Case Scenarios-NRCM

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Course

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LM02-NRCM

03 0107
Assignment: Course Packet 03

Assignment: Course Packet


Name: Cataina, Maria Elizabeth D. Group: 3

03Assignment: Course Packet 03


Read and analyze the following Newborn Case Scenarios. Identify which of the following
procedures is correct and which is not. Justify your answers based on your understanding.

Case Study 1:

A newborn is delivered by spontaneous vertex delivery at 39 weeks. Immediately after birth,


the newborn cries well and appears active. The cord is clamped right after delivery and wash
immediately because the newborn has a lot of vernix.

As the newborn appears healthy and the mother has no excessive vaginal discharge,
erythromycin is not put in the newborn’s eye and the newborn is placed in a cot beside the
mother.

- The newborn cries well and appears active is a good indication that there is good
activity and respiration.
- The newborn is full term
- The cord was clamped immediately right after the delivery, which is wrong. It should be
clamped at least 1 up to 3 minutes after the delivery.
- The newborn must only be bathed 6 hours after delivery. The vernix caseosa must also
not be wiped off
- Erythromycin or ophthalmic ointment application is important for eye care of the new
born. It should be applied after the first breastfeeding. After delivery, antibiotic eye
drops or ointment are applied to a newborn's eyes. This is done to keep neonates safe
from bacterial eye infections that might arise during delivery.
- An error against the protocol was done as the newborn was placed in a cot beside the
mother. The baby should have been put in the mother’s chest to facilitate skin-to-skin
contact or otherwise known as the “Unang Yakap”, which is important for the mother
and the child’s connection. It may result to difficulty while breastfeeding.

Case Study 2:

Learning Module: Care of Mother, Child, Adolescent (Well Client)


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After a normal pregnancy, an infant is born by spontaneously vertex delivery. There are no
signs of fetal discharge during labor. The mother received pethidine 2 hours before delivery.
Immediately after delivery the infant is dried and placed under a radiant warmer.

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There is no spontaneous breathing so suctioning is started. At 1 minute after birth the infant has
a heart rate of 80 beats per minute, has irregular gasps, has blue hands and feet but a pink
tongue, has some muscle tone but does not respond to stimulation. After the 1-minute APGAR

03Assignment: Course Packet 03


score the infant is ventilated with bag and mask for 3 minutes.

After 5 minutes the infant has a heart rate of 120 beats per minute and cries well. The tongue is
pink but the hands and feet are still blue. The infant moves actively and with grimacing when
stimulated. The infant is placed in the bassinet with continuous drop light and vitamin K, BCG,
Hepa B vaccines are given.

Case Study 3:

Baby Girl C is delivered via spontaneous vertex delivery at 42 weeks. Five minutes after birth,
the cord is clamped and cut and the infant is dried thoroughly and secretions in the nose and
mouth are wipe.

She has no vernix and a blue mark is noticed over the lower back and white bumps on her nose.
The infant passes urine after delivery and poop inside the womb of the mother but does not
pass urine again and has no bowel movement for 48 hrs.

Case Study 4:

Baby Boy J weighs 3000 g at birth. He is on breast milk feeding since day 1. By day 4, Baby Boy J
appears well but the weight has dropped to 2900 g. The mother has painful engorged breasts so
formula is started.

Learning Module: Care of Mother, Child, Adolescent (Well Client)


Course
Packet
LM02-NRCM

03 0107

Assignment: Course Packet


03Assignment: Course Packet 03
References:
Eye Medicine and Vitamin K Injection for Newborns – Health Encyclopedia – University of Rochester
Medical Center. (n.d.). from https://www.urmc.rochester.edu/encyclopedia/content.aspx?
contenttypeid=90&contentid=P02698

Learning Module: Care of Mother, Child, Adolescent (Well Client)

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