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Women and Families > Newborn Assessment > Flashcards

Newborn Assessment Flashcards

1
Q

when does the newborn assessment begin

A

before delivery

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2
Q

What to anticipate in prenatal history

A

what may have compromise the fetus in utero?

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3
Q

Prenatal history

A

maternal medical and prenatal history

  • blood type, lab values, GBS/HIV/HepB
  • DM or preecalmpsia
  • Smoking/substance abuse
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4
Q

what to think about intrapartum history

A

what happened during labor

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5
Q

intrapartum history

A
  • duration and course
  • maternal well being: analgesia or anesthesia
  • fetal well being:prolonged rupture of membranes, meconium stained amniotic fluid, nuchal cord, precipitous birth, use fo forceps of vacuum extraction, fetal distress
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6
Q

First assessment

A

transition to extrauterine life

  • ABC’s immediately at birth
  • thermoregulation
  • APGAR scoring
  • Incorporate data with brief physical assessment
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7
Q

What are APGAR scores

A
  • indication of extrauterine transition
  • assessed at 1-5 minutes
  • total score out of 0-10
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8
Q

Interpretation of APGAR score

A
  • 8-10: good prognosis
  • 4-7: active involvement/resuscitation efforts
  • 0-3: poor prognosis
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9
Q

what does APGAR stand for

A 
Appearance/ color
Pulse/heart rate
Reflex irritability/ grimace
Muscle tone/activity
Respiratory effort/respirations
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10
Q

APGAR: appearance

A

0- blue, pale
1-body pink, extremities blue
2- pink

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11
Q

APGAR: Pulse

A

0- absent
1- 60-100
2- over 100

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12
Q

APGAR: grimace

A

0- no response
1- grimace
2- vigorous cry

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13
Q

APGAR: activity

A

0- flaccid, limp
1- some upper extremity flexion
2- active motion of all extremities flexed

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14
Q

APGAR: respirations

A

0- apnea
1- slow, irregular, weak cry
2- lusty cry

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15
Q

Second assessment

A
  • physical examination of new born:
  • gestational age assessment if warranted
  • assessment of attachment
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16
Q

continuous process of assessing

A
  • progress of adaptation to extrauterine life
  • nutritional status and ability to feed
  • behavioral state/ organizational abilities
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17
Q

General measurement of newborn: weight

A
  • weight: 7lb 8oz

- 70-75% of weight is water

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18
Q

general measure of newborn: head circumference

A
  • 32-37 cm/ 12.5-14.5 inches
  • 2 cm/1 inch greater than chest circumference
  • measured above eyebrow at prominent part of the skull
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19
Q

general measurement of newborn: circumference

A

measured at nipple line

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20
Q

general measurement of newborn: abdominal circumference

A

measured just below umbilicus

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21
Q

general measurement of newborn: length

A

in USA, 20 inches

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22
Q

what does gestational age do? and when is it obtained

A
  • establish in first 4 hours after birth

- predict at risk infants and help keep alert for problems

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23
Q

Ballard tool

A
  • tool for estimating gestational age
  • each finding is given a point value
  • maternal condition may affect certain components
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24
Q

assessment of physical maturity characteristics

A
  • skin
  • languo
  • planar creases
  • areola/breast bud
  • eye/ear formation
  • genitalia
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25
Q

Assessment of neuromuscular maturity

A
  • posture
  • square window
  • arm recoil
  • popliteal angle
  • scarf sign
  • heel to ear
26
Q

newborn classification based on gestational age and weight

A
  • SGA: less than 2500g
  • AGA: 2500-3999g
  • LGA- 4000g
27
Q

physical assessment

A
  • complete with parent in systematic head to toe manner

- general appearance: head large for body and tend to stay in flexed position

28
Q

Newborn assessment care plan: skin

A
  • color: pallor, beefy red, jaundice, cyanosis
  • texture: cracked, peeling, absence of vernix
  • turgor: maintain tent shape
  • pigmentation: rashes, birth marks, petechiae
29
Q

skin variations

A
  • telangiectatic nevi: stork bites
  • Mongolian spots
  • nevus flames: port wine stains
30
Q

