NEWBORN ASSESSMENT Flashcards
Reminders on Newborn Assessment
- Seek parental consent
- Consider cultural needs
- Discuss with parents:purpose, process,
timing, and limitations of assessments - Ask about parental concerns
- Encourage participation
Initial exam immediately after birth and
any resuscitation
Newborn Assessment
- Full and detailed assessment
within __hours and always
prior to discharge
48
Preparation is
Explanation
Equipments
Environment
Equipments needed are
- Overheadwarmer if
required - Stethoscope
- Ophthalmoscope
- Tongue depressor
- Penlight torch
- Tapemeasure,
infant scales,
growthcharts - Pulse oximetry
- Documentation
- Infant Personal Health record
- Medical Health Record
Environment should have
adequate warmth
and lighting
Prevent cross infection by
implementing standard
precautions
Guidelines in NA
- General observations to specific measurements.
- Least disturbing aspects of the examination before more
intrusive techniques, such as deep palpation and examination
of the hips. - Head-to-toe approach.
4.The overall physical appearance of the newborn is
evaluated first, followed by vital signs, weight, and length - Thorough head-to-toe assessment follows, ending with
neurologic reflexes and the gestational age assessment. - The behavioral assessment is integrated throughout
the examination.
Indications for further investigation:
Dysmorphic features
Clinical Assessment
- Skin, color, integrity, perfusion
- State of Alertness
- Activity, range of spontaneous
movement - Posture, muscle tone
Looks Floppy
Feels Floppy
Incrased joint mobility
Floppy infant
Normal Heart Rate Newborn
110-160
Normal RR
30-60
Temp
36.5 - 37C
BP
60-80/40-45 mm HG
the preferred
site for newborn
temperature measurement.
axilla
Blood pressures are not taken routinely. If they are measured, the cuff must be
an appropriate size, and the pressure may be measured on an
arm or leg
Obtainthe head circumference
by
placing a paper tape measure
around the widest circumference
of the head
To measure the chest
circumference,
place the infant on
his or her back with the tape measure
under the lower edge of the scapulae
posteriorly and then bring the tape
forward over the nipple line.
Head Circumference
33-35.5cm
Chest Circumference
30.5-33cm
Document on the appropriate
centile charts:
- Weight
- Length
- Head circumference, C C
Indications for further
investigation
Urgent follow-up
Excessive weight loss
Skin Clinical Assessment
Color
* Trauma
* Congenital or subcutaneous
skin lesions
* Edema
SKIN - Indicationsfor further investigation
Urgentfollow-up
Anyjaundice atless than24hours of age
Central cyanosis
a white cheeselike substance that covers thebodyof
the fetus during the secondtrimester.Vernix protects fetal skin fromthe
dryingeffects of amniotic fluid.
Vernix caseosa
fine downy hair that is present in abundance on the preterm infant but is found in thinning patches on the shoulders, arms , and back of the term newborn
Lanugo
is the best environment
in which to assess for jaundice.
If sunlight is not available inside the nursery,
use indirect lighting
natural sunlight
A yellow tinge to the sclera indicates the
presence of
jaundice
Press thenewborn’s skin over the
forehead or nose withyour finger andnote
if theblanchedarea
appears yellow
