Initial Newborn Examination Flashcards
The initial newborn examination should occur…
in the first few hours following birth
allowing time for skin to skin and first feed
any newborn examination should occur in an environment that is…
warm and has a good light source
during baby’s assessment immediately following birth, all of the following should be reviewed:
the head (circumference and shape of face) eyes nose mouth ears neck clavicles arms chest abdomen genitalia legs spine skin elimination weight length reflexes (rooting, sucking, plamar grasp etc)
initial newborn examination: the head
head size should be reviewed in relation to body
parents should be reassured any moulding will resolve itself after 48 hours
visible signs of trauma should be noted (e.g. FSE, amnihook)
suture lines and fontanelles should be palpated
occipitofrontal circumference should be measured (though will change over next few days)
should be symmetrical face shape
(initial newborn examination) moderate facial asymmetry is associated with…
prolonged second stage
forceps delivery
macrosomia
if face appears unusual in appearance, parents faces should be studied before expressing concern
(initial newborn examination) widely spaced suture lines are indicative of…
preterm babies - lack of moulding
hydrocephalus (build up of fluid in brain)
(initial newborn examination) a large diamond shaped anterior fontanelle is indicative of what?
prematurity
hypothyroidism
hydrocephalus
(initial newborn examination) a small diamond shaped anterior fontanelle is indicative of what?
microcephaly
smaller head due to improper development
(initial newborn examination) what diameter is used to measure head circumference?
occipitofrontal circumference
(initial newborn examination) normal head circumference should be between which measurement?
around 32-38 cm
(initial newborn examination) if baby’s eyes are closed…
baby should be gently tipped backwards and raised upwards
(initial newborn examination) what appearance of the eyes is considered abnormal?
heavily wide spaced or narrow spaced eyes
what are epicanthic folds?
normal in certain ethnic groups, e.g. east, southeast, central asians
can also be associated with underlying syndromes, e.g. T21
(initial newborn examination) cloudy cornea may suggest?
infection
more severe birth trauma (e.g. from forceps)
congenital glaucoma - can cause childhood blindness if not treated
conjunctival haemorrhage:
usually acquired during second stage of labour, caused by pressure from birth
should resolve after a few days
(initial newborn examination) if baby has substantial eye discharge…
if it is profuse or purulent, should be noted and swab taken for testing
indicative of infection
(initial newborn examination) the width of the bridge of baby’s nose should be…
greater than 2.5cm
(initial newborn examination) baby’s nostrils flaring is indicative of…
respiratory illness
(initial newborn examination) asymmetrical lips may suggest…
facial Bell’s palsy
a baby with an abnormally small mouth may indicate…
micrognathia
an abnormally small lower jaw
(initial newborn examination) when looking into baby’s mouth, the following should be for:
an intact palate
length of frenulum
(initial newborn examination) baby’s ears:
should spring back into position when moved forward gently
low set ears may be indicative of chromosomal abnormalities, e.g. T21
(initial newborn examination) a webbed neck is suggestive of…
chromosomal abnormalities
e.g. Turner’s syndrome
(initial newborn examination) skin folds at the back of the neck may suggest…
Down’s syndrome / Trisomy 21
what may increase the risk of a fractured clavicle?
baby born in breech presentation that required manipulation
polydactyly vs syndactyly:
P = presence of extra fingers or toes S = webbing or fusing together of two or more fingers or toes
what are palmer creases?
babies should have 3 creases across palm
a single crease may indicate down’s syndrome
