Newborn Assessment/ Neonates Assessment (0-28 days)
Purpose of neonatal assessment
1. Hypothermia
2. Aspiration
3. Inability to breastfeed
4. Hypoglycemia
5. Ensure orifice and spontaneous breathing
6. Congenital malformation
7. Brain injury
8. Birth injury (forceps delivery injury)
On the basis of time of performing; 3 types of assessment are-
1. Immediate assessment of newborn
2. Transitional assessment during period of reactivity
3. Periodic assessment
1. Immediate assessment of newborn
1. APGAR Scoring
A- Appearance
P- Pulse rate
G- Grimace (reflex, irritability)
A- Activity (muscle tone)
R- Respiration
APGAR score
> 7 = satisfactory
4-6; moderate distress
0-3= severe distress
2. Recording birth weight/ baby length
3. Umbilical cord examined
Presence of 2 Umbilical arteries and 1 vein
4. Orifice checking
1. Mouth
Lip cleft
Palate cleft
2. Ear
3. Nose
4. Anus
Checked for imforation or malformation
5. Urethra checked
Hypospadias
Opening of penis is on underside rather than tip, ventral aspect.
Epispadias
Urethra tube doesn't develop into full tube, dorsal aspect.
6. Visible lesion on back or front
2. Transitional assessment during period of reactivity
Transitional changes in newborn in active half hours, after sleeping.
After birth first 24 hours of life "period of reactivity"
Changes in vital function;
Heart rate
Respiration
Motor activity
Skin color
Bladder
Bowel activity
During first 30 minutes of birth neonates very active and alerts; cries, strong sucking.
Transitional Assessment includes;
1. General examination
2. Anthropometric Assessment
3. Head to toe examination
4. Neurologic examination
5. Reflexes
6. Estimation of gestational age
1. General examination
Posture
Activity
Cry
Color
Vital sign
2. Anthropometric Assessment
Baby length;
Weight;
Head circumference;
Chest circumference;
Mid arm circumference;
3. Head to toe examination
Skin
Head
Face
Eye
Ear
Nose
Mouth
Neck
Chest
Abdomen
Feet and hands
Genitalia
Nipple
Back and spine
4. Neurologic examination
Muscle tone; muscle tone is resistance of muscle to active and passive stretch.
(Muscle tone is tension in muscle at rest)
Posture;
Passive tone
Active tone
Stretch
Joint mobility
Autonomic reflexes
Body movement
5. Reflexes
6. Estimation of gestational age
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