NCM 107 RLE REVIEWER

ORAL ADMIN
Phamacokinetics – How the body absorbs and used medicine
A: Absorption D: Distribution M: Metabolism E: Excretion

Medication - administration of a substance for the diagnosis, cure, treatment, relief or prevention of disease.
Standing or routine: Administered until the dosage is changed or another medication is prescribed
prn: Given when the patient requires it
Single (one-time): Given one time only for a specific reason
STAT: Given immediately in an emergency
Now: When a medication is needed right away, but not STAT
Prescriptions: Medication to be taken outside of the hospital

Frequency of taking drugs abreviations

QID 4X a day Violet How therapeutic agent is Types of Administered
OD Once a day White administered
TID 3x a day Pink [Link] patient swallow Oral Administration
BID 2x a day Yellow [Link] therapeutic agent Sublingual administration
C/D Consume & Discontinue under the tongue.
Q4 Every 4 hours Red [Link] patient inhale the Inhalation
therapeutic agent.
Q6 Every 6 hours Green
4. Inserting therapeutic
PRN When necessary Orange agent into: 1. Vaginal Administration
1. vagina 2. Rectal Administration
2. rectum
5. Placing the therapeutic Topical Administration
agent on the skin.
6. Dropping therapeutic Instillation
agent into the mucous
membrane.
7. Flushing mucous Irrigation
membrane with large
amounts of the therapeutic
agent.
8. Injecting therapeutic Parental Administration
agent into the:
a. Corium a. Intracutaneuos or
b. Subcutaneous tissue intradermal injection
c. Muscle tissue b. Hypodermic/subcutaneous
d. Vein injection
e. Subarachnoid space of c. Intramuscular injection
spinal canal d. Intravenous injection
f. Peritoneal cavity e. Intrathecal or Intraspinal
g. Heart f. Intraperitoneal
h. Cavity of a joint. g. Intracardiac
h. Intra-articular.

GENERAL RULES IN THE ADMINISTRATION OF MEDICINES

The “ten-right” (Joyce Kee) in giving each medication:
1. the right client 6. the right documentation
Factors Hampers Safe Medication
2. the right drug 7. the client’s right to education
Administration
3. the right time 8. the right evaluation
1. Fatigue
4. the right route 9. the right assessment 2. Interruption
5. the right dose 10. the client’s right to refuse. 3. Multitasking
4. Emotional stress

1.
Medication: Forms

Caplet – Shaped like a capsule and coated for easier swallowing

Caplet – Shaped like a capsule and coated for easier swallowing

Capsule – powder, liquid or oil in gelatin shell
Tablet – compressed powder
Enteric coated – dissolves in small intestine

Lozenge – dissolves in mouth

Elixir – mixed with water or alcohol and a sweetener
Syrup – Medication dissolved in a sugar solution
Suspension – drug particles in a liquid medium; left alone will settle in the bottom
Solution – Sterile preparation that contains water and one or more dissolved compounds (IM, SQ, or IV)
Lotion – liquid suspension for skin
Ointment – semisolid (salve another name)
Paste – semisolid, but thicker than ointment – slower absorption
Transdermal disk or patch – semi-permeable membrane disk or patch with drug applied to skin
Suppository – solid drug mixed with gelatin inserted into body cavity to melt (rectum or vagina)

Common Metric Measurements: Liquid Measurement (volume)

Most capsules and tablets are in 1 ml = 1 cc
milligrams (mg) or grams (gm) 2 ½ ml = ½ teaspoon (tsp)
5 ml = 1 teaspoon (tsp)
1000 mg = 1 gram 15 ml = 3 teaspoons (tsp)
500 mg = 0.5 gram 15 ml = 1 Tablespoon (Tbsp)/0.5
250 mg = 0.25gram fluid ounce
30 ml = 1fluid ounces (oz)

ADMINISTRATION OF MEDICINE BY MOUTH

 Oral administration of drugs is generally safest, most convenient, and least expensive. Drugs for
oral administration are available in many different forms: tablets, enteric coated tablets,
capsules, syrups, emulsion, elixirs, oils, suspensions, powders, and granules.

