<p> PLACE LABEL HERE NEWBORN ADMISSION LATE PRETERM (< 37 WEEKS) STANDING ORDERS </p><p>Nurse initiated protocol based on medical staff approved criteria and policy # 7000-09 (birth of a newborn with an estimated gestational age of less than 37 weeks). </p><p>1. Admit as Inpatient </p><p>2. Vital signs at 30 min of age, then q 30 min until temperature is stable for 2 hrs</p><p>3. If infant has any of the following risk factors or symptomatic, initiate hypoglycemia protocol (#7008-08)  Infants born at ≥ 34 weeks EGA to diabetic mothers  Infants born at ≥ 34 weeks EGA who are LGA  Infants born at term (≥ 37 weeks EGA) who are SGA  The late preterm infant (34 - 366/7 weeks EGA)</p><p>SCHEDULED MEDICATIONS:</p><p>4. AquaMephyton (phytonadione) 1 mg IM x 1 dose </p><p>5. Erythromycin ointment to each eye x 1 dose</p><p>6. Hepatitis B vaccine 0.5 ml IM x 1 dose per parent’s request (form # 18777)</p><p>______Date Time Nurse Signature Physician Signature PID Number</p><p>Copy to pharmacy</p><p>*1-34149* FORM 1-34149 REV. 09/2014 Page 1 of 1</p>