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Assessment in Newborn Slide 1 Assessment in Newborn Slide 2 Assessment in Newborn Slide 3 Assessment in Newborn Slide 4 Assessment in Newborn Slide 5 Assessment in Newborn Slide 6 Assessment in Newborn Slide 7 Assessment in Newborn Slide 8 Assessment in Newborn Slide 9 Assessment in Newborn Slide 10 Assessment in Newborn Slide 11 Assessment in Newborn Slide 12 Assessment in Newborn Slide 13 Assessment in Newborn Slide 14 Assessment in Newborn Slide 15 Assessment in Newborn Slide 16 Assessment in Newborn Slide 17 Assessment in Newborn Slide 18 Assessment in Newborn Slide 19 Assessment in Newborn Slide 20 Assessment in Newborn Slide 21 Assessment in Newborn Slide 22 Assessment in Newborn Slide 23 Assessment in Newborn Slide 24 Assessment in Newborn Slide 25 Assessment in Newborn Slide 26 Assessment in Newborn Slide 27 Assessment in Newborn Slide 28 Assessment in Newborn Slide 29 Assessment in Newborn Slide 30 Assessment in Newborn Slide 31 Assessment in Newborn Slide 32 Assessment in Newborn Slide 33
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Assessment in Newborn

  1. 1. New Born Type of Assessment
  2. 2. • Full term baby is deliver at 38-42 weeks. If baby deliver before 28 weeks known as preterm. Baby cries just after birth and establish rhythmic respiration. • The new born are more prone for infection as they have less immunity. • Physical character of new born- • Weight -2.5-3.5 kg • Height-45-50cm • Head Cir.-35cm • Chest Cir.-32-33 cm • Mid arm cir.-12-13 cm
  3. 3. • Body Proportion-1.7:1 • Presence of lanugo, vernix caseosa, meconium • Ext auditory canal is short and straight • Physiological characteristics- Temp-36.5-37.5 Pulse-120-160/min At sleep pulse is 100/min Resp-30-60/min Bp- systolic-60-80 mm Hg Diastolic 25-40 mm Hg
  4. 4. Reflexes Beginning age Disappearance age Sucking reflex At birth At 6 months Rooting reflex At birth 4-7 months Gagging At birth Does not disappear Swallowing At birth Does not disappear Blinking At birth Does not disappear Sneezing and coughing At birth Does not disappear Dolls eye At birth 3 months Stepping or dance At birth Diminish 3-4 weeks Moro At birth 3-4 months Parachute 7-9 months Some time Not disappear Tonic neck 2 month 6-9 month of age Palmer grasping At birth Diminish by 3 month age Planter grasp At birth Diminish by 8 month Pincer grasp 8-9 month Diminish at 11 month
  5. 5. • Assessment of new born: • Assessment of new born helps to screen disease in initial stage at new born. There are 4 types of assessment- • 1.Initial assessment (by APGAR score & anthropometric measurement): • 2.Transitional assessment: • 3.Physical assessment: • 4. Gestational age assessment:
  6. 6. • 1.Initial assessment (by APGAR score & anthropometric measurement): • Appearance (skin coloration) • Pulse (heart rate) • Grimace response (medically known as "reflex irritability") • Activity and muscle tone • Respiration (breathing rate and effort)
  7. 7. • 2.Transitional assessment: first 24 hrs are very critical for new born, it require a lot of care. • There are changes in heart rate, respiration, ms tone, motor activity etc. first 24 hrs known as period of reactivity. • i. first period of reactivity- first 6-8 hrs after birth called first period of reactivity. During this ms tone should be active • ii. Second period of reactivity- 9-24 hr of first day. The nurse should observe abnormal physiology of nervous system, respiratory sys, muscular system
  8. 8. • 3.Physical assessment of new born- • SHE ENT MNC HAG RE • 4. Gestational age assessment: • This hepls us to identify about gestational age of baby. On the basis of this we can identify about preterm and term baby. • The method is known as New Ballard score. The nurse should observe 2 types of signs in neonate.