 Oral drugs are sometimes prescribed in higher dosage than their parenteral equivalents because
after absorption through the gastrointestinal system, they are immediately broken down by the
liver before they reach the systemic circulation. Nausea, vomiting, inability to swallow and
unconsciousness may contraindicate oral administration.

Purpose of Oral administration:

 To prepare and administer oral medication safely and accurately so that patient may receive
maximum therapeutic effectiveness from them.

ADMINISTERING EYE Eye instillation

MEDICATION  Avoid the cornea.
Definition: Ophthalmic (eye)  Avoid the eyelids with
medication is the administration droppers or tubes to
of a medicine to the eyes. It may decrease the risk of
infection.
be in the form of drops or
 Use only on the affected
ointment.
eye.
 Never allow a patient to
Purpose: use another patient’s eye
1. To treat infections. medication.
2. To relieve inflammations.
3. To hasten the healing process of
 Elderly may have difficulty
the eye after surgery.
with drops
4. To diagnose foreign bodies and
 Risk of transmitting
corneal abrasions.
infection from one eye to
5. To dilate the pupils to facilitate
the other, do not touch any
refraction.
part of the eye with eye
6. To lubricate the socket for
applicator
 insertion of artificial eye.  Apply ointment along
7. To protect the neonate from eye lower eyelid, drops into
infection (Crede’s prophylaxis). conjunctival sac
8. To anesthetize the eye.
ADMINISTERING OTIC MEDICATION

Definition: Otic medication is the administration of a drug through the ears.

Purposes:
1. To treat infection.
2. To relieve pain.
3. To soften and remove impacted cerumen.
4. To produce local anesthetic effect.
5. To facilitate removal of a foreign body.

Contraindications:
1. Perforated ear drum.
2. Hydrocortisone is contraindicated in viral (herpes) and fungal infections.

ADULT – Pull ear back and up

CHILD – Pull ear back and down

FW1 Boloron, Ritchel P. 24 y.o

Ampicillin 250 mg IVTT q 8 hours ANST ( )
10 am- 6pm – 2 am

FW1 Boloron, Ritchel P. 24 y.o

ASCOF Forte ( Vitex Negundo L.) 600 mg/5 ml Syrup
5ml t.i.d p.o
6-12-6

ADMINISTRATION OF MEDICATIONS VIA Nasal Cavity This feeding tube is inserted via the
THE NASGASTRIC TUBE (NGT) Esophagus nose & exits in the stomach
Definition: Administration of Stomach
medications/feeding via the NGT or OGT Adult/Tube: 90-100cm long
for patient who are unconscious, too
weak or unable to take
medicines/feeding orally.

Purposes:
1. To improve or maintain the nutritional
status.
2. To administer prescribed medications.

ADMINISTERING ENTERAL FEEDING

Definition: Administration of liquid feedings given via the G.I. tract (stomach, duodenum and jejunum); may
be administered by intermittent or continuous feeding.

VAGINAL MEDICATION
Definition: It is the introduction of medications into the vagina in the form of suppository, tablets, or creams
which melts at body temperature.
Purpose:
1. To remove offensive or irritating discharge.
2. To relieve vaginal discomfort such as pain or itchiness.
3. To treat infection or reduce inflammation.
4. To hasten the progress of labor.
5. To promote family planning method.

Topical Medications: Vaginal Instillation

Vaginal: use gloves, privacy, patient may choose to self-administer, may need pad to collect any drainage
 Vaginal medications are available as suppositories,  Solid, oval suppositories come individually packaged in foil wrappers
foam, jellies, or creams. and sometimes are stored in the refrigerator to prevent them from
melting. After a suppository is inserted into the vaginal cavity, body
 Because vaginal medications are often given to treat temperature causes it to melt and be distributed and absorbed.
infection, discharge is usually foul smelling. Follow  Give a suppository with a gloved hand in accordance with standard
aseptic technique, and offer the patient frequent precautions. Patients often prefer administering their own vaginal
opportunities to maintain perineal hygiene. medications and need privacy.
  The diagram on the right shows instillation of medication into the
vaginal canal.
 Shown on the left is insertion of a suppository into  Foam, jellies, and creams are administered with an applicator
the vaginal canal. inserter.

