1- Prepare the equipments & instruments
– Basin with warm water ( 40.6 c )
– Mild soap
– Cotton balls
– Soft washcloth
– Dry clean clothing
– on sterile gloves
– Alcohol pad ( If umbilical cord care is indicated )
– Baby lotion
2- Explain the procedure to family
3- Assemble the equipment at the bedside.
4- Wash hands
5- Screen the child
6- Take & record temperature , pulse and respiration
7- Wash the child from head to feet. Dry washed areas with a towel , giving added emphasis to skin folds
8- Moisten a cotton ball with water and wipe eyes from inner to outer canthus. repeat with a clean cotton ball on the other eye
9- Wet washcloth & wring. Gently wash one side of the face from forehead to chin, going around the nose and mouth. Repeat on other side of the face .Do not use soap on the face
– Dry infant’s face with towel
– To cleanse the baby’s scalp, pick up baby securely by sliding hand under the baby until the head is well supported in the palm of the hand. Cover ears with thumb and middle finger. Hold baby’s head over the basin. Soap and rinse head and dry with towel
– Continue washing ears and neck, giving particular attention to the skin folds of the neck, behind the ears, and the external part of the ears. Wipe washed areas repeatedly to rinse off soap
– Remove infant’s shirt. Wash trunk and arms. Wash between fingers. Turn infant one on side to wash back
– Cover infant with a blanket. Rinse and wring washcloth, then wipe away soap. Repeat to ensure removal of soap
– Dry area with towel. Cover trunk after drying
– Remove diaper, exposing lower half of body. Keep upper half of body covered with blanket
10- Lightly soap washcloth, wipe over abdomen & around umbilical cord .Work down each leg to the foot, using long stroking motions. Wash between toes. clean around umbilical cord with alcohol swab or sterile applicator
11- Rinse washcloth and wipe soap off body , paying particular attention to skin creases
Wash genitalia with cotton balls. Spread apart the female’s labia and clean between folds, using a front to back motion. use each cotton ball for one stroke only
12- The male genitalia should be washed with cotton balls from penis to anus. Do not retract
the foreskin of the penis
13- Next wash the anus and between the glottal fold and buttocks
14- Dry lower half of body. Rediaper .Redress and position the infant in the isolate or bassinet.
Document any abnormalities in the skin surface in the medical record :
- Desquamation – peeling of the skin during the first 2-4 weeks of life
- Milia –tiny, white papillae occurring on the nose and chin that are caused by obstruction of the sebaceous glands. these disappear in 1-2 weeks
- Jaundice –yellow discoloration of the skin that appear between the thirds and seventh day of life
- Telangiectatic nevi ( Stork bites ) – flat ,red localized area of capillary dilatation forming a variety of angiomas , most notably on the upper eyelids , these disappear usually by 2 years of age
- Forceps marks – marks left on part of the body here the blades exerted pressure
Incubator Nursing care
To maintain body temperature &prevent or minimize cold stress or hypothermia
- To accelerates billirubin turnover &excretions by photooxidation.
- Causes revisable isomerization of unconjugated bilirubin in the skin.
- During phototherapy infants form a substances , a water soluble product called lumirubin . It is form slowly & excreted rapidly in both urine &feces.
The side effects of phototherapy Bronze baby syndrome has occurred in some newborns receiving phototherapy .The serum, urine ,&skin turn bronze . The cause is unclean .Almost all newborns recover from bronze baby syndrome without sequelae.