born out of asepsis (BOA), (in a hospital) denoting a newborn who was not delivered in the usual place in an obstetric unit. Depending on the policy of the institution, a BOA-designated infant may have been born on the way to the hospital or in the hospital, on the way to the delivery suite, or in a labor room. ▪ OBSERVATIONS: Initial assessment in the admitting unit includes evaluation of respiration, quality of cry, skin color, apical pulse rate, muscle tone, reflexes, temperature, condition of umbilical cord or cord stump, ability to suck, presence of meconium, congenital defect, skin eruption, or signs of sepsis, including jaundice, anorexia, vomiting, diarrhea, irritability or lethargy, high-pitched cry, and hypothermia or hyperthermia. ▪ INTERVENTIONS: The usual steps in caring for a newborn are performed. Head and chest circumferences are measured, weight is taken, and the baby is placed in a warmer until the axillary temperature is 36.5° C. Vitamin K and silver nitrate are usually given. In many hospitals, BOA infants are placed in a special nursery and isolated from other infants to prevent contagion if they are infected. ▪ PATIENT CARE CONSIDERATIONS: Daily care for the BOA infant is the same as that given to other newborns, but, in addition, the BOA baby is closely observed for signs of sepsis. The parents are involved in the care of the infant as soon as possible, and the usual instructions are given at discharge for home care of the baby.
