1 / 18

SHARON GAN 2 West - Austin Hospital School of Nursing and Midwifery

Examination and assessment of the newborn baby. SHARON GAN 2 West - Austin Hospital School of Nursing and Midwifery . Objectives. Revise transition of intrauterine to extrauterine life of a newborn Perform a systematic examination of the newborn - view video

kanoa
Download Presentation

SHARON GAN 2 West - Austin Hospital School of Nursing and Midwifery

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Examination and assessment of the newborn baby SHARON GAN 2 West - Austin Hospital School of Nursing and Midwifery

  2. Objectives • Revise transition of intrauterine to extrauterine life of a newborn • Perform a systematic examination of the newborn - view video • Know the characteristics of the newborn including reflexes and its implications.

  3. Examination of the Newborn • The transition from intrauterine to extrauterine life is a dramatic one and demands considerable physiological alterations by the baby to ensure survival • The uterine environment has provided oxygen, nutrition, excretion and thermoregulation and a dulled environment to the stimuli of the outside world

  4. Examination of the Newborn • The fetus is subjected in labour to intermittently diminished supply of oxygen during contractions, compression of the head and chest, extension of the limbs, hips and spine during birth • The baby then emerges to encounter light, noises, cool air, gravity and tactile stimuli

  5. Examination of the Newborn • Once born the baby has to make rapid adjustments to the respiratory and circulatory systems as well as controlling body temperature • These initial adaptations are crucial to the baby’s subsequent well being

  6. Examination of the newborn • A complete examination will be done prior to discharge from hospital • Top to toe • Check history – congenital problems? Birth problems? • Involve parents and explain what she is doing (and share results) • Be careful and methodical • If abnormality found, handle sensitively and arrange paediatric follow up • Answer questions and give appropriate education • Unwrap baby and examine gently in warm, well lit space

  7. General observations • Overall appearance – color, behaviour, activity • Breathing - 36-60 breaths per minute • Pink • Vernix caseosa • Post mature - less vernix, drier skin, creases on feet • Variable amount of hair • Blue/green eyes • Lanugo - fine hair, usually on preterm baby • Note - movement and tone • HR – 100-160bpm • Temp – 36.5-37.1 degrees (PA) • Cry – not high pitched

  8. Neurological examination • Note symmetry • State – alert, sleepy • Lethargy • Irritability • Posture • Tone • Muscle strength • Reflexes

  9. Examination of the Newborn • There are some reflexes that the midwife can test for soon after birth • The assessment should be done while the baby is in a quiet, alert state • Weak or absent responses may indicate immaturity, cerebral damage or abnormality

  10. A healthy baby? • A healthy, term baby: • Can maintain stable temperature • Will initiate feeds, suck well and settle between feeds • They are not excessively irritable, tense, sleepy or floppy • Pass meconium and urine within 24 hours

  11. Examination of the Newborn • The Moro reflex is a response to a sudden stimulus • The baby is held supine with head and trunk supported, the head and shoulders are allowed to fall back • The baby responds by abduction and extension of the arms with the fingers fanned, accompanied by a tremor

  12. Examination of the Newborn • Rooting reflex is obtained by stroking of the cheek or the side of the mouth and the baby will turn to the source of the stimulus • Sucking and swallowing reflexes can be observed when the baby is feeding • Gag, cough and sneeze reflexes are to protect the baby from airway obstruction • Grasp reflex is obtained by placing a finger in the palm of the baby’s hand and the baby will grasp the finger

  13. Examination of the Newborn • Walking and stepping reflexes are found when the baby is supported upright with the feet touching a flat surface • The baby will simulate walking • Crawling reflex present when baby is placed on stomach, knees drawn, kick their legs out, shuffle and move in a crawling motion

  14. Central Nervous System

  15. Summary • Review assessment of a newborn • Consider reflexes present in newborn, interpret results and care for the babies in our care.

  16. References • Fuloria, M &Kreiter, S. (2002). The newborn examination: Part 1. American Family Physician, 65 (1): 61 – 68 • Fuloria, M &Kreiter, S. (2002). The newborn examination: Part 2. American Family Physician, 65 (2): 265 – 270 • Yang, M. (2004) Newborn neurologic examination. • Video: Examination of the newborn

  17. Questions and Comments mlmlblog.wordpress.com

More Related