Module 6 Flashcards
Assessment of the Newborn - Prenatally
- Anticipate what may have compromised the fetus in utero
-Maternal medical and prenatal history:- Blood type, lab values- GBS/HIV/ Hep B status
- Diabetes or preeclampsia
-Smoking or substance abuse
Assessment of the Newborn- Intrapartum
- Anticipate what may have occurred during labor
- Analgesia/Anesthesia
- Prolonged rupture of membranes
- Meconium stained amniotic fluid
- Nuchal cord
- Use of forceps or vacuum
- Evidence of fetal distress (FHR)
APGAR Score
Assess 1 minute and 5 minutes after birth
Activity ( muscle tone)
Pulse
Grimace (Reflex irritability)
Appearance (skin color)
Respiration (effort)
Newborn Vital Signs
Blood Pressure: 60-80/40-50
Heart Rate: 110-160 (180 if crying… 100 if sleeping)
Respiratory Rate: 30-60 breaths/min
Temperature: 99.7-99.5
General Measurements
Weight: 7lbs 8oz (Average full term)… 2500-4000g
- 70-75% of newborn weight is water
Head Circumference: Avg 33-35cm… should be 2cm greater than chest circumference
Chest Circumference: -Nipple Line
Length: Avg 18-22in
Small for Gestational Age
Intrauterine Growth Restriction (IUGR)
Risk Factors:
- Affecting fetal growth
- Infection
- Tetratogens
- Chromosomal abnormalities
Monitor for Hypoglycemia (treatment: Breastfeeding, formula, IV dextrose)
- Keep infant warm
- Maintain a clear airway
Large for Gestational Age
Estimation of Gestational Age
Establish in the first 4 hours after birth
- Gestational age can predict at-risk infants, and can help you keep alert for problems
Ballard Tool
- ?
Sole Creases
Full term: Deep sole creases down to and including the heel as the skin looses fluid and dries after birth
Ear Form and Cartilage
The pinna is folded toward the face and released. If the auricle stays in the position in which it is pressed or returns slowly, usually means that the gestational age is less than 38 weeks.
Head Variations
Molding: Abnormal head shape that results from pressure ex: birth (normal)
Cephalohematoma: Collection of blood from broken blood vessels that build up under the scalp (Does not cross suture lines)
Caput Succedaneum: Swelling under the skin of the scalp… fluid field (crosses suture line)
Craniosynostosis
Premature fusion of cranial sutures, results in growth restriction perpendicular to the affected suture(s) and compensatory overgrowth in unrestricted regions
Plagiocephaly
Infants rapidly growing head attempts to expand and meets some type of resistance such as a flat surface of a crib mattress
Hip Assessment
Barlow Test: Adduct the hip, then apply a download pressure over the knee w/ your thumb
- If unstable, the femoral head will slip out of the acetabulum
Ortolani Test: Flexing hips and knees of supine infant to 90 degrees, place anterior presser on the greater trochanter gently abducting in the infant’s legs
Female Genitalia
Pseudomestruation: Blood-tinged vaginal secretion in a neonate that results from the residual influence of maternal estrogen
Uric Acid Crystals: High levels of uric acid in blood