RECTAL MEDICATION
Definition: It is insertion into the rectum of a medicated mass which melts at body temperature.
Purposes:
1. To produce a general or systemic effect such as reducing temperature and nausea.
Example : paracetamol
2. To stimulate defecation through mechanical pressure or chemical irritation of the nerve endings of the rectum.
Example : bisacodyl
3. To destroy a number of microorganisms in the GIT pre and post GI surgery.
Example: metronidazole

Topical Medications: Rectal Instillation

Rectal: gloves, may need lubricant, rounded end to ease administration, place past the internal anal
sphincter to prevent expelling, do not force

Different types of syringe tips:

[Link]-tip - a smooth tip in which the needle is
attached just by slipping it onto the syringe

2. Luer-Lok tip - a threaded end in which the needle

can be locked by twisting.
 Bevel - flat, slanted edge of the needle
Shaft - hollow steel tube of the needle through which
the medication passes into the patient
Hub- component that facilitates the attachment of the
needle to the syringe
Lumen - bore of a hollow needle
Safety device - A mechanism to shield the needle after
use.
Ampule – a glass container with a stem that holds a
single dose of medication
Vial - a glass or plastic container that may contain either
a single dose or multiple doses of medication
Cartridge unit - a disposable, prefilled, single-dose
cartridge of medication that slips into a nondisposable
injection device

Parenteral medication - administration of medication into the body tissues other than the alimentary
tract.
Common Routes:
1. Intradermal
2. Subcutaneous
3. Intramuscular
4. Intravenous
INTRADERMAL OR INTRACUTANEOUS INJECTION Site of Injection:
It is the introduction of a solution by means of a syringe and 1. Inner surface of the forearm
needle into the superficial layer of the skin. 2. Upper chest
Purposes: 3. Upper back
1. To identify allergens to which the client may be
hypersensitive(skin test).
2. To diagnose individuals who have developed antibodies against
specific pathogens, such as tubercle bacillus.
3. To infiltrate superficial layers of the skin with a local anesthetic,
such as 1% xylocaine, prior to performing a venipuncture.
4. To vaccinate, e.g. BCG.
SUBCUTANEOUS OR HYPODERMIC INJECTION Sites:
Definition: It is the introduction of a small amount 1. upper arm
of solution by means of syringe and needle into 2. thigh
the adipose tissue beneath the skin. 3. lower abdomen
4. upper back
Purposes:
1. To deliver medication more rapidly to the
bloodstream than oral administration.
2. To allow slower and sustained drug administration
than intramuscular Injection.
3. To prevent destruction of the drug by the action of
digestive secretions.
4. To minimize tissue trauma and avoid the risk of
hitting large blood vessels and nerves.

INTRAMUSCULAR INJECTION Sites:

1. deltoid
Definition: It is the introduction of medication 2. vastus lateralis
deep into muscle tissue where a large network of 3. rectus femoris
blood vessels can absorb it readily and quickly. 4. dorsogluteal
5. ventrogluteal
Purposes:
1. To allow painful administration of irritating drugs.
2. To allow more rapid absorption of the drug compared
to subcutaneous injection.
3. To administer large doses (up to 5 ml in appropriate
sites) of the medication.
4. To give drugs to patients who can not take
medications orally and for drugs that are degraded by
the digestive juices.

Intramuscular Injection
 Faster absorption than subcutaneous Amounts:
route Adults: 2 to 5 mL can be absorbed
 Many risks, so verify the injection is Children, older adults, thin patients: up to 2 mL
justified Small children and older infants: up to 1 mL
 Needles: Very obese: 3 inches; use Smaller infants: up to 0.5 mL
different route

Intramuscular Injection
 Remove the air from the syringe because air takes up space that should be filled with
medication. Bubbles can cause pain or discomfort or air emboli if they are injected.
 Assess the muscle before giving the injection.
 Properly identify the site by palpating bony landmarks.
 Be aware of potential complications with each site.
 The site needs to be free of tenderness.
 Aspirate to ensure not in a blood vessel.
 Minimize discomfort.
 Insertion angle is 90 degrees.
 Z-Technique of Intramuscular
Injection
Definition: Introduction of oily or
viscous medication deep into the
muscle tissue using the chosen muscle
site.
Indication: It is used with certain drugs
that irritate and discolor subcutaneous
tissue.

