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Abdominal Wall Defect Initial Care

  1. Perform hand hygiene and apply sterile, latex-free gloves and gown. If the newborn is being delivered via cesarean section, follow institutional policy for appropriate surgical room attire.
  2. Receive newborn to radiant warmer.
  3. Perform initial newborn assessment and address any immediate complications including respiratory distress according to institutional policy.
  4. Wrap exposed organs in normal saline non-adhesive dressing and clear plastic wrap to cover the exposed abdomen if being transported within the facility. If preparing for transport to another facility for surgery, place the lower body, not including the defect, into a bowel bag, then place the newborn and first bowel bag into another bowel bag that covers the defect and secure at axilla, ensuring minimal contact with exposed organs.
  5. Place indwelling urinary catheter, if ordered.
  6. Administer Vitamin K according to institutional policy.
  7. Initiate IV and antibiotic therapy according to institutional policy and physician's order to manage fluid losses and prevent infection.
  8. Place nasogastric tube and monitor according to institutional policy.
  9. Position the newborn in a side-lying position, preferably the right side, which provides support to the herniated organs.
  10. Maintain strict IV intake and urine output monitoring both pre- and postoperatively.
  11. Remove gloves and discard in proper trash receptacle. Perform hand hygiene.
  12. Document the procedure in the patient's record.