COMPLETE ASSESSMENT OF THE NEWBORN pt 2 Flashcards
immature fusion of the newborn’s cranial bones
Craniosynostosis
an accumulation of blood under the scalp, specifically in the subperiosteal space.
Cephalhematoma
swelling (edema) that affects a newborn’s scalp
Caput Succedaneum
Depressed fontanel
dehydration
Full bulging fontanel
intracranial pressure
Strabismus due until
4-6 months
red spot on the sclera
Subconjunctival hemorrhage
Subconjunctival hemorrhage is absorbed in
2-3 weeks
bleeding in the skull
Cephalhematoma
superficial, involve scal tissues, does not cross the suture line, bleeding between periostum and skull
Caput Succedaneum
determines if lens are clear = cataract
red reflex
pink iris means
sore eyes
Preauricular papillomas
ear tags
Low placement or low set of ears indicate:
- Chromosomal defect
- Kidney disease
- Craniofacial lesions
Stenosis of naris
choanal atresia
small white epithelial cysts along midline of hard
palate
EPSTEIN PEARL
tongue tie
Frenulum linguae
white cheesy patches in mucous membrane and tongue
Moniliasis/Candidiasis
Usually blowing bubbles, mucus, drooling indicates
tracheoesophageal fistula and esophageal atresia
head can’t be turned from side to side; damaged sternocleidomastoid muscles
Torticollis or wry neck
Engorged breast due to influence of maternal hormone
witch milk
drawing in of the chest wall with inspiration
Retraction
Heart sounds heard on right side
dextrocardia
Umbilical stump appears
bluish white with 3 vessels
Umbilical stump appears ________ within ________________________________
dry; several hours after birth
Bowel sounds occur _________________ and are _____________ in ________________.
1 hour after birth; transient; first 24 hrs
Liver is usually palpable _________________________________
1 to 2 cm below the right costal margin.
Edge of the spleen may be palpable
1 to 2 cm below the left costal margin
bowel positioned in the chest instead of the abdomen
diaphragmatic hernia
protrusion or sac formation of abdominal content
Omphalocele
Vaginal discharge
mucoid or blood tinged (pseudo menstruation)
Location of urinary meatus of
penis
➢ dorsal (above – ________________)
or ventral (________________)
epispadias; hypospadias
absence of one or two testicles in the scrotum (undescended testes)
Cryptorchidism
ventral curvature of penis
Chordee
Unusually short arms may signify
achondroplastic dwarfism
___________________ (a single palmar crease) – associated with _______________
Simian crease; Down syndrome
Digits Assessment:
Syndactyly, polydactyly, adactyly
indicates clubfoot
Plantar flexed feet
Hip dislocation or dysplasia:
➢ Signs:
➢ ** (+) Ortolani’s Sign, (+) Barlow’s
Sign
➢ ** uneven gluteal folds, one knee
that is lower than the other
➢ *** when the newborn is supine
with both knees flexed.
SKIN
➢ Normal: ________________________ at birth
: 2nd and 3rd day- ______________
red pink skin, smooth; pink, flaky, dry
Hemangiomas
Nevus Flammeus, Strawberry Hemangioma, Cavernous
Hemangioma
Birthmarks
A. Hemangiomas- Nevus Flammeus, Strawberry Hemangioma, Cavernous Hemangioma
B. Mongolian Spots
Curve of back usually develops at
5-6 months
incomplete closure of vertebrae indicates
spina bifida
an opening in the spinal column with or without herniation of the meninges
spina bifida/Meningocele
Touching Palms or sole near the base of digits
Grasping reflex
Stroking outer sole upward from heel across ball of
foot
Babinski reflex
Flexion of Hands &
Toes
Grasping reflex
Hyperextension of toes and dorsiflexion of hallux
Babinski reflex
DISAPPERANCE
Grasping reflex
Palmar- lessens after 3
months
Plantar- lessens by 8
months
DISAPPERANCE
Babinski reflex
After 1 year
Newborn’s lips are touched
Sucking reflex
DISAPPERANCE
Sucking reflex
Begins to
diminish about 6
months of age
and disappears
by 1 year old
Newborns who are held in
a vertical position with their
feet touch a hard surface
Step (walk)-in place
Reflex
DISAPPERANCE Step (walk)-in place
Reflex
Disappears by 3
months of age.
Touching the anterior
surface of the lower part of
a newborn’s leg against a
hard surface such as the
edge of a bassinet or table
Placing
Reflex
Nb will take a few
quick, alternating
Steps
Step (walk)-in place
Reflex
Newborn
Makes a few quick
lifting motions, as
if to step onto the
table
Placing
Reflex
Newborns lie in a prone
position and are touched
along the paraventral area
by a probing finger
Trunk incurvation
reflex (gallant)
They flex their trunk and
swing their pelvis
toward the touch
Trunk incurvation
reflex (gallant)
DISAPPERANCE
Trunk incurvation
reflex (gallant)
4 months
Newborn who is held in a
prone position with a hand
underneath, supporting the
trunk
Landau
Reflex
Demonstrate
some muscle tone
Landau
Reflex
Patellar reflexes
- Tapping the patellar
tendon with the tip of
the finger
Biceps reflex
- Place the thumb of
your left hand on the
tendon of the bicep’s
muscles
Deep
Tendon
Reflexes
Lower leg
Moves perceptibly
if the infant has an
intact reflex.
You are more
likely to feel the
tendon contract
than to observe
movement.
Deep
Tendon
Reflexes
Pressure is applied to the
soles of the feet of a
newborn lying in a suping
position
Magnet
Reflex
Pushes
Back against the
pressure.
Magnet
Reflex
One leg of the newborn
lying supine is extended
and the sole of that foot is
irritated by being brushed
with a soft object such as a
thumbnai
Crossed
Extension
Reflex
Infant raises
the other leg
And extends it, as
if trying to push
away the hand
irritating
Crossed
Extension
Reflex
FEEDING
* every
2 to 4 hours
Feeding patterns become
fairly regular in approximately
2 weeks
SLEEPING
* approximately
16 to 20 hours per day
difficult for infants to fall
asleep by themselves (parents may rock,
walk, cuddle, or otherwise comfort the infant
as he tries to fall asleep)
first 3 to 4 months
There are wide variations of “normal” as to
when babies sleep through the night. Some
are able to do so by __________________.
Others may not until they are ________________________
6 to 7 weeks of age; 3 or 4 months
old.
may be used to detect
congenital disorders
Blood sampli
Determined by state law or institutional
practice
NEWBORN SCREENING
The Comprehensive Newborn Screening
(NBS) Program was integrated as part of
the country’s public health delivery system
with the enactment of the
Republic Act no.
9288 otherwise known as Newborn
Screening Act of 2004.
Inclusions: screening of six disorders:
- Congenital Hypothyroidism (CH)
- Congenital adrenal hyperplasia (CAH)
- Phenylketonuria (PKU)
- Glucose-6- phosphate dehydrogenase
(G6PD) Deficiency - Galactosemia (GAL)
- Maple syrup urine disease (MSUD).
The Expanded Newborn Screening will include 22
more disorders such as hemoglobinopathies and
additional metabolic disorders, namely, organic
acid, fatty acid oxidation, and amino acid disorders.
The latter are included in the standard care across
the globe.
- Cystic Fibrosis
- Biotinidase Deficiency
- Organic Acid Disorders
- Fatty Acid Oxidation Disorders
- Amino Acid Disorders
- Urea Cycle Disorders
- Hemoglobin Disorders
ENBS is ideally done immediately after
4 hours
from birth.