 Use a sharp-beveled needle in the smallest suitable length and gauge.

 Select the proper injection site, using anatomical landmarks.
 Apply a vapocoolant spray or topical anesthetic to the injection site before giving the
medication, when possible.
 Divert the patient’s attention from the injection through conversation using open-ended
questioning.
 Insert the needle quickly and smoothly to minimize tissue pulling.
 Hold the syringe steady while the needle remains in tissues.
 Inject the medication slowly and steadily.

Medication Errors Medication Errors: How does it Medication: Error Prevention

 Report all medication errors. happen
 Patient safety is top priority  Inaccurate prescribing  Checking compatibility
when an error occurs.  Giving the wrong medication charts
 Documentation is required.  Using the wrong route  Checking kidney or liver
 The nurse is responsible for  Giving at the wrong time function & allergies
 Extra doses  Never administer drugs
preparing a written
 Omission of scheduled dose prepared or documented by
occurrence or incident
 Similar drug names (25%) others
report: an accurate, factual  Never leave meds at
 CeFAZolin vs. CefTRIAXone
description of what occurred  Limit verbal orders; follow all bedside
and what was done. procedures  Open med at bedside –
 Nurses play an essential role  Use only approved check medication sheet
in medication reconciliation. abbreviations, symbols with ID band
 OK to question, clarify, repeat  Some drugs require 2
 Occurrence report for errors: nurses to check (insulin,
nurse’s responsibility, MD heparin, hyperalimentation,
informed, within 24 hours, etc.)
reflect, context, identify  Check expiration dates
factors
 RESPIRATORY SYSTEM - ADMINISTERING OXYGEN
Purposes:
1. To relieve dyspnea (difficult or labored breathing)
2. To reduce or prevent hypoxemia (low oxygen in the blood) and hypoxia (low oxygen in
the tissues)
3. To alleviate the anxiety associated with the struggle to breathe.

NURSING HOME VISIT - CHN Bag Technique

 Community Health Nursing also called public health nursing, combines primary healthcare and
nursing practice in a community setting.
 NURSING HOME VISIT - a professional face contact made by a nurse to the patient or the family
to provide necessary health care activities/ services.
 CHN Bag - It is an essential and indispensable equipment of the Community Health Nurse.

Purposes:

1. Protection against disease. Roles of nurses in

2. Provide essential treatment. CHN?
3. Provide comfort & relief from pain to the patient.
4. Give support and empathy to the patient & family. [Link] Provider
5. Provide health education. [Link]
[Link]
[Link]
Purposes: [Link]
6. Leader
[Link] against disease.
[Link]
[Link] essential treatment.
[Link] comfort & relief from pain to the patient.
[Link] support and empathy to the patient & family.
[Link] health education.
6. It should be convenient, acceptable and educative to the patients.
7. The nurse should make an attempt to include each family member while using nursing process.
8. The nurse & family must develop positive interpersonal relationship in their work to achieve the goal.
9. The nurse must respect the patient’s rights.
10. Home visits should be recorded in the family folder.

Factors to be Considered in Determining the Frequency of Home Visit:

1. Needs of the individual and family.
2. The acceptance of the family for the services offered.
3. Number of health personnel already involved in the care of the specific family.
4. A careful evaluation of past services given to a family and how they made use of such nursing
services.

