assessment newborn
DESCRIPTION
physical examinationTRANSCRIPT
COMMUNITY HEALTH NURSING
PHYSICAL EXAMINATION NEW BORN BABY
QUESTION ?
EXPLAIN THE PHYSICAL EXAMINATION FOR
NEW BORN
PURPOSE
1. To identify characteristics of the normal newborn.
2. To identify congenital abnormalities of birth injuries.
3. To facilitate early treatment of baby to avoid complication
4. To obtain baseline data for continuous assessment.
ASSESSMENT
1. Observe general condition of baby : -skin colour-centrally pink, present lanugo
and vernix -Baby active or not (hand and leg
movements) -Strong cry or not
ASSESSMENT
2. Perform anthropometry -Body weight (2.5-4.0 Kg) -Length(46-56 Cm) -Head circumference (32-37 Cm)
ASSESSMENT3.Check baby’s head: Moulding , caput
succedaneum ,cephalohematoma Size of fontanalle: - Anterior(can admit 2 finger,closes at 18month) -Posterior(can admit 1 finger and close at 2- 3 month)Birth injuries(bruises,wound on scalp)
ASSESSMENT
4.Examine:• Face for characteristics of Down’s syndrome
like:• Upward slanting of eyes with thick epicqnthic
folds• Small mouth with thick tounge and always
sticking out• Nose-flattened• Low set ears
ASSESSMENT
5.Eyes:• Has 2 eyeballs• Lens clear and without cataract• Can open eyes spontaneously• No bleeding in the sclera
ASSESSMENT
6.Mouth• No cleft lip• Feel inside baby’s mouth to identify for signs
of cleft palate• Presence tongue tie• Check for presence teeth
ASSESSMENT
7.Nose• Has 2 nostrils
• Any nasal flaring
ASSESSMENT
8.Ears• Check position of ears : upper notch pinna
same level of the canthus of the eye.• Check if auditory meatus(canal) is patent.• Has ear lobes
ASSESSMENT
9.Check neck-by lifting chin up to observe for:• Enlargement of thyroid gland• Sternomastoid tumour (palpate side of neck)
ASSESSMENT
10.Check hands• Both hand same length • Both hand can move• Palm of hand has 3 normal creases and not
the “simian crease”• Any fracture,dislocation and paralysis• Check for grasp reflex
ASSESSMENT
11.Check chest for:• Chest movement during respiration to identify
for sterna/ intercostals recession.• Pigeon chest(chest appears to be higher)• Nipple well formed and no extra nipple
ASSESSMENT
12.Check abdomen :• Shape-convex• Soft • Umbilical cord(has 2 arteries and 1 vein)• No bleeding should be clamped properly• No umbilical hernia• Exomphalus/gastrochiasis
ASSESSMENT
13.Check genitalia :• Identify sex and ensure if it is not ambigous
Male female
Both testis descended Has labia majora and minora and vaginal orife
No epispadias,hypospadias A little of whitish mucus is normal
No hydrocele,no phimosis Presence of smegma in labiaminora is normal
ASSESSMENT
13.Check feet:• Both leg are of same length• No fracture and paralysis • No talipes • Both legs have sufficient toes and no decrease
number of digits on the toes.
ASSESSMENT
14.Check baby’s back :• Turn baby to the side and ensure baby’s back
is straight and flat.• Use the fingers and check from neck to
sacrum• Ensure there is no dimples curves,lumps ‘hair
tuft’ and spinal bifida.
ASSESSMENT
15.Anus :• Check to ensure anus patent• Insert rectal temperature into the anus as far
as 2.5cm• Place baby in lateral position for this
procedure
ASSESSMENT16.Basic neurological test :
Grasp reflexMoro reflex
Sucking reflexRooting reflex
-han-