Newborn Assessment
What function is establish with the cutting of the umbilical cord and what shunts close during the newborn's transition to extrauterine life?
Respiratory system (breathing) is established and the ductus arteriosus, ductus venosus, and foramen ovale close during newborn's transition to life.
What to teach parents about circumcision care?
Vaseline gauze will be applied to the site after the procedure
Watch for infection, hemorrhage, and voiding difficulty due to swelling afterwards
What assessment tool is used to determine the gestational age of the baby
Ballard Scoring System
What are small raised lesions (white) on chin, nose and forehead?
Milia
What is the moro reflex?
Infant feel like she is falling
Will throw arms out, then in, then cries out
Ends around 3-6 months
What is a good APGAR score?
1 minute and 5 minute (10 minute if poor APGAR previously)
Like to see a score of 8-10
Usually lose points for blue extremities.
When instructions should be given related to newborn cord care?
No tub baths until cord has fallen off and healed correctly
Clean cord with water and dry with each diaper change.
What is posture like in a preterm baby?
Less tone, lay extended, floppy
Yellowish white, cheesy coating that covers babies (not seen as much in post term)
Vernix caseosa
Describe a normal Babinski in infants
Toes fan UP and OUT under 1 year=NORMAL
What is a normal infant respiration rate?
What are signs of distress in an infant?
30 to 60 breaths per minute
Count for 1 minute
Nasal flaring, retractions, grunting, cyanosis, stridor
What test examines for inborn errors of metabolism?
PKU...tests for hypothyroidism, Maple Syrup disease, Galactosemia
Describe Scarf sign in preterm infants
Elbow goes past midline in preterm infants
What is the name of the downy, fine hair found on infants after birth (not postterm)
Lanugo
Describe the newborn head circumference
Head will be either equal to or is larger than the circumference of the chest by 1 inch
What is the difference between caput succedaneum and cephalhematoma?
Caput succedaneum--localized, CROSSES the suture line, will go away in a few days
Cephalhematoma--Collection of blood between the periosteum and a bone of the skull it covers; does NOT cross the suture line, and can take WEEKs to resolve
What can a direct Coombs test identify?
Tested on umbilical cord blood to monitor for antibodies that attack your RBCs
Hemolytic anemia
Sometimes the infant will have yellow skin/eyes
Describe postterm skin?
Dry cracked and peeling skin with little vernix and lanugo
What are purple-bluish spots found on the backside of babies that can be mistaken as abuse?
Mongolian spots
Absence of what reflex would indicate congenital cataracts?
Red reflex...check with ophthalmoscope and red glow should appear in eye if the eyes are clear
When does the anterior fontanelle close?
When does the posterior fontanelle close?
What does sunken fontanelle mean?
What does a bulging fontanelle mean?
Closes at 18 months
Closes 2-3 months
Dehydration
increased ICP (could be d/t crying, etc....)
A blood sugar below what is indicative of hypoglycemia?
Which infants do you usually see hypoglycemia in?
Below 45
Typically seen in macrosomic babies, pre/post term, mom with diabetes, SGA, IUGR, asphyxiated, cold stress, and mother that had to receive tocolytics
Describe appropriate car seat safety.
Rear facing until 2 years of age
45 degree angle to prevent airway obstruction
harness should be snug and clip at or right below armpits
No bulky clothing while in carseat
Flat, red marks on upper eyelids, back of neck, and forehead present after birth and will eventually go away
What are telangiectatic nevi or stork bites
What is Ortolani maneuver used for?
Assessing for hip dysplasia. If hear a clicking sound, could be positive for dysplasia