Making Home Visit: 6. The nurse should sit down and talk with the client in order to
1. Before leaving the clinic, it is important to have the obtain needed information.
correct names and address of the clients to be visited.
7. Select the most responsible member of the family to assist
2. The record of these case have been reviewed as during the visit.
regards the previous visits.
8. Look for the place to put down the bag, on table or chair.
3. Bring watch with second hand, pen, notebook and Line the table with newspaper before putting down the bag.
umbrella.
9. If nursing care will be given, proceed to get articles needed
4. Upon arrival, observe the rules of courtesy by knocking from the bag observing bag technique.
at the door.
10. Make an appointment for the next visit.
5. After being admitted, introduce yourself professionally
if it is a first visit.
Priorities (in the care) to prevent cross contamination:
1. Newborn
2. Post partum
3. Pregnant mothers
4. Morbid cases

Guiding principles in the use of public health bag:

Content should be prepared by the one who will make home visit

Cleaning
-The inner part of the bag should be clean & sterile
-Should be done every after home visit

Contamination
-The less one opens the bag, the lesser chance of contamination
Guiding principles in the use of public health bag:
Content should be prepared by the one who will
make home visit
-In general, the bag is open 3x:
Cleaning 1. Putting out materials for handwashing
-The inner part of the bag should be clean & sterile 2. Putting out materials used for nursing care
-Should be done every after home visit 3. Returning all what have been used

Contamination
-The less one opens the bag, the lesser chance of
contamination

BAG TECHNIQUE – a tool by which the nurse during the home visit can perform a nursing procedure
with ease and deftness, saving time and effort with view of effective nursing care.

IV – URINE TEST FOR ALBUMIN

Purpose: To test presence of albumin in the urine
Albumin is normally found in the blood and filtered by the kidneys. When the kidneys are damaged,
abnormal amounts of albumin leak into the urine. This is called albuminuria.

Interpretation:
Slight cloudiness - +2
Thick cloudiness/moderate - +3
Egg white cloudiness - +4
A positive test for albumin implies presence of pregnancy – induced hypertension.

Urine Test for Sugar

Interpretation:
No change in color (still blue) - negative
Greenish – blue - Traces
Yellowish – green - +3
Orange – yellow or brick red - +4
Note: Presence of Sugar in the urine may indicate diabetes mellitus.
LEOPOLD’S MANUEVER
- is a systematic method of observation and palpation to determine fetal presentation and
position and are done as part of a physical examination.
- It helps determine the position and presentation of the fetus.
- (1846-1912)
- Named after the Gynecologist Christian Gerhard Leopold.
- Maneuver is preferably performed after 24 weeks gestation when fetal outline can be already
palpated.
- It is not a diagnostic test

PROCEDURE PRINCIPLE

1. First manuever: Stand at the foot of the  This maneuver determines whether the
woman, facing her, and place both hands fetal head or breech is in the fundus. A
flat on her abdomen. Palpate the superior head feels more firm that a breech, is
surface of the fundus. Determine round and hard, and moves independently
consistency, shape and mobility. of the body (the breech feels softer and
moves only in conjunction with the body)

2. Second maneuver: Face the woman, hold  This maneuver locates the back of the
the left hand stationary on the left side of fetus. The fetal back feels like a smooth,
the uterus while you palpate with the right hard, and resistant surface; the knees and
hand on the opposite side of the uterus elbows of the fetus on the opposite side
from top to bottom. Repeat palpation feel more like a number of angular bumps
using the opposite side. or nodules.

3. Third maneuver: Gently grasp the lower  This maneuver determines which part of
portion of the abdomen just above the the fetus is at the inlet and its mobility. If
symphysis pubis between the thumb and the presenting part moves upward so your
fingers and try to press the thumb and fingers and thumb can be pressed
finger together. Determine any together, the presenting part is not
movement and whether the part feels firm engaged ( not firmly settled into the
or soft. pelvis). If the part is firm, it is the head; if
soft, then it is breech.