  9. 9. External Physical sign: ( HSE BGP) 1. Hair texture 2. Skin texture and opacity 3. Ear cartilage 4. Brest nodules and nipple formation 5. Planter creases 6. Genitalia- male/female
  10. 10. • Neuromuscular sign: 1. Body posture 2. Square window 3. Arm recoil 4. Popliteal angle 5. Scarf sign 6. Heel to ear (PSA PSE)
  11. 11. • 1. Posture • Total body muscle tone is reflected in the infant's preferred posture at rest and resistance to stretch of individual muscle groups • To elicit the posture item, the infant is placed supine (if found prone) and the examiner waits until the infant settles into a relaxed or preferred posture.
  12. 12. posture
  13. 13. • 2. Square Window • Wrist flexibility and/or resistance to extensor stretching are responsible for the resulting angle of flexion at the wrist. • The examiner straightens the infant's fingers and applies gentle pressure on the dorsum of the hand, close to the fingers. From extremely pre- term to post-term, the resulting angle between the palm of the infant's hand and forearm is estimated at; • >90°, 90°, 60°, 45°, 30°, and 0°. • The appropriate square on the score sheet is selected.
  14. 14. square window
  15. 15. • 3. Arm Recoil • This maneuver focuses on passive flexor tone of the biceps muscle by measuring the angle of recoil following very brief extension of the upper extremity. • With the infant lying supine, the examiner places one hand beneath the infant's elbow for support. Taking the infant's hand, the examiner briefly sets the elbow in flexion, then momentarily extends the arm before releasing the hand.
  16. 16. arm recoil
  17. 17. • 4. Popliteal Angle • This maneuver assesses maturation of passive flexor tone about the knee joint by testing for resistance to extension of the lower extremity. With the infant lying supine, and with diaper re-moved, the thigh is placed gently on the infant's abdomen with the knee fully flexed. After the infant has relaxed into this position, the examiner gently grasps the foot at the sides with one hand while supporting the side of the thigh with the other.
  18. 18. popliteal angle
  19. 19. • 5. Scarf Sign • This maneuver tests the passive tone of the flexors about the shoulder girdle. • The examiner nudges the elbow across the chest, felling for passive flexion or resistance to extension of posterior shoulder girdle flexor muscles.
  20. 20. scarf sign
  21. 21. • 6. Heel to Ear • The examiner supports the infant's thigh laterally alongside the body with the palm of one hand. The other hand is used to grasp the infant's foot at the sides and to pull it toward the ipsilateral ear.
  22. 22. heel to ear
  23. 23. • Nursing management or care of normal new born: • A. establishing & maintain patent airway • B. maintain normal body temperature • C. monitoring vital signs General care : i.weighing ii.bowels and urinary passage iii. care of eyes iv.care of cord v. care of skin
  24. 24. • Vi. Administration of Vit. K • Vii. Care of genital • Viii. Prevention of infection • Ix. Adequate nutrition • X. clothing of baby • Xi. Baby bath • Xii. Immunization • Xiii. Psychological bonding with parents • Xiv. Parents health education and follow up
  25. 25. • Minor problems of neonate: • i. vomiting: • Ii. Constipation • Iii. Diarrhea • Iv. Excessive crying • V. Evening colic • Vi. Excessive sleepiness • Vii. Sneezing and nose block • Viii. Hiccups • Ix. Napkin rash • X. breathing holding spells
  26. 26. • Xi. Cradle cap • Xii. Obstructed naso lacrimal duct • Xiii. Umbilical granuloma • Xiv. Mastitis neonatrum • Xv. Vaginal bleeding and mucoid secretion • Xvi. Physiologic phimosis • Xvii. Mongolian blue spots • Xviii. Milia • Xix. Predeciduous teeth • Xx. Umbilical hernia • Xxi. Congenital hydrocele xxii. Bowed legs
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