I became an RN last summer and was hired onto a Family Birthing unit. I have done postpartum since August and began L & D training last month. Doing PP I have had a few baby's go south and so I am very vigilant with them. Two nights ago during a NSVD recovery, I noticed both mom and baby temps rising every 15 minutes. This was a midwife delivery and there were many variable and some late decels the last four hours of labor during which my preceptor and I continually monitored, turned the pt, bolused, had her on 10 L O2 via face mask etc, as well as frequent contact with the midwife. The baby had yellow mec on it's back at birth.
An RN from our special care nursery caught the baby and was with her the first 20 minutes or so. I received an order for ibuprofen when mom's temp was 100.9. When I checked baby hers was 100.7, the nursery nurse was still at our desk so she offered to do a rectal temp, which was 100.9. I called the midwife again about baby and was given an order for Tylenol. She couldn't give me a dose so I called down to the nursery and asked what the normal dose is for a newborn.
At this point the nurse who answered the phone read me the riot act that I had just accepted an unsafe order and needed to call back and refuse it and demand a septic workup. I called back and (politely) mentioned that there was concern the child needed a workup and she ordered a CBC, CRP and blood culture. The nurse who caught the baby had been discussing the hx with the one who answered the phone. When I took baby to them to have the blood drawn I was given a stern talking to about never,ever, EVER giving Tylenol for newborn fever as it can mask the signs of infection. I was unaware of this and so were several of my coworkers, and some of them are quite seasoned OB nurses.
So... my question is, is this always true? Is it ever appropriate to give a newborn with a temp tylenol? I want to the best I can by my patients.
Thanks for taking the time to read this.