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Newborn assessment. Meaning. Newborn assessment is the critical analysis and evaluation or judgment of the status of a newborn. PHASES. Apgar scoring Assessment of gestational age Systematic physical examination Transitional assessment during the period of reactivity. BALLARD SCALE.
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Meaning Newborn assessment is the critical analysis and evaluation or judgment of the status of a newborn
PHASES • Apgar scoring • Assessment of gestational age • Systematic physical examination • Transitional assessment during the period of reactivity
BALLARD SCALE Tests used are • Posture • Square window • Arm recoil • Popliteal angle • Scarf sign • Heel to ear
Weight related to gestational age • Appropriate for gestational age (AGA) • Large for gestational age (LGA) • Small for gestational age (SGA)
Systematic physical assessment General physical examination Head circumference: 33-33.5cm Chest circumference: 30.5 – 33cm Crown to rump length : 31 – 35cm Head to heel length : 48 – 53cm Body weight : 2700 – 4000gm
Vital signs • Temperature : 36.5 – 37degree C • Heart rate : 120- 140/ min • Respiration : 30 -60/min • BP : 65/41 mmHg
General appearance • Posture
Skin • At birth red, puffy and smooth • Then pink, flaky, dry • Acrocyanosis
Lanugo • Edema
SKIN ..Variations • Neonatal jaundice • Echymosis or petichae • Miliria or sudamina • Talagiectatic navi
Head • Anterior fontanel (diamond) 4 – 5 cm • Posterior fontanel (triangle) 0.5 – 1 cm Should be soft, flat and firm
Variations • Bulging fontanel • Caput succedaneum • Cephalhematoma
Transitional assessment • First stage • Second stage
Reflexes • Localized reflexes EYES • Blinking or corneal reflex • Pupillary
Nose • Sneezing • Glabellar
Mouth and throat • Sucking • Gag • Rooting • Extrusion • Yawn • Cough
Extremities • Grasp • Babinski • Ankle clonus
Mass reflexes • Moro reflex
Mass reflexes • Startle • Perez • Crawl