Unit 6 - 6.1 PP TAYLOR
Unit 6 - 6.1 PP TAYLOR
Unit 6 - 6.1 PP TAYLOR
Cardiopulmonary Exam
• Look at the chest
• Observe colour, symmetry, work of breathing,
resp rate.
• Heart sounds; rate, rhythm. 2 distinct sounds.
Head
• Head circumference – average 34-35cm
• Fontanels
• Molding
• Cephalohematoma
• DO NOT cross suture lines
• Caput Succedaneum
• Can cross suture lines
Newborn Assessment
Gastro-Intestinal
• LOOK & LISTEN first
• Inspect
• Auscultate bowel sounds
• Feel the tummy – should be soft
• Anus Patent
• Cord Clamp secure
• What do we teach about cord care? Water, keep dry
• What does an infected cord look like? Red, pusy
Newborn Assessment
Genitourinary: Male
• Penis:
• Do not attempt to retract foreskin over glans
• Look for epi- or hypospadias
Testes:
• Feel both testes (support), look for hydroceles, hernias any
abnormalities
• Assess rugae for gestational age assessment
Ambiguous genitalia
Note first void
Newborn Assessment
Genitourinary: Female
• Labia:
• Large labia major is common due to maternal hormones
• Observe size & separation of labia for gestational age.
Vagina:
• Vaginal discharge is common.
• Pseudomenses is possible due to maternal hormones
Ambiguous genitalia
Note first void
Newborn Assessment
Musculoskeletal
• Clavicles – Feel for fractures
• Positional Feet
• Also assessing creases on soles for gestational age assessment
Musculoskletal – Spine
• Turn infant over onto your forearm & look at entire spine
• Feel vertebral column for defects
Neurological
• Look carefully and evaluate neurological status during
exam of other systems
• Symmetry of motion, tone, response to stimuli, pitch
of cry, repetitive motions, palsies
Reflexes:
• Moro - startle
• Grasp – palmar, plantar
• Suck
• Rooting
Newborn Assessment
Skin
• Look at entire skin throughout the exam
• Jaundice
• Mongolian spots
• Rashes
• Milia
• Cradle Cap
• Stork bites - telangiectatic nevus
Hypoglycemia:
• Often seen in Large for gestational age (LGA) and macrosomic
babies
• Can result from the effort the newborn needs to expend to establish
respirations
• Energy expended to regulate heat
• Babies of GDM moms – rebound hypoglycemia
• Babies are prone to hypoglycemia; need to be assessed carefully
Hyperglycemia
• Often do not see in the newborn
• Could be due to infection in the newborn
• Often have no symptoms; can produce large urine output and become
dehydrated
Hypothermia
Treatments of Jaundice
• Mild Jaundice - Keep baby warm, feed baby
• Moderate Jaundice - As above, plus more frequent checking of
bilirubin levels, may use phototherapy
• Severe Jaundice - As above, plus phototherapy,IV fluids and
possibly exchange transfusion
Hyperbilirubinemia-Jaundice
PHOTOTHERAPY
• Protect eyes
• Check temperature
• Encourage more fluids(breast milk/formula)
• Monitor bilirubin levels
• Monitor intake and output
• Observe neurodevelopmental