4. Fourth maneuver: Place fingers on both  This maneuver is only done if the fetus is
sides of the uterus approximately 2 in. in a cephalic presentation because it
above the inguinal ligaments, pressing determines fetal attitude and degree of
downward and inward in the direction of fetal extension into the pelvis.
the birth canal. Allow fingers to be carried  The fingers of one hand will slide along the
downward. uterine contour and meet no obstruction,
indicating the back of the fetal neck.
 The other hand will meet an obstruction
an inch or so above the ligament- this is
the fetal brow.
 The position of the fetal brow should
correspond to the side of the uterus that
contained the elbows and knees of the
fetus.
 If the fetus is in poor attitude, the
examining fingers will meet an obstruction
on the same side as the fetal back; that is,
the fingers will touch the hyperextended
head. If the brow is very easily palpated
(as if it lies just under the skin), the fetus is
probably in a posterior position (the
occiput is pointing toward the woman’s
back).
 [Link] Grip
[Link] Grip
[Link]’s Grip
[Link] Grip

ESTIMATES OF EXPECTED DATE OF CONFINEMENT AND AGE OF GESTATION (AOG)

1. Naegeles’ Rule
- derived from a German obstetrician, subtracts 3 months and adds 7 days to calculate
the estimated due date (EDD).
- It is prudent for the obstetrician to get a detailed menstrual history, including duration,
flow, previous menstrual periods, and hormonal contraceptives.
- most women deliver: due date + or -2 weeks
Add 7 days to the first day of the LMP
Subtract 3 month
Add 1 year

Subtracts 3 months and adds 7 days to calculate the estimated due date (EDD).
Add 7 days to the first day of the LMP Example:
Subtract 3 months 1st day of LMP = May 16, 2022
Add 1 year (optional) Add 7 days = 16 + 7 = 23
Subtract 3 mos. = February 23
Add 1 year = February 23, 2023 (EDC)

Mcdonalds method
Determines AOG in monthss by measuring from the fundus to the symphysis pubis (in cm) then divide\
by 4
 Fundic ht (cm)=AOG (weeks)
 Fundic ht (cm) / 4= AOG (months)

Ex: FH 16 cm
16cm/ 4 = 4 mos AOG or 16 weeks AOG
Exercises:
FH 21 cm
FH 18 cm

Bartholomew’s Rule
 Estimate AOG by the relative position of the uterus in the abdominal cavity
- 3rd month: fundus is slightly above symphysis pubis
- 5th month: fundus is at level of umbilicus
- 9th month: below the xiphoid process
- 8th & 10th: months: same level because of lightening
 Haase’s Rule: determines the length of the fetus in cm
During the 1st half of pregnancy, square the no. of the month.
Ex. 2 x 2 = 4cm
During the 2nd half of pregnancy, multiply the month by 5.
Ex. 6 x 5 = 30cm

Johnson’s Rule
 Estimates weight of the fetus in grams.
Formula:
Fundic height in cm - n x K = gm
“K” is constant, it is always 155 Ex. FH 21 cm; not engaged
21cm – 11 x 155 = 1550 gms
“n” is = 11 if fetus is not yet engaged
= 12 if fetus is already engaged

COMPUTATION FOR AGE OF GESTATION

 It is the period of time between conception and birth.
 During this time, the baby grows and develops inside the mother's womb
 Gestational age refers to the number of weeks of age of the fetus or newborn infant, based on
the time from the mother's last menstrual period until the present date.

How to compute AOG

LMP: April 20, 2022
Clinic Visit: Sept. 5, 2022
Complete Day of April – LMP: April 30 – April 20 = 10
April 10
May 31
June 30
July 31
Aug 31
Sept. 5
138
138/7 = 19 weeks and 5 days AOG

DONNING & REMOVING STERILE GLOVES (OPEN GLOVE TECHNIQUE)

 The sterile gloves provide a barrier between the nurse’s hands and the objects she contacts.
He/she is able to freely touch objects in a sterile field without fear of contamination. When
 wearing sterile gloves, she should always remain conscious of which objects are sterile and
which are not.

EQUIPMENT:
A PAIR OF STERILE PRE-POWDERED GLOVES.

Action Rationale
1. Wash /scrub hands thoroughly. 1. Reduces number of microorganisms residing on
surfaces of hands.
2. Selects appropriate size of gloves. 2. Size of gloves should not too loose and too tight to
prevent discomfort and contamination.

