newborn assessment : fine tuning your assessment skills kim mccullen, nnp-bc munson medical center
TRANSCRIPT
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Newborn Assessment:Fine Tuning Your Assessment Skills
Kim McCullen, NNP-BCMunson Medical Center
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Organizing the Newborn Exam
• The significance of OBSERVATION• Tools used to complete the Physical Exam (PE)– Auscultation– Palpation– Percussion – http://newborns.stanford.edu/PhotoGallery/
VSD4.html
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Perinatal History
• Brief review of the Perinatal History for “clues” to potential pathology
• The newborn’s history begins with conception and includes events that occur throughout gestation, labor, and delivery.
• Categorization of High-Risk Pregnancy Factors -Socioeconomic Factors, Demographic Factors, Medical Factors, Current Maternal Obstetric Status, Habits
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Basic Newborn Assessment of the Term Neonate
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Skin
• PE of the skin, what does and can it mean?– Cutis Marmorata– Harlequin Color Change– Ecchymosis– Macule– Petechiae– Vesicle– Pustule
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Cutis Marmorata
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Harlequin Color Change
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Ecchymosis (Bruising)Increases Risk for Jaundice
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Macule
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Petechiae
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Vesicle
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Head to Toe Assessment!
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Head
• Measurement: Microcephaly? Macrocephaly?• Shape: molding?
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Skull: fontanels and sutures
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Face
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Ears
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Eyes
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Nose
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Mouth
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Chest
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Heart
• Murmur?• 4 limb Blood Pressure• Pulses
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Fetal Circulation
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Normal Heart
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PDA
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Coarctation of the Aorta
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Abdomen
• Size• Shape• Movement
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Abdomen
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Genitourinary
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Hypospadius
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Hymenal Tag
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Musculoskeletal
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Late Preterm Newborn
• Hypothermia• Hypoglycemia• Respiratory distress• Apnea• Hyperbilirubinemia• Feeding difficulties
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Medications At Birth
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Vitamin K
• http://www.cdc.gov/ncbddd/blooddisorders/documents/vitamin-k.pdf
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Hepatitis B Vaccine
• http://www.cdc.gov/hepatitis/B/
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Public Health Services
• Newborn Screen• CCHD Screen• Hearing Screen
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Questions?
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Newborn Assessment: Fine Tuning Your Assessment Skills
•Interactional reference for physical examination:
•http://newborns.stanford.edu/PhotoGallery/
•Vitamin K reference:
•http://www.cdc.gov/ncbddd/blooddisorders/doc uments/vitamin-k.pdf
•Hepatitis B Vaccine reference:
•http://www.cdc.gov/hepatitis/B/