ) cephalhematoma
( ) ear deformities ( ) facial deformities
( ) pink palp conj ( ) anicteric sclerae
( ) SCE ( ) retractions ( ) clear BS
( ) wheezes/crackles
( ) AP ( ) NRRR ( ) murmur
( ) globular abdomen ( ) NABS ( ) soft
( ) 2A:1V
( ) passage of meconium (thickly/thinly)
( ) grossly N external genitalia
( ) hermaproditism
( ) patent anus
( ) grossly N extremeties ( ) cyanosis
( ) pulses full and equal
Final Dx: Newborn
BW
HC
BL
LC

CC
RR

AS
BS AC

Inform ward officer of this admission

Refer accordingly

Do CBC
Give antibiotics (ATB)
o Blood C/S 14 days
o Urine/Stool C/S 10 days
o Lumbar tap (+) infxn 21 days

Mother with Hx of Hep B

o (+) give w/in 24hr Ig + Hep B vaccine R/L thigh

Request blood typing for type O + mother

Meconium stained
o
Note for color of umbilicus N pearly white
o
Thinly meconium stained good as well baby
o
Yellowish (mod stained) antibiotic: Ampicillin only;
150mg if septic
o
Greenish (severely stained) Ampi + Genta OD
Do CBC: WBC N 9-13x10 9/L; < 8 septic

CEPHALIC WITH BW___ BS___AS___

Please admit to Nursery
Secure consent for admission & management
TPR q4 & record
Temp reg. at 36.5 37.5C under droplight
O2 inhalation at 1lpm prn
Suction secretions prn
Routine NB care
o Aseptic ligation, cutting & dressing of umbilical cord with 70%
alcohol
o Vit K injection 1mg IM
o Terramycin ophthalmic ointment OU

Start breastfeeding with SAP

Refer accordingly

NURSERY ADMISSION
Dx : NB, FT, ALIVE BB _____ DEL. VIA NSD/CS

INSTRUCTIONS FOR FOLLOW-UP

1.
clean umbilical cord stump with alcohol TID
2.
Exposure to early morning sunlight 15-30 mins by 6-7am daily
3.
TCB at pedia OPS on ______ for BCG vaccination and ff-up 911am
POTENTIALLY SEPTIC
Dx: NB, FT, ALIVE, BB ___ DEL VIA NSD WITH BW ___ KG

Please admit to nursery

Secure consent for admission and management

TPR q4 and record please

Start breastfeeding with aspiration precautions

Dx: CBC, U/A, F/A

TX:

Ampicillin ___mg IM q12

Gentamycin ___mg IM OD

Routine NB care

Aseptic ligation, cutting and dressing of umbilical cord with 70%

alcohol

Vit K 1mg IM

Terramycin ophthalmic ointment OU

Signs of Sepsis (Baby)

1. hypothermia
2. Leukopenia < 8x109/L
3. poor suck, poor cry
DM mother
fear of hypoglycemia
do Hgt
Big baby > 3.5 kg
Small baby < 2.5 kg wait 1 min before wipe out
SGA and LGA = N 20mg/dl Hgt
Term = N 40mg/dl and above
Preterm = N 20-30mg/dl
If dec. Hgt breastfeed baby
MAP = (systolic + 2 diastolic )
AFB smear = 104/ml of sputum
(+) PPD test = 8 mm induration in 48hr
Suction: Mouth first then nose, tilt head
O2 mask: 5-6 lpm
Nasal cannula: 1-2 lpm
Hood: 10 lpm
Ampicillin injection
usual inj: wt x 100 / 2 = ____ q12
deep stained:
septic dose: wt x 150 / 2 = ___q12
meningitic: wt x 300 / 2 = ____ q12
Gentamycin injection
wt x 7 = ____ OD
Cannulate
Preterm newborn = D10W wt x 60 = ___/4 = ___ugtts/min
3rd 4th day of life = D5W
Preterm
-

Aminophylline stimulate respiratory center; given in HMD

Ambroxol 15mg IV also given to stimulate respiratory center
IV IgG Surfactant for HMD
Heraclene stimulate appetite and protein metab

Apnea assoc with bradycardia > 20 secs

Periodic breathing no bradycardia

Jitterness if you hold patient chilling will stop

Seizure even if you hold the px, it wont stop