Neonatal Assessment

Question 1

Neonate Neurological LOC

Answer 1

LOC - alert, lethargic or comatose.

if the baby is approach with sounds, they should be startled.
the baby shouldn’t be hyper-excitable

Question 2

Neonatal Neurological activity

Answer 2

normal, decreased, or inactive

Question 3

Neonatal neurological postures

Answer 3

• normal posture is flexed hips and flexed knees (fetal position)
• immature babies have extension of the legs normally

“arms/hips/knee extension/flexion, decorticate or decerebrate posturing”

Question 4

Neonatal Neurological assessment large components:

6 parts

Answer 4

1. LOC
2. Activity
3. posture
4. tone
5. primitive reflex
6. autonomic systems

Question 5

Neonatal Neurological Tone

Answer 5

Tone Central: “normal, hypotonic or flaccid”

-head lag, vertical suspensions, ventral suspension

Limb Tone:
“ability of provider to stretch or flex the limbs, and the passive resistance seen. Passive tone is assessed when the baby is not fighting or manipulation”

Question 6

Neonatal neurological Primitive Reflex

Answer 6

“normal, weak/incomplete, or absent”

Suck reflex - should be elicited easily, usually no longer requiring a minute of prompting

Gag - typically won’t seee until >1 month.. but should be strong, elicited by touching the infants soft palate

Grasp - reflex is considered normal

Pupillary - constriction is present by 28-30 weeks EGA

Moro Reflex -

1) abduction of the upper extremities with hand splaying
2) abduction most prominent by 32 weeks, adduction usually seen by 37 weeks

Question 7

Neonatal Autonomic System

Answer 7

Pupils, HR, respiration

Question 8

Maternal/Antenatal History

Answer 8

• age of mom
• gestational age/weight
• perinatal care/screening?
• GTPAL
• full serology (GBS status usually 35 weeks)
• maternal fever/chorio
• medications mom has received (Abx, steroids, tocolytics, magnesium)

Question 9

Labour and Delivery Hx

Answer 9

• APGAR
• SVD/C-Section and why
• complications during
• ROM, and when
• fetal heart rate assessment ?
• duration in time and contractions

Question 10

APGAR definition and how its grades

Answer 10

Appearance, pulse, grimace, activity and respiration graded 0-2 each, at 1,5 and 10 minutes

Its an accepted, universally used method to assess the status of the newborn infant immediately after birth.

Approx 90% of neonates have APGAR scores of 7-10 and require no intervention

Question 11

what are the two drugs given to neonates after delivery and why ?

Answer 11

1. Erythromycin prevent neonatal gonococcal opthalmali (causing blindness)
2. IM Vit k1 to prevent vitamin k deficient bleeding.