Newborn assessment and care plan: head

A
  • general appearance
  • proportion to ody
  • circumference
  • molding
  • fontanelles
  • sutures
31
Q

head: general appearance and proportion

A
  • piagiocephaly
  • brachycephaly
  • dolichocephaly
32
Q

head shape in zika

A

microcephaly

33
Q

head variations: molding

A
  • caput succedaneum: edema, bruising of presenting part, crosses suture line
  • cephalohematoma: collection of blood within suture line
34
Q

head: fontanelles

A
  • anterior fontanelle: diamond shaped and closes around 18 months
  • posterior fontanelle: triangle shaped an closes around 8-12 weeks
35
Q

head: sutures

A

no bulging and no depression

36
Q

newborn assessment and care plan: eyes

A
  • placement and appearance
  • eyelids and movement
  • color
37
Q

new born eye assessment

A
  • tearless crying
  • peripheral vision
  • can fixate on near objects
  • can perceive faces, shapes, and color
  • clink in response to bright light
  • pupillary reflex is present
38
Q

eyelid variations

A
  • ptosis

- epicanthal folds

39
Q

newborn assessment and care plan: nose

A
  • small and narrow

- must breath through nose

40
Q

newborn assessment and care plan: mouth

A
  • palate: soft and hard
  • tongue
  • lips pink
  • taste buds present
41
Q

newborn assessment and care plan: ears

A
  • appearance
  • cartilage/ recoil
  • hearing
42
Q

newborn assessment and care plan: ears

A
  • appearance: soft, pliable,
  • cartilage/ recoil: pinna parallel with inner and outer cants, ready to recoil
  • hearing
43
Q

newborn assessment and care plan: neck

A
  • appearance: short with skin folds, low muscle tone
  • movement
  • clavicles: intact, check for crepitus
44
Q

newborn assessment and care plan: chest

A
  • appearance: cylindrical and symmetrical
  • breast: engorged, whitish secretions
  • auscultation
  • circumference
45
Q

newborn assessment and care plan: heart:

A
  • auscultation: PMI located at 3-4 ICS, midclavicular line
  • rhythm/rate/murmurs: heart rate: 110-160
  • xiphoid cartilage
46
Q

signs of respiratory distress

A
  • nasal flaring
  • intercostal or xiphoid retractions
  • expiratory grunting or sighing
  • seesaw respirations
  • tachypnea
47
Q

newborn assessment and care plan: abdomen

A
  • cylindrical and soft
  • bowel sounds present by 1 hr after brith
  • umbilical cord: initially white and gelatinous, two arteries, one vein
48
Q

newborn assessment and care plan: genitalia

A
  • female: labia majora covers labia minora

- male- testes descended, pendulous scrotum

49
Q

female genitalia variations

A
  • vaginal tag/ hymnal tag

- pseudomenstration

50
Q

male genitalia variations

A
  • hypospadias

- left hydrocele

51
Q

newborn assessment and care plan: extremities

A
  • short flexible, and move symmetrically

- leg are equal in length with symmetrical creases

52
Q

variations in extremities

A
  • gross deformities
  • extra digits
  • clubfoot
  • hip dislocation
53
Q

newborn reflexes

A
  • palmar and plantar grasp
  • rooting reflex
  • moro reflex
  • fencer reflex/ asymmetric tonic neck
  • babinski reflex
  • galant reflect: trunk incurvation
54
Q

newborn protective reflexes

A
  • blinking
  • yawn
  • cough
  • sneeze
55
Q

behavioral sates of newborn

A
  • deep sleep
  • light sleep
  • drowsiness
  • quiet alert
  • active alert
  • crying
56
Q

behavioral response

A
  • habituation
  • orienting response
  • motor organization
  • consolability
  • cuddliness
57
Q

infant nutritional requirements

A

-calories: 100-120 cal/kg/day
-protien for cell growth
carbs for energy
-fat for brain and CNS developement
-fluid: 100-150 ml/kg/day
-iron: reserves depleted by 6 most
-vitamin D
-Babies regain BW by 10-14 days

58
Q

early nutritional assessment: growth

A

-lose weight in first 3-4day of life
if formula feed: can lose 3.5%
if breast fed should not lose more than 7%
-no greater than 10% weight loss priorate discharge
-weighed daily

59
Q

weight changes in first yeasr

A

double weight by 5 months

  • tripe BW by 1 year
  • quad BW by 2 years
60
Q

breastfeeding assessment

A
  • let down response
  • nipple condition
  • maternal comfort during feeding
  • infant’s weight
61
Q

what to monitor for in breast assessment

A

-montior process of
-anticipatory guidance/education
-maternal repose to infant cues
-latch on technique
positioning

62
Q

signs of effective breastfeeding

A
  • infant nursing 8 or more time in 1 day
  • mother can hear infant swallow
  • mother’s breast soften after feeding
  • number of wet diapers increases
  • infant stols besinning to lighten
  • characteristic output

Women and Families (7 decks)

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