3. Removes outer package wrapper by carefully peeling 3. Prevents inner glove package from accidentally
apart the sides. opening and touching contaminated objects

4. Grasp inner package and lay it on a clean flat 4. Sterile objects held below your waist is considered
surfaces just above waist level. Open the package contaminated. Inner surface of your glove packages
keeping the gloves on the wrapper. Places gloves is considered sterile
with cuff end toward the body.
5. Identify right and left gloves. Each gloves has a cuff 5. Proper identification of gloves prevents
approximately 5 cms. (2 inches) wide. Glove your contamination by improper fit. Gloving of dominant
dominant hand first. hand first improves your dexterity.
6. With thumb and first two fingers of your non- 6. Inner edge of cuff will lie against your skin and that
dominant hand, touch only the gloves’ inside is not considered sterile.
surface.
7. 7. Carefully pull glove over your dominant hand, 7. If glove’s outer surface touches your hand or wrist,
leaving a cuff and being sure that cuff does not roll it is contaminated.
up to your wrist. Be sure that thumb and fingers are
in proper spaces.
8. With your gloved dominant hand, slip your four 8. Cuff protects your gloved fingers. Sterile touching
fingers underneath second glove’s cuff with the sterile prevents glove contamination.
thumb abducted.
9. Carefully pull second glove over your non-dominant 9. Contact of gloved hand with exposed hand results
hand. Do not allow fingers and thumb or gloved in contamination.
dominant hand to touch any part of your exposed
dominant hand.
10. 10. Using dominant gloved hand, grasp the other 10. Contaminated area does not come in contact with
glove and remove by inserting it, keeping the hands or waist.
contaminated area on the inside. Continue to hold
unto gloves.
11. Slide fingers of ungloved hand inside remaining 11. None
glove. Grasp glove on inside and remove by turning
out over hand and the other glove.
12. . Discard gloves inside the wrapper on appropriate 12. Handwashing reduces the spread of
container and wash hands. microorganisms

ENC UNANG YAKAP - IMMEDIATE CARE OF THE NEWBORN

- These include activities that will prevent the occurrence of untoward effects in the
newborn including hypothermia, infection, bleeding, etc.
Purpose: 1. To prevent bleeding from the cord.
2. To prevent infection of the cord and eyes.

Apgar Score – invented by Dr. Virginia Apgar

 Immediately after delivery
 After 5 minutes
- standardized evaluation of the newborn.
- Done 1 minute after birth to determine general condition & then at 5 minutes to
determine how well the newborn is adjusting to extrauterine life

Anthropometric measurements of the

baby
- The core elements of
anthropometry are height, weight,
head circumference, body mass
index (BMI), body circumferences
to assess for adiposity (waist, hip,
and limbs), and skinfold thickness

CREDE’s prophylaxis on the eyes.

- Eye prophylaxis is given to newborns to prevent eye infections through sexually transmitted
diseases. After birth, your baby's nurse will place medicated eye ointment in your baby's eyes to
prevent potential infection or blindness from gonorrhea and chlamydia infections.

UNANG YAKAP- Essential Newborn Care

Prepared by TEAM EINC for the Association of Deans of Philippine Colleges of Nursing Inc. 3-day live-in
Training of Trainers on EINC
- Essential Newborn Care protocol, developed by the Department of Health.
- They directly address the Milleneum development goals of reducing child mortality.
- The Philippines is among 42 countries that accounts for 90% of mortality rates in children under
5 years old.
- Studies have shown that 70% of Newborn Deaths may be averted during labor, delivery, and
immediately post partum.
- In short, it is in the first few seconds, and minutes of life that every newborn Filipino is given the
chance to survive, and to have a better life, during those first few moments in the arms of a
mother, during the first embrace, sa unang yakap.

SUMMARY OF ESSENTIAL NEWBORN CARE

1. Immediate and thorough drying
2. Early skin-to-skin contact
3. Properly timed cord clamping
4. Non-separation for Early Breastfeeding
5. Carry-out eye care and immunization procedures.
6. Rooming-in
7. Exclusive breastfeeding from birth up to six months.
Capsule – powder, liquid or oil in gelatin shell