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N143 > Module 8- Newborn Assessment > Flashcards

Module 8- Newborn Assessment Flashcards

1
Q

how is a newborn positioned when being examined?

A
  • infant is supine on warming table or examination table with heating light
  • or on parents chest
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2
Q

how should the patient be dressed?

A

nude is preferred, but if a boy then wear a diaper

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3
Q

how should infants height, weight and head circumference be noted?

A

plotted on a growth curve to make sure they’re in the average percentile

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4
Q

what general appearance do you want to see with a newborn?

A
  1. Body symmetry, spontaneous position, flexion of head and extremities and spontaneous movement
  2. Skin colour and characteristics; any abnormalities
  3. Symmetry and positioning of facial features
  4. Alert, responsive affect
  5. Strong, lusty cry
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5
Q

what should you look for and assess with head and face?

A
  1. Note moulding of the cranium after delivery, any swelling on cranium, and bulging of fontanelle with crying or at rest
  2. Palpate fontanelles, suture lines, and any swellings
    Inspect positioning and symmetry of facial features while the infant is at rest and during crying
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6
Q

what should you look for and assess with ears?

A
  1. Note startle reflex in response to loud noise
  2. Palpate flexible auricles
  3. Inspect size, shape, alignment of auricles; patency of auditory canals and any extra skin tags or pits
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7
Q

what should you look for and assess with nose?

A
  1. Determine patency of nares

2. Note nasal discharge, sneezing, and any flaring with respirations

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8
Q

what should you look for and assess with neck?

A
  1. Lift shoulders and let head lag to inspect the neck: note midline trachea, any skinfolds, and lumps
  2. Palpate lymph nodes, thyroid, any masses
  3. While infant is supine, elicit the tonic neck reflex; note suppleness of the neck with movement
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9
Q

what should you look for and assess with lower extremities?

A
  1. Note ROM
  2. Note alignment of feet and toes, looks for flat soles, and count toes; any syndactyly
  3. Perform the Ortolani manoeuvre to test for hip stability
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10
Q

what is the ortolani/barlow test?

A

moving the hips in and out to check for hip stability

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11
Q

what should you look for and assess with spine and rectum?

A
  1. Turn over and hold it prone in hands or place the infant prone on exam table
  2. Inspect length of spine, trunk, incurvation reflex, and symmetry of gluteal folds
  3. Inspect skin
  4. Note patent anal opening. In a newborn, check for passage of meconium stool during first 24-48hrs
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12
Q

what is incurvation?

A

bend in spine

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13
Q

what is average HR and BP?

A
  • HR=120-160BPM

- BP=85/54mm Hg

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14
Q

when is the first comprehensive nursing assessment conducted on an infant?

A

usually performed as soon as newborns physiological functioning is stable (usually few hrs after birth)

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15
Q

what is the average weight, length and head circumference for infant?

A

-average weighs 3400g, is 50cm in length and 35cm head circumference

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16
Q

what causes 10% of birth weight to be lost in infants?

A

primarily due to fluid losses by respiration, urination, defecation, and low fluid intake

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17
Q

are respiratory movements generally abdominal or chest?

A

abdominal

18
Q

what is average RR?

A

30-60 breaths per min

19
Q

what is lanugo?

A

excessive hair on back

20
Q

what is peripheral cyanosis?

A

bluish colouration on hands and feet as newborns

21
Q

why is there a moulding or overlapping of soft skull bones?

A

allows the fetal head to adjust to various diameters of maternal pelvis (common with vaginal births)

22
Q

what part of the head are typically palpable at birth?

A

sutures and fontanelles

23
Q

list normal reflexes for newborns

A

sucking, rooting, gasping, yawning, coughing, sneezing, hiccupping, blinking in response to bright light and startling in response to sudden loud noises

24
Q

what is the sucking reflex?

A

paired with the rooting reflex, where the newborn searches for a food source

25
Q

what could it mean if the newborn doesnt display one or more of these reflexes?

A

absence of any of these or other reflexes indicates prematurity, possible trauma, CNS complications

26
Q

where do newborns breathe out of and for how long?

A

breathe through their nose up until 4 months of age

27
Q

what is hyperbilirubinemia?

A

-hyperbilirubinemia- excessive bilirubin accumulates in the blood, can be toxic, phototherapy, infant immature liver is unable to balance the destruction of RBC’s with the use of or excretion of byproducts

28
Q

what is screening?

A

-Screening- newborns are screens using blood tests to see if there are any inborn errors in metabolism, rare but serious. Also screened for cystic fibrosis, hemophilia

29
Q

what do you do to demonstrate a non verbal and verbal approach?

A 
• Smile
• Eye contact
• Warm hands and stethoscope
• Smooth movement
-Soft voice
30
Q

what sequence do you do for newborn assessment?

A

• Seize sleeping opportunities
• Least distressing to more invasive (look at handout at order)
• May need to reorder assessment
-Moro reflex at the end- why? Because crying babies are difficult to assess

31
Q

what is the moro reflex?

A

a response to a sudden loss of support, when the infant feels as if it is falling

32
Q

describe important key points of the APGAR test

A
  • 1 min and 5 min after birth
  • Infants immediate response to extrauterine
  • Higher the number, better the infant
  • Always looking for the increase in score, that is why you check regularly
33
Q

what does APGAR stand for?

A 
A- Appearance (skin colour)
P- Pulse
G- Grimace (reflex irritability)
A- Activity (muscle tone)
R-Respiration
34
Q

what is meconium

A

first bowel movement. Odourless and black/tarry

35
Q

what are the 3 main holds for breastfeeding?

A
  1. cradle
  2. football
  3. cross holding
36
Q

when baby is born with colostrum, how long does it take for true milk to come in?

A

2 days

37
Q

when is the best time to assess a newborn?

A

about 1-2hrs after feeding (not too drowsy or hungry)

38
Q

how often is the APGAR scoring done? and describe it

A
  • at 1 and 5 minutes after birth
  • each category is rated 0, 1, or 2
  • higher score means less intervention needed
39
Q

are sporadic movements normal?

A

yes, if symmetrical

40
Q

what is the normal finding that newborns do in relation to fixing on an object?

A

Ability to fixate on moving objects about 20 to 25 cm from faces

41
Q

what is normal for sleeping for newborns

A

sleeping almost continuously for first 2-3 days

N143 (10 decks)

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