A nurse is caring for a newborn immediately following delivery. After assuring a patent airway, which of the following actions should be the nurse’s priority?
A.
Dry the newborn.
B.
Administer phytonadione IM.
C.
Document the Apgar score.
D.
Apply identification bands.
The Correct answer and Explanation is:
The correct answer is:
A. Dry the newborn.
Explanation:
Immediately after birth, one of the nurse’s primary concerns is to ensure the newborn’s transition from the intrauterine to the extrauterine environment is as smooth as possible. After confirming a patent airway, the most critical next step is to dry the newborn. This action helps prevent heat loss, which is vital for the newborn’s well-being.
Newborns are particularly susceptible to hypothermia due to several factors: they have a large surface area relative to their body mass, their skin is thin, and they lack the insulating fat layers that older infants and adults possess. Additionally, newborns do not shiver to generate heat; instead, they rely on non-shivering thermogenesis, which primarily involves metabolizing brown fat. However, brown fat reserves are limited, and if the newborn experiences cold stress, it can lead to significant health complications such as hypoglycemia, respiratory distress, and metabolic acidosis.
Drying the newborn removes the amniotic fluid from the skin, which can rapidly cool and lower the baby’s temperature. The evaporation of fluid from the skin is a significant source of heat loss, so this step is critical in stabilizing the newborn’s body temperature. Furthermore, as the nurse dries the newborn, this process provides gentle stimulation, which can help promote breathing and circulation, both essential components of a healthy transition to life outside the womb.
The other options, while important, are not as immediate in this context:
- Administering phytonadione (vitamin K) IM is crucial to prevent bleeding disorders, but this can wait until after the newborn is stable and dry.
- Documenting the Apgar score is necessary for assessing the newborn’s overall condition but is typically done after ensuring the newborn is warm and stable.
- Applying identification bands is essential for security and proper identification, but again, this step can follow after initial stabilization.
In conclusion, drying the newborn is the most immediate priority after ensuring the airway is clear, as it directly addresses the newborn’s need to maintain a stable body temperature, which is crucial for preventing complications and supporting the baby’s overall health and adaptation to life outside the uterus.